Reference ranges and normal values

Abstract We used a computer-based method to help validate the reference ranges of assays for triiodothyronine (T3) and thyroxin (T4). A retrospective search of a database of laboratory results for the previous six months identified all patients with apparent euthyroid status, as defined by methods independent of the immunoassay under review. A computer-generated reference group (CGR Group) of 2001 records had a gaussian distribution of T4 values and a reference range (mean +/- 2 SD) of 56-161 nmol/L, compared with the supplier's suggested range for euthyroid subjects (58-148 nmol/L) and an in-house range of 60-144 nmol/L for a group of 97 normal subjects. A similar CGR Group of 1902 records gave a reference range for T3 of 0.7-2.1 nmol/L (manufacturer's range 0.8-2.8; normal subjects 0.8-2.2). An attempt to devise a reference range for thyrotropin failed when we found that its concentration in the population of patients with normal values for thyroid hormones was distributed differently from that in the normal population. The method is intended to be used in addition to conventionally derived ranges based on results for healthy subjects. It allows the laboratory to conveniently verify the reference ranges for T3 and T4 assays at regular intervals by using very large samples with appropriate age, sex, and weight distribution, drawn from the population of patients' samples submitted for analysis.

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Establishing reference ranges and normal values for coagulation screening in healthy Indian male volunteers enrolled for a longitudinal study

Biomedical and Biotechnology Research Journal (BBRJ) ◽

10.4103/bbrj.bbrj_140_18 ◽

2019 ◽

Vol 3 (1) ◽

pp. 22

Author(s):

Prosenjit Ganguli ◽

Rehan Ahmed ◽

Natwar Singh ◽

Surinderpal Singh ◽

UmeshDas Gupta ◽

...

Keyword(s):

Longitudinal Study ◽

Normal Values ◽

Reference Ranges ◽

Male Volunteers ◽

Indian Male

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Clinical evaluation of immunoinhibition determination of creatine kinase B subunits in coronary care.

Clinical Chemistry ◽

10.1093/clinchem/29.2.353 ◽

1983 ◽

Vol 29 (2) ◽

pp. 353-355 ◽

Cited By ~ 1

Author(s):

J Booth ◽

P J McCarthy ◽

R N Walmsley

Keyword(s):

Creatine Kinase ◽

Chest Pain ◽

Normal Values ◽

Clinical Findings ◽

Reference Ranges ◽

B Subunit ◽

Creatine Kinase B ◽

Coronary Care ◽

Total Creatine

Abstract One hundred patients with chest pain of cardiac origin were evaluated on the basis of clinical findings, electrocardiograph results, and total creatine kinase (CK) and creatine kinase B-subunit (CK-B) activity (as determined by immunoinhibition with the Boehringer CK-MB kit) in serum. All patients diagnosed as having had an acute myocardial infarction had increased values for both CK-B and total CK. In no case was normal total CK activity associated with an increased CK-B, nor was normal CK-B associated with an increased total CK. During collection of data for reference ranges, we found 10 patients who had no evidence of cardiac disease but had various other diseases, who exhibited high values for CK-B in serum; four of these had normal values for total CK. We conclude that estimations of CK-B in serum by this method added no more diagnostic information than did data on total CK in the evaluation of chest pain.

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A Method for Deriving Quasi-healthy Cohorts From Clinical Data

Biomedical Informatics Insights ◽

10.1177/1178222618777758 ◽

2018 ◽

Vol 10 ◽

pp. 117822261877775

Author(s):

Satoshi Irino ◽

Yukio Kurihara

Keyword(s):

