Performance Comparison of CGM Systems: MARD Values Are Not Always a Reliable Indicator of CGM System Accuracy

Journal of Diabetes Science and Technology
Harald KirchsteigerLuigi Del Re

Abstract

The ongoing progress of continuous glucose monitoring (CGM) systems results in an increasing interest in comparing their performance, in particular in terms of accuracy, that is, matching CGM readings with reference values measured at the same time. Most often accuracy is evaluated by the mean absolute relative difference (MARD). It is frequently overseen that MARD does not only reflect accuracy, but also the study protocol and evaluation procedure, making a cross-study comparison problematic. We evaluate the effect of several factors on the MARD statistical properties: number of paired reference and CGM values, distribution of the paired values, accuracy of the reference measurement device itself and the time delay between data pairs. All analysis is done using clinical data from 12 patients wearing 6 sensors each. We have found that a few paired points can have a potentially high impact on MARD. Leaving out those points for evaluation thus reduces the MARD. Similarly, accuracy of the reference measurements greatly affects the MARD as numerical and graphical data show. Results also show that a log-normal distribution of the paired references provides a significantly different MARD than, for example, a uniform distribution. MAR...Continue Reading

References

Mar 15, 2008·Diabetes Care·Boris KovatchevWilliam Clarke
Feb 27, 2009·Diabetes Technology & Therapeutics·Satish K GargPeter A Gottlieb
Oct 16, 2012·Journal of Diabetes Science and Technology·Yoeri M LuijfUNKNOWN AP@home consortium
Dec 22, 2012·Diabetes Technology & Therapeutics·Lalantha LeelarathnaRoman Hovorka
Jan 1, 2013·Diabetes Care·Edward R DamianoSteven J Russell
May 9, 2013·Diabetes Technology & Therapeutics·Yoeri M LuijfUNKNOWN AP@home consortium
Aug 6, 2013·Journal of Diabetes Science and Technology·Günther Schmelzeisen-RedekerMichael Schoemaker
Aug 6, 2013·Journal of Diabetes Science and Technology·Eva ZschornackGuido Freckmann
Aug 6, 2013·Journal of Diabetes Science and Technology·Guido FreckmannCornelia Haug
Apr 25, 2014·Diabetes Technology & Therapeutics·Timothy S BaileyScott W Lee
May 31, 2014·Journal of Diabetes Science and Technology·Edward R DamianoSteven J Russell
Jul 20, 2014·Journal of Diabetes Science and Technology·David Rodbard

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Citations

May 26, 2017·Diabetes Technology & Therapeutics·Timothy S Bailey
Jul 14, 2018·Journal of Diabetes Science and Technology·Katharina FritzenOliver Schnell
Dec 19, 2019·Journal of Diabetes Science and Technology·Manuela LinkGuido Freckmann
Jun 21, 2019·Journal of Diabetes Science and Technology·Lutz HeinemannLuigi Del Re
Aug 28, 2016·Journal of Diabetes Science and Technology·Florian ReitererLuigi Del Re
Oct 24, 2018·European Endocrinology·Lutz HeinemannLutz Heinemann
Aug 14, 2018·Diabetology & Metabolic Syndrome·Keiko KoideYoshihito Atsumi
Nov 21, 2018·Journal of Diabetes Science and Technology·Guido FreckmannBrian Levy
Apr 8, 2020·Frontiers in Endocrinology·Brynn E Marks, Joseph I Wolfsdorf
Feb 8, 2019·Journal of Diabetes Science and Technology·Guido FreckmannRaimund Weitgasser
Oct 6, 2020·Biomedical Optics Express·Ine L JernelvAstrid Aksnes
Dec 29, 2020·Clinica Chimica Acta; International Journal of Clinical Chemistry·Guido FreckmannRobbert J Slingerland
Feb 23, 2021·Journal of Diabetes Science and Technology·Stefan PleusGuido Freckmann

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