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Indirect methods for reference interval determination - review and recommendations.

Graham R D Jones1,2, Rainer Haeckel3, Tze Ping Loh4

  • 1Department of Chemical Pathology, SydPath, St Vincent's Hospital, Sydney, NSW, Australia.

Clinical Chemistry and Laboratory Medicine
|April 20, 2018
PubMed
Summary
This summary is machine-generated.

The indirect approach offers a faster, cheaper, and safer method for establishing clinical laboratory reference intervals by analyzing routine patient data. This approach, supported by the IFCC, leverages existing data for more efficient interval determination.

Keywords:
decision limitsindirect methodspathology testingreference intervalsstatistical approach

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Area of Science:

  • Clinical Chemistry
  • Hematology
  • Laboratory Medicine

Background:

  • Reference intervals are crucial for interpreting numerical pathology results.
  • Traditional direct methods involve collecting samples from a preselected population.
  • An alternative indirect approach analyzes routine pathology testing results.

Purpose of the Study:

  • To summarize current thinking on indirect approaches for establishing reference intervals.
  • To highlight the advantages and limitations of the indirect method.
  • To encourage the use and development of indirect methods by the IFCC Committee on Reference Intervals and Decision Limits (C-RIDL).

Main Methods:

  • Analysis of results generated from routine pathology testing.
  • Application of appropriate statistical techniques for interval determination.
  • Comparison of indirect methods with traditional direct methods.

Main Results:

  • Indirect approaches are faster, cheaper, and avoid patient inconvenience and risks.
  • Indirect methods utilize the same techniques as patient management and provide large datasets.
  • A key limitation is the potential effect of diseased subpopulations on derived intervals.

Conclusions:

  • The indirect approach presents significant advantages over direct methods for establishing reference intervals.
  • The IFCC C-RIDL advocates for the adoption and publication of indirect methods.
  • Further development of statistical techniques for indirect methods is supported.