I found this quote:

Unpaired Bland-Altman plots were used to check systematic or bias errors in the SPECT myocardial uptake coefficients with respect to the reference standard PET data.

in the following paper:

ALHASSEN, Fares, et al. Myocardial blood flow measurement with a conventional dual-head SPECT/CT with spatiotemporal iterative reconstructions-a clinical feasibility study. American journal of nuclear medicine and molecular imaging, 2014, 4.1: 53.

My knowledge of "Bland-Altman plot" is the following:

I have $n$ distinct objects and two instruments, A and B; the instruments measure a property $w$ of the objects.

$\mathbf{w}_A\in{\mathbb{R}}^n$, $\mathbf{w}_A=[w_{1A},w_{2A},\ldots,w_{nA}]$ and $w_{iA}$ is the measurement of the $i$-th object made with instrument A.

$\mathbf{w}_B\in{\mathbb{R}}^n$, $\mathbf{w}_B=[w_{1B},w_{2B},\ldots,w_{nB}]$ and $w_{iB}$ is the measurement of the $i$-th object made with instrument B.

The plot is made by the $n$ points $p_i(x_i,y_i)$ where

$\mathbf{x}\in{\mathbb{R}}^n$, $\mathbf{x}=\frac{\mathbf{w}_A+\mathbf{w}_B}{2}=[x_1,x_2,\ldots,x_n]$

$\mathbf{y}\in{\mathbb{R}}^n$, $\mathbf{y}=\mathbf{w}_A-\mathbf{w}_B=[y_1,y_2,\ldots,y_n]$

So, what is an "Unpaired Bland-Altman plot" and how it's made?

  • $\begingroup$ @Penguin_Knight Thank you. If you convert your comment to an answer I will be glad to accept it. $\endgroup$ Commented Feb 26, 2014 at 17:14
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    $\begingroup$ Note that Bland-Altman is a widely accepted name within medical statistics (biostatistics), but not necessarily outside. The name is fitting in so far as Martin Bland and Douglas Altman wrote several very widely read expositions of method comparison, stressing this plot as one of the things to use. But plotting difference versus mean is a much older idea, being used by Tukey from the early 1960s if not earlier and by Neyman in the 1950s, and quite likely much earlier. $\endgroup$
    – Nick Cox
    Commented Feb 27, 2014 at 16:29
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    $\begingroup$ I sent this to Martin Bland, who said (as @NickCox already has) "I tried to comment [but failed], just to say that we never claimed priority for plotting difference versus mean and that adding the limits of agreement was our contribution." $\endgroup$ Commented Feb 27, 2014 at 18:15
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    $\begingroup$ That's entirely consistent with my comment, I think. $\endgroup$
    – Nick Cox
    Commented Feb 27, 2014 at 18:24

1 Answer 1


I have never heard of this name.

In fact, the plot looks just like any Bland Altman plot I have seen, other than there are two sets of data overlaid on the plot. I guess the "unpaired" indicates that you cannot tell which MLEM and ST-MLEM data are coming from the same patient, because there is no linkage between the blue and the pink data points on the plot.


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