Reference Intervals: Comparison of Calculation Methods and Evaluation of Procedures for Merging Reference Measurements From Two US Medical Centers

American Journal of Clinical Pathology
George KleeChristina M Wood-Wentz

Abstract

To analyze consistency of reference limits and widths of reference intervals (RIs) calculated by six procedures and evaluate a protocol for merging intrainstitutional reference data. The differences between reference limits were compared with "optimal" bias goals. Also, widths of the RIs were compared. RIs were calculated using Mayo-SAS quantile, EP Evaluator, and four International Federation of Clinical Chemistry and Laboratory Medicine methods: parametric and nonparametric (NP) with and without latent abnormal values exclusion (LAVE). Regression parameters from cotested samples were evaluated for harmonizing intrainstitutional reference data. Mayo-SAS quintile, LAVE(-)NP, and EP Evaluator generated similar RIs, but these RIs often were wider than RIs from parametric procedures. LAVE procedures generated narrower RIs for nutritional and inflammatory markers. Transformation with regression parameters did not ensure homogeneity of merged data. Parametric methods are recommended when inappropriate values cannot be excluded. The nonparametric procedures may generate wider RIs. Data sets larger than 200 are recommended for robust estimates. Caution should be exercised when merging intrainstitutional data.

References

Nov 11, 2010·Clinical Chemistry and Laboratory Medicine : CCLM·Kiyoshi IchiharaUNKNOWN IFCC Committee on Reference Intervals and Decision Limits (C-RIDL)
May 2, 2013·Clinical Chemistry and Laboratory Medicine : CCLM·Kiyoshi IchiharaUNKNOWN Committee on Reference Intervals and Decision Limits, International Federation for Clinical Chemistry and Laboratory Medicin
May 2, 2013·Clinical Chemistry and Laboratory Medicine : CCLM·Yesim OzardaUNKNOWN Committee on Reference Intervals and Decision Limits (C-RIDL), International Federation for Clinical Chemistry and Laborator
Feb 13, 2014·Clinica Chimica Acta; International Journal of Clinical Chemistry·Kiyoshi Ichihara
Sep 27, 2016·Clinica Chimica Acta; International Journal of Clinical Chemistry·Kiyoshi IchiharaUNKNOWN Committee on Reference Intervals and Decision Limits, International Federation of Clinical Chemistry and Laboratory Medicine
Sep 27, 2016·Clinica Chimica Acta; International Journal of Clinical Chemistry·Kiyoshi IchiharaUNKNOWN Committee on Reference Intervals and Decision Limits, International Federation of Clinical Chemistry and Laboratory Medicine

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Citations

Mar 12, 2020·Clinical Chemistry and Laboratory Medicine : CCLM·Anwar BoraiMohammed Almohammadi
Sep 4, 2020·International Journal of Laboratory Hematology·Abigail S A BawuaJulius Fobil
Jun 4, 2021·Clinica Chimica Acta; International Journal of Clinical Chemistry·Yesim OzardaUNKNOWN IFCC Committee on Reference Intervals and Decision Limits (C-RIDL)

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