Laboratory Test ◽

Clinical Data ◽

Laboratory Tests ◽

Normal Values ◽

Specific Reference ◽

Reference Ranges ◽

Healthy Individuals ◽

Clinical Database ◽

Age Dependent ◽

Effective Condition

We evaluated quasi-healthy cohorts (model cohorts), derived from clinical data, to determine how well they simulated control cohorts. Control cohorts comprised individuals extracted from a public checkup database in Japan, under the condition that their values for 3 basic laboratory tests fall within specific reference ranges (3Ts condition). Model cohorts comprised outpatients, extracted from a clinical database at a hospital, under the 3Ts condition or under the condition that their values for 4 laboratory tests fall within specific reference ranges (4Ts condition). Because even a patient with a serious illness, such as cancer, may present with normal values on basic laboratory tests, one additional condition was added: the duration (1 or 3 months; 1M or 3M) during which patients were not hospitalized after their first laboratory test. For evaluations, cohorts were specified by age and sex. The 4Ts + 3M condition was the most effective condition, under which model cohorts were used to successfully simulate age-dependent changes and sex differences in laboratory test values for control cohorts. Therefore, by properly setting the conditions for extracting quasi-healthy individuals, we can derive cohorts from clinical data to simulate various types of cohorts. Although some issues with the proposed method remain to be solved, this approach presents new possibilities for using clinical data for cohort studies.

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Reference ranges and normal values

Dacie and Lewis Practical Haematology ◽

10.1016/b0-44-306660-4/50006-4 ◽

2006 ◽

pp. 11-24 ◽

Cited By ~ 14

Author(s):

S. Mitchell Lewis

Keyword(s):

Normal Values ◽

Reference Ranges

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Reference ranges (“normal values”) for cardiovascular magnetic resonance (CMR) in adults and children: 2020 update

Journal of Cardiovascular Magnetic Resonance ◽

10.1186/s12968-020-00683-3 ◽

2020 ◽

Vol 22 (1) ◽

Author(s):

Nadine Kawel-Boehm ◽

Scott J. Hetzel ◽

Bharath Ambale-Venkatesh ◽

Gabriella Captur ◽

Christopher J. Francois ◽

...

Keyword(s):

Cardiovascular Magnetic Resonance ◽

Deep Learning ◽

Magnetic Resonance ◽

Normal Values ◽

Relaxation Times ◽

Pulmonary Arteries ◽

Reference Ranges ◽

Adults And Children ◽

And Function ◽

Chamber Size

AbstractCardiovascular magnetic resonance (CMR) enables assessment and quantification of morphological and functional parameters of the heart, including chamber size and function, diameters of the aorta and pulmonary arteries, flow and myocardial relaxation times. Knowledge of reference ranges (“normal values”) for quantitative CMR is crucial to interpretation of results and to distinguish normal from disease. Compared to the previous version of this review published in 2015, we present updated and expanded reference values for morphological and functional CMR parameters of the cardiovascular system based on the peer-reviewed literature and current CMR techniques. Further, databases and references for deep learning methods are included.

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Establishing normal values of total testosterone in adult healthy men by the use of four immunometric methods and liquid chromatography-mass spectrometry

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2017-1201 ◽

2018 ◽

Vol 56 (11) ◽

pp. 1936-1944 ◽

Cited By ~ 8

Author(s):

Giacomo Montagna ◽

Samuela Balestra ◽

Federica D’Aurizio ◽

Francesco Romanelli ◽

Cinzia Benagli ◽

...

Keyword(s):

