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Establishment of Reference Intervals for Alkaline Phosphatase in Pakistani Children Using a Data Mining Approach
Sibtain Ahmed1, Jakob Zierk2, Aysha Habib Khan1
1Section of Clinical Chemistry, Department of Pathology & Laboratory Medicine, Aga Khan University, Karachi, Pakistan.
Objective:
To establish reference intervals (RIs) for alkaline phosphatase (ALP) levels in Pakistani children using an indirect data mining approach.
Methods:
ALP levels analyzed on a Siemens Advia 1800 analyzer using the International Federation of Clinical Chemistry's photometric method for both inpatients and outpatients aged 1 to 17 years between January 2013 and December 2017, including patients from intensive care units and specialty units, were retrieved. RIs were calculated using a previously validated indirect algorithm developed by the German Society of Clinical Chemistry and Laboratory Medicine's Working Group on Guide Limits.
Results:
From a total of 108,845 results, after the exclusion of patients with multiple specimens, RIs were calculated for 24,628 males and 18,083 females with stratification into fine-grained age groups. These RIs demonstrate the complex age- and sex-related ALP dynamics occurring during physiological development.
Conclusion:
The population-specific RIs serve to allow an accurate understanding of the fluctuations in analyte activity with increasing age and to support clinical decision making.
