scholarly journals Age- and sex-specific pediatric LMS-Percentiles for Laboratory Parameters enabled by Data mining

2022 ◽  
Author(s):  
Thomas Hundhausen ◽  
Andre Madsen
Keyword(s):  
Laboratory Data ◽  
Reference Intervals ◽  
Reference Ranges ◽  
Test Results ◽  
Laboratory Parameters ◽  
Reference Framework ◽  
Percentile Curves ◽  
Age Dependent ◽  
Regional Population ◽  
Primary Health Care Physicians

Abstract Background:Various laboratory parameters routinely measured in pediatric practice covariate with sex and age. Conventional reference intervals are not suitable to account for this variation. Here we demonstrate construction of continuous LMS percentile curves from routine laboratory data. This allows adequate adjustment for both sex- and age-dependent covariation in childhood.Material and Methods:Anonymized routine blood test results requested by primary health care physicians were collected, outliers excluded and LMS-models generated in R.Results:Percentiles for several biomarkers derived from a regional population were established in the 'LMS' framework and provided here for comparison with etablished reference ranges, discussion and, potentially, clinical use.Conclusion: The reference framework 'LMS' is well-known from pediatric growth charts and can also be used in laboratory medicine.

Blood sampling frequency as a proxy for comorbidity indices when identifying patient samples for review of reference intervals

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Simon Lykkeboe ◽  
Stine Linding Andersen ◽  
Claus Gyrup Nielsen ◽  
Peter Vestergaard ◽  
Peter Astrup Christensen
Keyword(s):  
Laboratory Data ◽  
Low Frequency ◽  
Reference Interval ◽  
Reference Intervals ◽  
Sampling Frequency ◽  
Blood Sampling ◽  
Test Results ◽  
Healthy Individuals ◽  
Simple Method ◽  
Blood Samples

Abstract Objectives Indirect data mining methods have been proposed for review of published reference intervals (RIs), but methods for identifying patients with a low likelihood of disease are needed. Many indirect methods extract test results on patients with a low frequency blood sampling history to identify putative healthy individuals. Although it is implied there has been no attempt to validate if patients with a low frequency blood sampling history are healthy and if test results from these patients are suitable for RI review. Methods Danish nationwide health registers were linked with a blood sample database, recording a population of 316,337 adults over a ten-year period. Comorbidity indexes were defined from registrations of hospital diagnoses and redeemed prescriptions of drugs. Test results from patients identified as having a low disease burden were used for review of RIs from the Nordic Reference Interval Project (NORIP). Results Blood sampling frequency correlated with comorbidity Indexes and the proportion of patients without disease conditions were enriched among patients with a low number of blood samples. RIs based on test results from patients with only 1–3 blood samples per decade were for many analytes identical compared to NORIP RIs. Some analytes showed expected incongruences and gave conclusive insights into how well RIs from a more than 10 years old multi-center study (NORIP) performed on current pre-analytical and analytical methods. Conclusions Blood sampling frequency enhance the selection of healthy individuals for reviewing reference intervals, providing a simple method solely based on laboratory data without the addition of clinical information.

Mining the Age-Dependent Reference Intervals of B Vitamins from Routine Laboratory Test Results

2018 ◽  
Vol 50 (1) ◽  
pp. 54-63 ◽  
Author(s):  
Osman Evliyaoglu ◽  
Josef van Helden ◽  
Matthias Imöhl ◽  
Ralf Weiskirchen
Keyword(s):  
Laboratory Test ◽  
Reference Intervals ◽  
B Vitamins ◽  
Routine Laboratory ◽  
Test Results ◽  
Routine Laboratory Test ◽  
Laboratory Test Results ◽  
Age Dependent

Recognizing Laboratory Medicine's Collaborative Role in Identifying and Eliminating Health Disparities

2020 ◽  
Author(s):  
Sarah E Wheeler ◽  
Joanne H Hasskamp ◽  
Octavia M Peck Palmer
Keyword(s):  
Health Disparities ◽  
Ethnic Diversity ◽  
Clinical Laboratory ◽  
Laboratory Data ◽  
Healthcare Providers ◽  
Laboratory Medicine ◽  
Reference Intervals ◽  
Reference Ranges ◽  
Data Generation ◽  
Unconscious Bias

