Passing–Bablok regression is a method from robust statistics for nonparametric regression analysis suitable for method comparison studies introduced by Wolfgang Bablok and Heinrich Passing in 1983. The procedure is adapted to fit linear errors-in-variables models. It is symmetrical and is robust in the presence of one or few outliers. The Passing-Bablok procedure fits the parameters a {\displaystyle a} and b {\displaystyle b} of the linear equation y = a + b ∗ x {\displaystyle y=a+b*x} using non-parametric methods. The coefficient b {\displaystyle b} is calculated by taking the shifted median of all slopes of the straight lines between any two points, disregarding lines for which the points are identical or b = − 1 {\displaystyle b=-1} . The median is shifted based on the number of slopes where b < − 1 {\displaystyle b<-1} to create an approximately consistent estimator. The estimator is therefore close in spirit to the Theil-Sen estimator. The parameter a {\displaystyle a} is calculated by a = median ( y i − b x i ) {\displaystyle a=\operatorname {median} ({y_{i}-bx_{i})}} . In 1986, Passing and Bablok extended their method introducing an equivariant extension for method transformation which also works when the slope b {\displaystyle b} is far from 1. It may be considered a robust version of reduced major axis regression. The slope estimator b {\displaystyle b} is the median of the absolute values of all pairwise slopes. The original algorithm is rather slow for larger data sets as its computational complexity is O ( n 2 ) {\displaystyle O(n^{2})} . However, fast quasilinear algorithms of complexity O ( n {\displaystyle O(n} ln n ) {\displaystyle n)} have been devised. Passing and Bablok define a method for calculating a 95% confidence interval (CI) for both a {\displaystyle a} and b {\displaystyle b} in their original paper, which was later refined, though bootstrapping the parameters is the preferred method for in vitro diagnostics (IVD) when using patient samples. The Passing-Bablok procedure is valid only when a linear relationship exists between x {\displaystyle x} and y {\displaystyle y} , which can be assessed by a CUSUM test. Further assumptions include the error ratio to be proportional to the slope b {\displaystyle b} and the similarity of the error distributions of the x {\displaystyle x} and y {\displaystyle y} distributions. The results are interpreted as follows. If 0 is in the CI of a {\displaystyle a} , and 1 is in the CI of b {\displaystyle b} , the two methods are comparable within the investigated concentration range. If 0 is not in the CI of a {\displaystyle a} there is a systematic difference and if 1 is not in the CI of b {\displaystyle b} then there is a proportional difference between the two methods. However, the use of Passing–Bablok regression in method comparison studies has been criticized because it ignores random differences between methods.
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