A new confidence interval for the difference between two binomial proportions of paired data

Motivated by a study on comparing sensitivities and specificities of two diagnostic tests in a paired design when the sample size is small, we first derived an Edgeworth expansion for the studentized difference between two binomial proportions of paired data. The Edgeworth expansion can help us understand why the usual Wald interval for the difference has poor coverage performance in the small sample size. Based on the Edgeworth expansion, we then derived a transformation based confidence interval for the difference. The new interval removes the skewness in the Edgeworth expansion; the new interval is easy to compute, and its coverage probability converges to the nominal level at a rate of O(n(-1/2)). Numerical results indicate that the new interval has the average coverage probability that is very close to the nominal level on average even for sample sizes as small as 10. Numerical results also indicate this new interval has better average coverage accuracy than the best existing intervals in finite sample sizes. (C) 2003 Elsevier B.V. All rights reserved.