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Clinical laboratory test reference intervals vary significantly across self-identified racial and ethnic groups (SIREs) in healthy individuals. This highlights the need to re-evaluate universal reference intervals for accurate patient care.

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Area of Science:

  • Clinical laboratory science
  • Medical decision-making
  • Population health

Background:

  • Clinical laboratory test results are crucial for medical decisions.
  • Reference intervals, representing the 95% range in healthy individuals, guide test interpretation.
  • Laboratories may adjust reference intervals based on local populations, instrumentation, and demographic factors like sex, age, and self-identified race and ethnicity (SIRE).

Purpose of the Study:

  • To develop a novel approach using electronic health record (EHR) data.
  • To identify healthy individuals and analyze laboratory test value differences between populations.
  • To investigate potential disparities in laboratory test results among different SIREs.

Main Methods:

  • Leveraged electronic health record (EHR) data.
  • Developed a novel computational approach.
  • Identified healthy individuals within the EHR data.
  • Analyzed laboratory test value distributions across different SIREs.

Main Results:

  • Over 50% of laboratory tests with fixed reference intervals showed differing distributions among healthy individuals across SIREs.
  • Confirmed known SIRE-specific differences for creatinine.
  • Identified potential for SIRE-specific variations in numerous other laboratory tests.

Conclusions:

  • The study confirms SIRE-specific variations in laboratory test results, extending beyond creatinine.
  • Current 'one-size-fits-all' reference intervals may not be universally applicable.
  • Further research is essential to understand the clinical implications of SIRE-specific test distributions and inform updated reference interval guidelines.