Notes on Testing Equality in Dichotomous Data with Matched Pairs

In attempting to improve the efficiency of McNemar's test statistic, we develop two test procedures that account for the information on both the discordant and concordant pairs for testing equality between two comparison groups in dichotomous data with matched pairs. Furthermore, we derive a test procedure derived from one of the most commonly-used interval estimators for odds ratio. We compare these procedures with those using McNemar's test, McNemar's test with the continuity correction, and the exact test with respect to type I error and power in a variety of situations. We note that the test procedures using McNemar's test with the continuity correction and the exact test can be quite conservative and hence lose much efficiency, while the test procedure using McNemar's test can actually perform well even when the expected number of discordant pairs is small. We also find that the two test procedures, which incorporate the information on all matched pairs into hypothesis testing, may slightly improve the power of using McNemar's test without essentially losing the precision of type I error. On the other hand, the test procedure derived from an interval estimator of adds ratio with use of the logarithmic transformation may have type I error much larger than the nominal α-level when the expected number of discordant pairs is not large and therefore, is not recommended for general use.