Reference Intervals for Common Laboratory Tests in Melanesian Children

SummaryThrombelastography, although proven as a useful research tool has not been evaluated for its clinical utility against common coagulation laboratory tests. In this study we compare the thrombelastographic measurements with six common tests (the hematocrit, platelet count, fibrinogen, prothrombin time, activated thromboplastin time and fibrin split products). For such comparisons, two samples of subjects were selected, 141 normal volunteers and 121 patients with cancer. The data was subjected to various statistical techniques such as correlation, ANOVA, canonical and discriminant analysis to measure the extent of the correlations between the two sets of variables and their relative strength to detect blood clotting abnormalities. The results indicate that, although there is a strong relationship between the thrombelastographic variables and these common laboratory tests, the thrombelastographic variables contain additional information on the hemostatic process.

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Evaluation and cost estimation of laboratory tests overuse through a CCDSS in a university hospital

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.221 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

D Vallone ◽

A Tamburrano ◽

C Carrozza ◽

A Urbani ◽

A Cambieri ◽

...

Keyword(s):

Cost Estimation ◽

Laboratory Tests ◽

Quality Care ◽

Clinical Decision Support Systems ◽

Patient Characteristics ◽

Clinical Decision ◽

University Hospital ◽

Specific Patient ◽

Global Rate ◽

Common Laboratory

Abstract Computerized Clinical Decision Support Systems (CCDSS) are information technology-based systems that use specific patient characteristics and combine them with rule-based algorithms. The aim of this study is to conduct a survey to measure and assess the over-utilization rates of laboratory requests and to estimate the monthly cost of inappropriate requests in inpatients of the “Fondazione Policlinico Universitario A. Gemelli IRCCS” Care Units. This observational study is based on the count of rules violations for 43 different types of laboratory tests requested by the Hospital physicians, for a total of 5,716,370 requests, over a continuous period of 20 months (from 1 July 2016 to 28 February 2018). Requests from all the hospital internal departments (except for Emergency, Intensive Care Units and Urgent requests) were monitored. The software intercepted and counted, in silent mode for the operator, all requests and violations for each laboratory test among those identified. During the observation period a mean of 285,819 requests per month were analyzed and 40,462 violations were counted. The global rate of overuse was 15.2% ± 3.0%. The overall difference among sub-groups was significant (p < 0.001). The most inappropriate exams were Alpha Fetoprotein (85.8% ± 30.5%), Chlamydia trachomatis PCR (48.7% ± 8.8%) and Alkaline Phosphatase (20.3% ± 6.5%). All the exams, globally considered, generated an estimated avoidable cost of 1,719,337€ (85,967€ per month) for the hospital. This study reports rates (15.2%) similar to other works. The real impact of inappropriateness is difficult to assess, but the generated costs for patients, hospitals and health systems are certainly high and not negligible. Key messages It would be desirable for international medical communities to produce a complete panel of prescriptive rules for all the most common laboratory exam. That is useful not only to reduce costs, but also to ensure standardization and high-quality care.

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Système International (SI) Units Conversion Table for Common Laboratory Tests

Annals of Pharmacotherapy ◽

10.1177/106002809402801028 ◽

1994 ◽

Vol 28 (10) ◽

pp. 1208-1208

Keyword(s):

Laboratory Tests ◽

Si Units ◽

Conversion Table ◽

Common Laboratory

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Comparing Ethnicity-Specific Reference Intervals for Clinical Laboratory Tests from EHR Data

The Journal of Applied Laboratory Medicine ◽

10.1373/jalm.2018.026492 ◽

2018 ◽

Vol 3 (3) ◽

pp. 366-377 ◽

Cited By ~ 3

Author(s):

Nadav Rappoport ◽

Hyojung Paik ◽

Boris Oskotsky ◽

Ruth Tor ◽

Elad Ziv ◽

...

Keyword(s):

Race And Ethnicity ◽

Laboratory Tests ◽

Clinical Laboratory ◽

Local Population ◽

Reference Intervals ◽

Medical Decision ◽

Specific Reference ◽

Healthy Individuals ◽

Electronic Health Record Data ◽

Novel Approach

Abstract Background The results of clinical laboratory tests are an essential component of medical decision-making. To guide interpretation, test results are returned with reference intervals defined by the range in which the central 95% of values occur in healthy individuals. Clinical laboratories often set their own reference intervals to accommodate variation in local population and instrumentation. For some tests, reference intervals change as a function of sex, age, and self-identified race and ethnicity. Methods In this work, we develop a novel approach, which leverages electronic health record data, to identify healthy individuals and tests for differences in laboratory test values between populations. Results We found that the distributions of >50% of laboratory tests with currently fixed reference intervals differ among self-identified racial and ethnic groups (SIREs) in healthy individuals. Conclusions Our results confirm the known SIRE-specific differences in creatinine and suggest that more research needs to be done to determine the clinical implications of using one-size-fits-all reference intervals for other tests with SIRE-specific distributions.

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