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Evidence-based approach to harmonised reference intervals.

Gus Koerbin1, Ken Andrew Sikaris2, Graham Ross Dallas Jones3

  • 1ACT Pathology, Canberra, Australia; University of Canberra, Canberra, Australia.

Clinica Chimica Acta; International Journal of Clinical Chemistry
|November 5, 2013
PubMed
Summary
This summary is machine-generated.

Harmonizing laboratory reference intervals using an evidence-based approach is crucial for accurate patient assessment. This paper guides physicians and labs on achieving consistent reference intervals for better clinical decision-making.

Keywords:
Evidence-basedHarmonisationReference interval

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Area of Science:

  • Clinical Chemistry
  • Laboratory Medicine
  • Evidence-Based Practice

Background:

  • A significant gap exists between evidence-based medicine principles and the practical application of reference intervals in clinical settings.
  • Variations in reference intervals across laboratories, even with identical methods, can lead to physician confusion and complicate patient monitoring.
  • Discordant laboratory data due to differing reference intervals hinders effective patient assessment and care.

Purpose of the Study:

  • To demonstrate an evidence-based approach for harmonizing laboratory reference intervals.
  • To highlight factors influencing reference interval determination and the importance of consistency.
  • To advocate for the adoption of harmonized reference intervals to improve clinical decision-making.

Main Methods:

  • Discusses key factors influencing reference interval determination, including population selection, biological variability, partitioning, sample collection, and analytical aspects.
  • Explores the merits and limitations of a priori and a posteriori approaches for establishing reference intervals.
  • Emphasizes the validation of indirect a posteriori methods as a practical alternative for laboratories.

Main Results:

  • Identifies numerous factors that contribute to the variability of reference intervals across different laboratories.
  • Presents harmonized reference intervals as a solution to mitigate confusion and improve diagnostic accuracy.
  • Highlights the feasibility of using validated indirect a posteriori methods for harmonizing intervals.

Conclusions:

  • An evidence-based approach is essential for harmonizing reference intervals and bridging the gap between theory and practice.
  • Harmonized reference intervals are critical for enhancing the reliability of diagnostic information and supporting physician decision-making.
  • Continuous application of evidence-based practices in establishing harmonized reference intervals is necessary to meet physician quality expectations.