Abstract Background A health disparity is a health outcome that presents in a lesser or greater extent between populations. Health disparities in diseases are products of complex interactions between social, economic, and to a lesser extent, biological factors and can be mediated by structural racism and discriminatory policies. The objective of this review is to understand how both laboratorians and nonlaboratorians think about the relationship between laboratory medicine and health disparities and to highlight ways in which laboratory medicine can play a role in eliminating health disparities. Content We developed an electronic survey from which we selected the top responses reported by the 215 participants to frame a discussion around why laboratorians perceive health disparities exists, and how they can reduce health disparities Summary We found that both laboratorians and nonlaboratorians feel that laboratory medicine can and should play a role in reducing health disparities using many tools already in use in the clinical laboratory. The skills of laboratory workers in data generation, the establishment of reference ranges, control over the presentation of laboratory results, generation of test menus, and the development of novel diagnostics may impact health disparities. Laboratorians' responses in our survey indicated that they felt that they could reduce health disparities by using laboratory data to proactively track in cooperation with healthcare providers individuals with chronic conditions to prevent acute events, ensuring gender and ethnic diversity in new clinical trials, including appropriate curriculum in laboratory medicine training, using equations and reference intervals based on physiological differences and participating in unconscious bias training.

Determination of Age Dependent Reference Ranges for PT and aPTT

2019 ◽  
Author(s):  
S. Bursasiu ◽  
G. Samasca ◽  
C. Aldea ◽  
I.A. Esztergár ◽  
L. Wagner
Keyword(s):  
Reference Ranges ◽  
Age Dependent

scholarly journals Effect of 1 mg/kg oral prednisolone on biochemical analytes in ten dogs: a cross-over study

2021 ◽  
Author(s):  
Helena Pettersson ◽  
Carl Ekstrand ◽  
Anna Hillström ◽  
Inger Lilliehöök
Keyword(s):  
Clinical Relevance ◽  
Control Period ◽  
Iron Concentration ◽  
Oral Prednisolone ◽  
Reference Intervals ◽  
Specific Reference ◽  
Test Results ◽  
Prednisolone Treatment ◽  
Anti Inflammatory ◽  
And Control

AbstractPrednisolone is used for treatment of inflammatory, allergic, neoplastic, and immune-mediated diseases in dogs. As a glucocorticoid, prednisolone has biochemical effects, which may interfere with the interpretation of biochemistry test results. The aim of this study is to investigate the effects of prednisolone treatment in an anti-inflammatory dose on common biochemical analytes in dogs and to evaluate the clinical relevance of the changes. Ten beagle dogs, enrolled in a cross-over study, were treated with oral prednisolone (1 mg/kg 24 h) for 10 days. Blood samples were collected at day 0, 1, 3, 6, 9, 10, 12, 16, and 20. Data was analyzed using a general linear model with time and treatment as fixed factors. Pairwise comparisons were done between prednisolone and control period for each dog and sampling. Significant results were further evaluated for clinical relevance using laboratory-specific reference intervals and reference change values (RCVs), when available. Statistically significant changes were observed for ALP activity and iron concentration, which increased to levels exceeding the RCV, and several results were outside reference intervals. Phosphate and bile acids increased significantly, while amylase, lipase, and cholesterol decreased significantly, but with mean/median results remaining within reference intervals. Anti-inflammatory prednisolone treatment did not induce significant changes in ALT, GLDH, GGT, cPLI, glucose, or calcium. Treatment with an anti-inflammatory dose of prednisolone induced changes in several analytes. Only the increases in ALP and iron were of such magnitude that they are expected to affect the clinical interpretation of test results.

scholarly journals Data standardization implementation and applications within and among diagnostic laboratories: integrating and monitoring enteric coronaviruses

2021 ◽  
pp. 104063872110021
Author(s):  
Giovani Trevisan ◽  
Leticia C. M. Linhares ◽  
Kent J. Schwartz ◽  
Eric R. Burrough ◽  
Edison de S. Magalhães ◽  
...  
Keyword(s):  
Seasonal Pattern ◽  
Laboratory Data ◽  
Information Management System ◽  
Transmissible Gastroenteritis Virus ◽  
Test Results ◽  
Diarrhea Virus ◽  
Oral Fluids ◽  
Transmissible Gastroenteritis ◽  
Technology Processes ◽  
Laboratory Information Management

