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[The application of Hoffmann method in the establishment of children's reference intervals of erythrocyte count]
1Center for Clinical Epidemiology & Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China.
Insights
The Hoffmann method reliably establishes pediatric reference intervals for erythrocyte count in children. This convenient method is suitable for clinical practice, providing accurate results for healthy children.
Area of Science:
- Clinical Chemistry
- Pediatric Hematology
- Biostatistics
Background:
- Establishing accurate pediatric reference intervals (RIs) for erythrocyte count is crucial for diagnosing and monitoring childhood health conditions.
- Existing methods for RI determination may have limitations in terms of reliability and feasibility for pediatric populations.
Purpose of the Study:
- To evaluate the reliability and practicality of the Hoffmann method for determining pediatric reference intervals (RIs) of erythrocyte count.
- To establish gender- and age-stratified RIs for erythrocyte count in children using the Hoffmann method.
Main Methods:
- Utilized a large dataset of hospital-based erythrocyte count data from 392,000 children aged 1–17 years.
- Applied the Dixon method for outlier removal, followed by the Hoffmann method to establish gender- and age-specific pediatric RIs.
- Verified the established RIs using erythrocyte count data from 2,217 healthy children.
Main Results:
- The Hoffmann method generated specific RIs for erythrocyte count across four pediatric subgroups (male/female, 1-12/13-17 years).
- For instance, RIs for males aged 1-12 years were (4.1-5.4)×10^12/L.
- Verification showed acceptable out-of-range proportions in healthy children, ranging from 6.17% to 8.81% across subgroups.
Conclusions:
- The Hoffmann method provides reliable pediatric reference intervals for erythrocyte count that align with clinical observations in healthy children.
- The method is convenient and demonstrates potential for widespread adoption in clinical settings.
- This study supports the Hoffmann method as a valuable tool for pediatric hematology.
Objective:
To verify the reliability and feasibility of Hoffmann method in establishing pediatric reference intervals (RI) of erythrocyte count.
Methods:
Three hundreds and ninty-two thousands of hospital-based data for erythrocyte count of children aged in 1 to 17, measured by the Sysmex Xs-800i, was collected from Beijing Children's Hospital during January to December 2014. Outliers were removed using the Dixon method, then Hoffmann method was conducted to establish the gender and age stratified pediatric RIs of erythrocyte count. The erythrocyte count of 2 217 healthy children, recruited from Beijing Children's Hospital and Liaocheng Children's Hospital in Shandong province, was conducted as normal reference to verify the reliability of Hoffmann method in establishing RIs and to compare with existing RIs.
Results:
In 4 subgroups as following, male aging 1 to 12 years, male aging 13 to 17 years, female aging 1 to 12 years, female aging 13 to 17 years, the RIs of erythrocyte count established using Hoffmann method were (4.1-5.4)×10(12)/L, (4.4-5.7)×10(12)/L, (4.0-5.3)×10(12)/L, (4.0-5.3)×10(12)/L, respectively. The verification results in 2 217 healthy children showed that the proportions of out of range in four subgroups were 6.17%, 8.81%, 6.22%, 7.78%, respectively.
Conclusion:
Hoffmann method produce reliable RIs according with the actual situation in healthy children, which is also convenient and is worth popularizing in clinical practice.
