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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.
Insights
This study establishes alkaline phosphatase (ALP) reference intervals for Pakistani children. These population-specific ranges aid in accurate clinical interpretation of ALP levels during development.
Area of Science:
- Clinical Biochemistry
- Pediatric Laboratory Medicine
- Data Mining in Healthcare
Background:
- Alkaline phosphatase (ALP) levels vary significantly with age and sex.
- Establishing population-specific reference intervals (RIs) is crucial for accurate pediatric health assessment.
- Existing RIs may not accurately reflect Pakistani children's physiological development.
Purpose of the Study:
- To establish robust reference intervals (RIs) for alkaline phosphatase (ALP) in Pakistani children.
- To utilize an indirect data mining approach for RI determination.
- To provide age- and sex-stratified RIs for Pakistani pediatric population.
Main Methods:
- Retrieved ALP levels from 108,845 inpatient and outpatient results (ages 1-17) analyzed between 2013-2017.
- Applied a validated indirect algorithm from the German Society of Clinical Chemistry and Laboratory Medicine for RI calculation.
- Excluded patients with multiple specimens, resulting in data from 24,628 males and 18,083 females.
Main Results:
- Calculated age- and sex-specific RIs for alkaline phosphatase in Pakistani children.
- Demonstrated complex age- and sex-related dynamics of ALP during physiological development.
- Provided a comprehensive dataset for a large cohort of Pakistani children.
Conclusions:
- Population-specific RIs for ALP are essential for accurate interpretation in Pakistani children.
- These RIs support improved clinical decision-making by reflecting normal developmental fluctuations.
- The findings enhance understanding of analyte activity changes with age in this population.
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.
