PMID: 16648881May 2, 2006Paper

Making the most of a patient's laboratory data: optimisation of signal-to-noise ratio.

The Clinical Biochemist. Reviews
Per Hyltoft Petersen

Abstract

All results in laboratory medicine are compared to some reference for interpretation. This reference may be a previous result from the same patient, a reference population--either healthy or diseased, or both--or a decision limit recommended by an expert group. The aim for the medical laboratory is to improve the signal-to-noise ratio by increasing the signal or reducing the noise. This presentation deals with the more general tools for reduction of the noise component, and focuses on biological within-subject variation, reference intervals and decision models. Regarding biological within-subject variation, the estimation of reference change value (RCV) as a yardstick for judging measured differences within the patient over time is an important tool. Here, only type 1 errors are usually applied, but type 2 errors should also be taken into consideration. Moreover, variance homogeneity is assumed for the application of RCV, but this assumption is not always fulfilled, and erroneous interpretations may be introduced. A tool for comparison of different and more complicated algorithms applied to serial measurements is computer simulation (e.g. on data from tumour markers). In order to reduce the noise component from reference interv...Continue Reading

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