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Development of paediatric biochemistry centile charts as a complement to laboratory reference intervals

Tze Ping Loh1, Georgia Antoniou, Peter Baghurst

  • 11Department of Laboratory Medicine, National University Hospital, Singapore 2Public Health Research Unit, Women's and Children's Hospital, North Adelaide 3Disciplines of Paediatrics and Public Health, University of Adelaide 4Division of Laboratory Medicine, Women's and Children's Hospital, North Adelaide, SA, Australia.

Pathology
|May 7, 2014
PubMed

Insights

Paediatric biochemistry centile charts provide a smoother way to interpret lab results for children. These charts help track physiological changes and complement traditional age-specific reference intervals for better clinical insights.

Area of Science:

  • Clinical Biochemistry
  • Paediatric Medicine
  • Laboratory Science

Background:

  • Traditional age-specific reference intervals for paediatric laboratory results can be problematic at age bracket transitions.
  • Existing methods may mask subtle physiological changes in children's biochemistry over time.
  • Need for improved tools to interpret clinical biochemistry in ambulatory paediatric patients.

Purpose of the Study:

  • To construct smoothed centile charts for common clinical biochemistry tests in children aged 0-19.
  • To visualize age-related trends and physiological changes in paediatric biochemistry.
  • To provide tools that complement age-specific reference intervals for better interpretation.

Main Methods:

  • Retrospective collection of results for 16 common clinical biochemistry tests from ambulatory paediatric patients (0-19 years).
  • Data collected over 12 months ending 30 September 2013 from a large pathology service.
  • Construction of smoothed centile charts using a penalised maximum likelihood method.

Main Results:

  • Identified increasing trends with age for sodium, bicarbonate, creatinine, urate, total protein, and albumin.
  • Identified decreasing trends with age for potassium, chloride, anion gap, calcium, phosphate, and lactate dehydrogenase.
  • Observed age-dependent variations for urea, alkaline phosphatase, glucose, and total cholesterol; sex-based differences emerged around puberty.

Conclusions:

  • Smoothed paediatric biochemistry centile charts are intuitive tools for interpreting laboratory results.
  • These charts enhance the understanding of physiological changes in children's biochemistry.
  • Centile charts complement age-specific reference intervals, aiding in tracking and discussion of results.

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