Mass Spectrometry ◽

Liquid Chromatography ◽

Normal Values ◽

Late Onset ◽

The Body ◽

Specific Reference ◽

Total Testosterone ◽

Reference Ranges ◽

Healthy Men ◽

Normal Ranges

Abstract Background: The total testosterone (T) cutoffs clinically adopted to define late-onset hypogonadism (LOH) do not consider the differences that exist between different analytical platforms, nor do they consider the body mass index (BMI) or age of the patient. We aimed at providing method, age and BMI-specific normal values for total T in European healthy men. Methods: A total of 351 eugonadal healthy men were recruited, and total T was measured with four automated immunometric assays (IMAs): ARCHITECT i1000SR (Abbott), UniCel DxI800 (Beckman Coulter), Cobas e601 (Roche), IMMULITE 2000 (Siemens) and liquid chromatography-tandem mass spectrometry (LC-MS/MS). Reference ranges (RRs) were calculated for each method. Results: Passing and Bablok regression analysis and Bland-Altman plot showed an acceptable agreement between Abbott and LC-MS/MS, but a poor one between LC-MS/MS and the other IMAs. Age-specific T concentrations in non-obese (BMI <29.9 kg/m2) men were greater than in all men. The total T normal range, in non-obese men aged 18–39 years, measured with LC-MS/MS was 9.038–41.310 nmol/L. RRs calculated with LC-MS/MS statistically differed from the ones calculated with all individual IMAs, except Abbott and among all IMAs. Statistically significant differences for both upper and lower reference limits between our RRs and the ones provided by the manufacturers were also noticed. Conclusions: We calculated normal ranges in a non-obese cohort of European men, aged 18–39 years, with four commercially available IMAs and LC-MS/MS and found statistically significant differences according to the analytical method used. Method-specific reference values can increase the accuracy of LOH diagnosis and should be standardly used.

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Cardiovascular magnetic resonance (CMR) normal values for pulmonary arteries in healthy children and adolescents

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeaa356.401 ◽

2021 ◽

Vol 22 (Supplement_1) ◽

Author(s):

C Boll ◽

I Voges ◽

A Caliebe ◽

S Gati ◽

F Puricelli ◽

...

Keyword(s):

Cardiovascular Magnetic Resonance ◽

Magnetic Resonance ◽

Children And Adolescents ◽

Normal Values ◽

Pulmonary Arteries ◽

Right Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

Paediatric Population ◽

Reference Ranges ◽

Healthy Children

Abstract Funding Acknowledgements Type of funding sources: None. Background Changes in the right ventricular outflow tract (RVOT) and pulmonary arteries (PAs) are often seen in paediatric patients with congenital heart disease (CHD), pulmonary hypertension or genetic disorders (e.g. Marfan syndrome, Loeys-Dietz syndrome, Williams syndrome, DiGeorge syndrome). Cardiovascular magnetic resonance (CMR) imaging is an excellent method to visualize the RVOT and PAs without the use of ionizing radiation and contrast media but for the interpretation of CMR data in the paediatric population the knowledge of normal values is crucial. However, normal values for pulmonary arteries from contrast-free cine CMR images are lacking. Purpose The aim of this retrospective multicentre study was to establish reference ranges for the diameters of the mean PA (MPA), right PA (RPA) and left PA (LPA). Methods 163 CMR scans of healthy children and adolescents (mean age 13.8 ± 2.9 years; range 5-18 years) from two centres in the UK and Germany were included. The diameter of the MPA was measured in sagittal-oblique RVOT cine images and transaxial cine stacks, whereas the diameter of the RPA and LPA were measured from transaxial stacks and specific pulmonary artery branch cine images. Results Mean systolic and diastolic diameters for the MPA were 22.1 ± 2.8 mm (14.4 ± 2.2 mm/m²)/ 17.2 ± 2.3 mm (11.3 ± 1.9 mm/m²) measured in RVOT cine stacks. Mean systolic and diastolic diameters for the RPA and LPA were: 1) RPA, 12.4 ± 1.7 mm (7,9 ± 1,6 mm/m²)/ 9.8 ± 1.6 mm (5.9 ± 1.8 mm/m²) and 2) LPA, 13.3 ± 1.5 mm (8.3 ± 2.1 mm/m²)/ 10.8 ± 1.5 mm (6.8 ± 1.8 mm/m²). Separate centile charts for boys and girls for the MPA were created. Conclusions We established CMR normal values for the MPA, RPA and LPA for children and adolescents. Our data might be useful for the detection of PA stenosis and dilatation and may serve as a reference in future studies.

