Closing the gaps in pediatric reference intervals: An Update on the CALIPER Project

Abstract BACKGROUND Pediatric healthcare is critically dependent on the availability of accurate and precise laboratory biomarkers of pediatric disease, and on the availability of reference intervals to allow appropriate clinical interpretation. The development and growth of children profoundly influence normal circulating concentrations of biochemical markers and thus the respective reference intervals. There are currently substantial gaps in our knowledge of the influences of age, sex, and ethnicity on reference intervals. We report a comprehensive covariate-stratified reference interval database established from a healthy, nonhospitalized, and multiethnic pediatric population. METHODS Healthy children and adolescents (n = 2188, newborn to 18 years of age) were recruited from a multiethnic population with informed parental consent and were assessed from completed questionnaires and according to defined exclusion criteria. Whole-blood samples were collected for establishing age- and sex-stratified reference intervals for 40 serum biochemical markers (serum chemistry, enzymes, lipids, proteins) on the Abbott ARCHITECT c8000 analyzer. RESULTS Reference intervals were generated according to CLSI C28-A3 statistical guidelines. Caucasians, East Asians, and South Asian participants were evaluated with respect to the influence of ethnicity, and statistically significant differences were observed for 7 specific biomarkers. CONCLUSIONS The establishment of a new comprehensive database of pediatric reference intervals is part of the Canadian Laboratory Initiative in Pediatric Reference Intervals (CALIPER). It should assist laboratorians and pediatricians in interpreting test results more accurately and thereby lead to improved diagnosis of childhood diseases and reduced patient risk. The database will also be of global benefit once reference intervals are validated in transference studies with other analytical platforms and local populations, as recommended by the CLSI.

Download Full-text

Pediatric reference value distributions and covariate-stratified reference intervals for 29 endocrine and special chemistry biomarkers on the Beckman Coulter Immunoassay Systems: a CALIPER study of healthy community children

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2015-0558 ◽

2016 ◽

Vol 54 (4) ◽

Cited By ~ 9

Author(s):

Kimiya Karbasy ◽

Danny C.C. Lin ◽

Alexandra Stoianov ◽

Man Khun Chan ◽

Victoria Bevilacqua ◽

...

Keyword(s):

Pediatric Population ◽

Reference Value ◽

Reference Interval ◽

Reference Intervals ◽

Healthy Children ◽

Serum Samples ◽

Laboratory Assessment ◽

Research Initiative ◽

Closing The Gaps ◽

Gender Based

AbstractThe CALIPER program is a national research initiative aimed at closing the gaps in pediatric reference intervals. CALIPER previously reported reference intervals for endocrine and special chemistry markers on Abbott immunoassays. We now report new pediatric reference intervals for immunoassays on the Beckman Coulter Immunoassay Systems and assess platform-specific differences in reference values.A total of 711 healthy children and adolescents from birth to <19 years of age were recruited from the community. Serum samples were collected for measurement of 29 biomarkers on the Beckman Coulter Immunoassay Systems. Statistically relevant age and/or gender-based partitions were determined, outliers removed, and reference intervals calculated in accordance with Clinical and Laboratory Standards Institute (CLSI) EP28-A3c guidelines.Complex profiles were observed for all 29 analytes, necessitating unique age and/or sex-specific partitions. Overall, changes in analyte concentrations observed over the course of development were similar to trends previously reported, and are consistent with biochemical and physiological changes that occur during childhood. Marked differences were observed for some assays including progesterone, luteinizing hormone and follicle-stimulating hormone where reference intervals were higher than those reported on Abbott immunoassays and parathyroid hormone where intervals were lower.This study highlights the importance of determining reference intervals specific for each analytical platform. The CALIPER Pediatric Reference Interval database will enable accurate diagnosis and laboratory assessment of children monitored by Beckman Coulter Immunoassay Systems in health care institutions worldwide. These reference intervals must however be validated by individual labs for the local pediatric population as recommended by CLSI.

Download Full-text

Echocardiography in Saanen-goats: Normal findings, reference intervals in awake goats, and the effect of general anesthesia

Schweizer Archiv für Tierheilkunde ◽

10.1024/0036-7281/a000273 ◽

2011 ◽

Vol 153 (12) ◽

pp. 553-564 ◽

Cited By ~ 8

Author(s):

K. Steininger ◽

A.-S. J. Berli ◽

R. Jud ◽

C. C. Schwarzwald

Keyword(s):

General Anesthesia ◽

Reference Intervals

Download Full-text

Adrenal vein catecholamine levels and ratios: reference intervals derived from patients with primary aldosteronism

Endocrine Abstracts ◽

10.1530/endoabs.38.oc2.2 ◽

2015 ◽

Author(s):

Sam O'Toole ◽

Candy Sze ◽

Kent Tirador ◽

Scott Akker ◽

Matthew Matson ◽

...

Keyword(s):

Primary Aldosteronism ◽

Reference Intervals ◽

Adrenal Vein ◽

Catecholamine Levels

Download Full-text

Reference intervals of gestational sac, yolk sac, embryonic length, embryonic heart rate at 6-10 weeks after in vitro fertilization-embryo transfer

10.26226/morressier.5af300b1738ab10027aa971b ◽

2018 ◽

Author(s):

Yan Ouyang

Keyword(s):

Heart Rate ◽

In Vitro Fertilization ◽

Embryo Transfer ◽

Reference Intervals ◽

Embryonic Heart ◽

Yolk Sac ◽

Vitro Fertilization ◽

Gestational Sac

Download Full-text

The Reference Intervals Used in Pediatric Medical Analysis Laboratories to Interpret the Results Analysis for Total Serum Calcium

Revista de Chimie ◽

10.37358/rc.17.2.5428 ◽

2017 ◽

Vol 68 (2) ◽

pp. 243-245

Author(s):

Elisabeta Antonescu ◽

Maria Totan ◽

Gheorghe Cornel Boitor ◽

Julianna Szakacs ◽

Sinziana Calina Silisteanu ◽

...

Keyword(s):

Serum Calcium ◽

Colorimetric Method ◽

Age Groups ◽

Essential Element ◽

Reference Intervals ◽

Total Serum ◽

Electronic Archive ◽

Total Serum Calcium ◽

Analysis Laboratory ◽

Medical Analysis

Medical analysis laboratory must establish its own reference intervals depending on the facilities they are working with, the working substances and protocols. These reference intervals must be obtained depending on age groups in order to accurately interpret the results of the analyzes performed. The study is a retrospective one using 3217 data from the electronic archive of the S.C. Vladutiu&Garabedian S.R.L. Clinic in Medias. Total serum calcium was determined by the colorimetric method on the Konelab analyzer. Processing of the collected data was done using the Hoffmann method, considering 5% up to 95% of the values in the database, the values being randomly selected. For comparison, data from the literature was used. In children under 1 year old, it was not possible to calculate the reference intervals since data was insufficient. In the other age groups, reference intervals obtained in the current study were similar to the studied literature. Reference intervals established for calcium can provide important guidance for the reasonable supplementation of this essential element in children.

Download Full-text