Every day, thousands of samples from diverse populations of animals are submitted to veterinary diagnostic laboratories (VDLs) for testing. Each VDL has its own laboratory information management system (LIMS), with processes and procedures to capture submission information, perform laboratory tests, define the boundaries of test results (i.e., positive or negative), and report results, in addition to internal business and accounting applications. Enormous quantities of data are accumulated and stored within VDL LIMSs. There is a need for platforms that allow VDLs to exchange and share portions of laboratory data using standardized, reliable, and sustainable information technology processes. Here we report concepts and applications for standardization and aggregation of data from swine submissions to multiple VDLs to detect and monitor porcine enteric coronaviruses by RT-PCR. Oral fluids, feces, and fecal swabs were the specimens submitted most frequently for enteric coronavirus testing. Statistical algorithms were used successfully to scan and monitor the overall and state-specific percentage of positive submissions. Major findings revealed a consistently recurrent seasonal pattern, with the highest percentage of positive submissions detected during December–February for porcine epidemic diarrhea virus, porcine deltacoronavirus, and transmissible gastroenteritis virus (TGEV). After 2014, very few submissions tested positive for TGEV. Monitoring VDL data proactively has the potential to signal and alert stakeholders early of significant changes from expected detection. We demonstrate the importance of, and applications for, data organized and aggregated by using LOINC and SNOMED CTs, as well as the use of customized messaging to allow inter-VDL exchange of information.

Reference intervals of spinal mobility measures in normal individuals: the mobility study

2014 ◽  
Vol 74 (6) ◽  
pp. 1218-1224 ◽  
Author(s):  
Sofia Ramiro ◽  
Astrid van Tubergen ◽  
Carmen Stolwijk ◽  
Désirée van der Heijde ◽  
Patrick Royston ◽  
...  
Keyword(s):  
Axial Spondyloarthritis ◽  
Cross Sectional Study ◽  
Reference Intervals ◽  
Spinal Mobility ◽  
Cross Sectional ◽  
Percentile Curves ◽  
Normal Individuals ◽  
And Gender ◽  
Gender Specific ◽  
Spinal Flexion

ObjectivesTo establish reference intervals (RIs) for spinal mobility measures as recommended for patients with axial spondyloarthritis, and to determine the effect of age, height and gender on spinal mobility, in normal individuals.MethodsA cross-sectional study (MOBILITY) was conducted among normal individuals aged 20–69 years. Recruitment was stratified by gender, age (10-year categories) and height (10 cm categories). Eleven spinal mobility measures were assessed. Age specific RIs and percentiles were derived for each measure.Results393 volunteers were included. All spinal mobility measures decreased with increasing age. Therefore, age specific RIs were developed. The 95% RIs (2.5th and 97.5th percentiles), as well as the 5th, 10th, 25th, 50th, 75th and 90th percentiles for each spinal mobility measure and different ages are presented. Mobility percentile curves were also plotted for each of the measures. For instance, the 95% RI for lateral spinal flexion was 16.2–28.0 cm for a 25-year-old subject, 13.2–25.0 cm for a 45-year-old subject and 10.1–21.9 cm for a 65-year-old subject. After adjustment for age, there was no need for gender specific RIs, while RIs of some measures are height-adjusted.ConclusionsAge specific RIs and percentiles were derived for each of the spinal mobility measures for normal individuals. These may guide clinicians when assessing the mobility of patients with axial spondyloarthritis. The RIs may serve as cut-off levels for ‘normal’ versus ‘abnormal’, whereas the mobility percentile curves may be used to assess the level of mobility of patients with axial spondyloarthritis.

Pediatric reference interval verification for endocrine and fertility hormone assays on the Abbott Alinity system

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Mary Kathryn Bohn ◽  
Siobhan Wilson ◽  
Alexandra Hall ◽  
Khosrow Adeli
Keyword(s):  
Clinical Decision Making ◽  
De Novo ◽  
Reference Interval ◽  
Clinical Decision ◽  
Reference Intervals ◽  
Healthy Children ◽  
Confidence Limits ◽  
Test Results ◽  
Serum Samples ◽  
Abbott Architect

Abstract Objectives The Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) has developed an extensive database of reference intervals (RIs) for several biomarkers on various analytical systems. In this study, pediatric RIs were verified for key immunoassays on the Abbott Alinity system based on the analysis of healthy children samples and comparison to comprehensive RIs previously established for Abbott ARCHITECT assays. Methods Analytical performance of Alinity immunoassays was first assessed. Subsequently, 100 serum samples from healthy children recruited with informed consent were analyzed for 16 Alinity immunoassays. The percentage of test results falling within published CALIPER ARCHITECT reference and confidence limits was determined. If ≥ 90% of test results fell within the confidence limits, they were considered verified based on CLSI guidelines. If <90% of test results fell within the confidence limits, additional samples were analyzed and new Alinity RIs were established. Results Of the 16 immunoassays assessed, 13 met the criteria for verification with test results from ≥ 90% of healthy serum samples falling within the published ARCHITECT confidence limits. New CALIPER RIs were established for free thyroxine and prolactin on the Alinity system. Estradiol required special considerations in early life. Conclusions Our data demonstrate excellent concordance between ARCHITECT and Alinity immunoassays, as well as the robustness of previously established CALIPER RIs for most immunoassays, eliminating the need for de novo RI studies for most parameters. Availability of pediatric RIs for immunoassays on the Alinity system will assist clinical laboratories using this new platform and contribute to improved clinical decision-making.

