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Evaluating sequential values using time-adjusted biological variation.

Martin H Kroll1

  • 1Dallas VA Medical Center, TX 75216, USA. Martin.Kroll@med.va.gov

Clinical Chemistry and Laboratory Medicine
|July 13, 2002
PubMed
Summary
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Comparing sequential analyte values to biological variation helps identify disease. Differences exceeding Z times the square root of 2 times standard deviation of biological variation (SD(BV)) indicate significant changes.

Area of Science:

  • Clinical Chemistry
  • Biostatistics
  • Analytical Chemistry

Background:

  • Biological variation (BV) quantifies random analyte fluctuations over time.
  • Distinguishing biological variation from disease-related changes is crucial for accurate diagnosis.

Purpose of the Study:

  • To establish a method for comparing sequential analyte values against biological variation.
  • To develop a model for estimating variance over extended time periods.

Main Methods:

  • Utilized a random walk model to estimate variance spread with multiple sequential values.
  • Introduced a formula incorporating a 'restoring force' to adjust for longer time periods (SD2 BV,n = SD2 BV,1 sigma(n) j=1 e(-2)(j-1)phi).
  • Calculated the parameter phi to determine biological variance for any time period.

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Main Results:

  • A significant difference (delta) is identified when delta > Z square root 2n SD(BV).
  • The formula allows for the calculation of biological variance across different time intervals.
  • The 'restoring force' concept refines variance estimation by accounting for factors that diminish random disturbances.

Conclusions:

  • The developed model enables robust comparison of sequential analyte values with biological variation.
  • This approach facilitates the calculation of appropriate test intervals based on empirically derived biological variances.
  • Accurate assessment of biological variation is key to detecting clinically significant changes.