Are the common reference intervals truly common? Case studies on stratifying biochemical reference data by countries using two partitioning methods

Scandinavian Journal of Clinical and Laboratory Investigation
Ari Lahti

Abstract

The Harris-Boyd method, recommended for partitioning biochemical reference data into subgroups by the NCCLS, and a recently proposed new method for partitioning were compared in three case studies concerning stratification by countries (Denmark, Finland, Norway, and Sweden) of reference data collected in the Nordic Reference Interval Project (NORIP) for the enzymes alkaline phosphatase (ALP), creatine kinase (CK), and gamma-glutamyl transpeptidase (GGT). The new method is based on direct estimation of the proportions of two subgroups outside the reference limits of the combined distribution, while the Harris-Boyd method uses easy-to-calculate test parameters as correlates for these proportions. The decisions on partitioning suggested by the Harris-Boyd method deviated from those obtained by using the new method for each of the three enzymes when considering pair-wise partitioning tests. The reasons for the poor performance, as it seems to be, of the Harris-Boyd method were discussed. Stratification of reference data into more than two subgroups was considered as both a theoretical problem and a practical one, using the four country-specific distributions for each enzyme as illustration. Neither the Harris-Boyd method nor the ne...Continue Reading

References

Mar 11, 2004·Clinical Chemistry·Ari LahtiHelge Erik Solberg

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Citations

Sep 29, 2007·Clinical Chemistry and Laboratory Medicine : CCLM·Martin Gellerstedt, Per Hyltoft Petersen
Nov 11, 2010·Clinical Chemistry and Laboratory Medicine : CCLM·Kiyoshi IchiharaUNKNOWN IFCC Committee on Reference Intervals and Decision Limits (C-RIDL)
Jan 16, 2010·Scandinavian Journal of Clinical and Laboratory Investigation·Päivikki AlataloOnni Niemelä
Apr 30, 2009·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Emanuel K Manesis
Oct 24, 2006·Tropical Medicine & International Health : TM & IH·Llorenç QuintóPedro L Alonso
Jun 30, 2004·Scandinavian Journal of Clinical and Laboratory Investigation·P RustadA Uldall
May 17, 2018·Scandinavian Journal of Clinical and Laboratory Investigation·Mustafa K Özçürümez, Rainer Haeckel
Jun 30, 2004·Scandinavian Journal of Clinical and Laboratory Investigation·P RustadP Hyltoft Petersen
May 1, 2012·Journal of Environmental Science and Health. Part A, Toxic/hazardous Substances & Environmental Engineering·Frantisek NistiarEva Sedlakova
Dec 18, 2010·Clinical Chemistry·Brian H ShirtsBrian R Jackson
Dec 20, 2007·Clinical Chemistry·Kiyoshi IchiharaUNKNOWN Science Committee for the Asian-Pacific Federation of Clinical Biochemistry
Jan 29, 2008·Clinical Chemistry·James C Boyd
Aug 26, 2004·Clinical Chemistry and Laboratory Medicine : CCLM·Ari Lahti
Dec 10, 2019·European Journal of Pediatrics·Anne Bryde Alnor, Pernille Just Vinholt
Nov 20, 2020·American Journal of Clinical Pathology·Dustin R BunchJoe M El-Khoury

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