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Variations in haematological and biochemical parameters in healthy ponies

10.21203/rs.3.rs-36935/v1 ◽

2020 ◽

Author(s):

Witkowska-Piłaszewicz Olga ◽

Anna Cywinska ◽

Michlik-Połczyńska Katarzyna ◽

Czopowicz Michal ◽

Strzelec Katarzyna ◽

...

Keyword(s):

Creatine Kinase ◽

Blood Lactate ◽

Aspartate Aminotransferase ◽

Normal Values ◽

Lactate Concentration ◽

Blood Lactate Concentration ◽

Blood Parameters ◽

Specific Reference ◽

Reference Ranges ◽

Class A

Abstract Background Breed specific reference ranges for selected blood parameters are recommended for proper interpretation of blood tests, but there are only few reports dealing with ponies. The purpose of this study was to investigate if blood parameters differ among ponies’ classes and to check if general normal values for equine species are applicable to ponies. Results All, except total protein concentration, biochemical parameter significantly (p < 0.05) differed among ponies’ classes. The most pronounced difference was noted in blood lactate concentrations, higher (p < 0.001) in the smallest ponies (class A). In all groups of ponies muscle enzymes (aspartate aminotransferase and creatine kinase) and urea were high when compared to normal values for equine species, but triglycerides and creatinine were low. Blood lactate concentration was high in comparison with normal values for horses only in class A ponies’. Conclusions In healthy ponies, blood lactate concentration significantly differs between height classes. Normal values for equine species should not be directly applied to interpret the lactate, triglycerides, aspartate aminotransferase and creatine kinase values in ponies.

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Age- and sex-based normal values of layer-specific longitudinal and circumferential strain by speckle tracking echocardiography: the Copenhagen City Heart Study

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeab032 ◽

2021 ◽

Author(s):

Kristoffer Grundtvig Skaarup ◽

Mats Christian Højbjerg Lassen ◽

Niklas Dyrby Johansen ◽

Flemming Javier Olsen ◽

Jannie Nørgaard Lind ◽

...

Keyword(s):

Speckle Tracking ◽

Circumferential Strain ◽

Speckle Tracking Echocardiography ◽

Normal Values ◽

Reference Ranges ◽

Mean Values ◽

Heart Study ◽

Males And Females ◽

Copenhagen City Heart Study ◽

Age And Sex

Abstract Aims Technical advancements in 2D-speckle tracking echocardiography (2DSTE) have allowed for quantification of layer-specific global longitudinal strain (GLS) and circumferential strain (GCS) of the left ventricle (LV). The aim of this study was to establish age- and sex-based reference ranges of peak systolic layer-specific GLS and GCS and to assess normal values of regional strain. Methods and results We performed 2DSTE analysis of 1997 members of the general population from the fifth round of the Copenhagen City Heart Study, who were free of cardiovascular disease and risk factors. The mean age was 46 ± 16 years (range 21–97) and 62% were female. Mean values for peak systolic whole wall GLS (GLSWW.Sys), endomycardial (GLSEndo.Sys), and epimyocardial (GLSEpi.Sys) were 19.9 ± 2.1% (prediction interval [PI]: 15.8–24.0%), 23.5 ± 2.5% (PI: 18.6–28.4%), and 17.3 ± 1.9% (PI: 13.6–21.1%), respectively. Mean peak systolic whole wall GCS (GCSWW.Sys), was 21.6 ± 3.7% (PI: 14.3–28.9%), endomyocardial (GCSEndo.Sys) was 31.9 ± 4.7% (PI: 22.7–41.1%), and epimyocardial (GCSEpi.Sys) was 14.3 ± 3.8% (PI: 6.8–21.8%). A significant discrepancy in normal strain values between males and females was observed. Men had lower mean values and lower reference limits for all strain parameters. Furthermore, GLS and GCS changed differently with age in males and females. Finally, regional LS decreased from the apical to the basal LV region in both sexes, and regional CS varied significantly by LV segment. Conclusion In this study, we reported age- and sex-based reference ranges of layer-specific GLS and GCS. These reference ranges varied significantly with sex and age.

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