Reporting altered test results in hemolyzed samples: is the cure worse than the disease?

2017 ◽  
Vol 55 (8) ◽  
pp. 1112-1114 ◽  
Author(s):  
Giuseppe Lippi ◽  
Gianfranco Cervellin ◽  
Mario Plebani
Keyword(s):  
Laboratory Data ◽  
Turnaround Time ◽  
Reliable Data ◽  
Test Results ◽  
The Past ◽  
Laboratory Test Results ◽  
Performance Specifications ◽  
Life Threatening ◽  
The Many ◽  
Definition Of

AbstractThe management of laboratory data in unsuitable (hemolyzed) samples remains an almost unresolved dilemma. Whether or not laboratory test results obtained by measuring unsuitable specimens should be made available to the clinicians has been the matter of fierce debates over the past decades. Recently, an intriguing alternative to suppressing test results and recollecting the specimen has been put forward, entailing the definition and implementation of specific algorithms that would finally allow reporting a preanalytically altered laboratory value within a specific comment about its uncertainty of measurement. This approach carries some advantages, namely the timely communication of potentially life-threatening laboratory values, but also some drawbacks. These especially include the challenging definition of validated performance specifications for hemolyzed samples, the need to producing reliable data with the lowest possible uncertainty, the short turnaround time for repeating most laboratory tests, the risk that the comments may be overlooked in short-stay and frequently overcrowded units (e.g. the emergency department), as well as the many clinical advantages of a direct communication with the physician in charge of the patient. Despite the debate remains open, we continue supporting the suggestion that suppressing data in unsuitable (hemolyzed) samples and promptly notifying the clinicians about the need to recollect the samples remains the most (clinically and analytically) safe practice.

scholarly journals Reference Intervals of Thyroid Hormones and Correlation of BMI with Thyroid Function in Healthy Zhuang Ethnic Pregnant Women

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Yonghong Sheng ◽  
Dongping Huang ◽  
Shun Liu ◽  
Xuefeng Guo ◽  
Jiehua Chen ◽  
...  
Keyword(s):  
Thyroid Hormones ◽  
Pregnant Women ◽  
Thyroid Function ◽  
Reference Intervals ◽  
Thyroid Stimulating Hormone ◽  
Specific Reference ◽  
American Thyroid Association ◽  
Reference Ranges ◽  
Free Triiodothyronine ◽  
Cross Sectional

Ethnic differences in the level of thyroid hormones exist among individuals. The American Thyroid Association (ATA) recommends that an institution or region should establish a specific thyroid hormone reference value for each stage of pregnancy. To date, a limited number of studies have reported the level of thyroid hormones in Chinese minorities, and the exact relationship between BMI and thyroid function in pregnant women is ill. This study was performed to establish trimester-specific reference ranges of thyroid hormones in Zhuang ethnic pregnant women and explore the role of body mass index (BMI) on thyroid function. A total of 3324 Zhuang ethnic health pregnant women were recruited in this Zhuang population-based retrospective cross-sectional study. The values of thyroid stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) were determined by automatic chemiluminescence immunoassay analyzer. Multivariate linear regression and binary logistic regression were constructed to evaluate the influence of BMI on the thyroid function. The established reference intervals for the serum thyroid hormones in three trimesters were as follows: TSH, 0.02–3.28, 0.03–3.22, and 0.08-3.71 mIU/L; FT4, 10.57–19.76, 10.05–19.23, and 8.96–17.75 pmol/L; FT3, 3.51–5.64, 3.42–5.42, and 2.93–5.03 pmol/L. These values were markedly lower than those provided by the manufacturers for nonpregnant adults which can potentially result in 6.10% to 19.73% misclassification in Zhuang pregnant women. Moreover, BMI was positively correlated with isolated hypothyroxinemia (OR=1.081, 95% CI=1.007–1.161), while the correlation between the BMI and subclinical hypothyroidism was not statistically significant (OR=0.991, 95% CI=0.917–1.072). This is the first study focusing on the reference ranges of thyroid hormones in Guangxi Zhuang ethnic pregnant women, which will improve the care of them in the diagnosis and treatment. We also found that high BMI was positively associated with the risk of isolated hypothyroxinemia.

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