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Current State of Pediatric Reference Intervals and the Importance of Correctly Describing the Biochemistry of Child

Alicia N Lyle1, Fidelia Pokuah1, Dennis J Dietzen2

  • 1Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia.

JAMA Pediatrics
|April 25, 2022
PubMed

Insights

Accurate pediatric reference intervals are crucial for child health but are inconsistent. This review highlights the need for better biomarker reference intervals that reflect developmental changes for improved clinical decision-making.

Area of Science:

  • Biochemistry
  • Pediatric Medicine
  • Clinical Diagnostics

Background:

  • Pediatric reference intervals are essential for clinical decisions in child development.
  • Current pediatric reference intervals show significant inconsistencies across common biomarkers.
  • These inconsistencies can impact accurate diagnosis and treatment in pediatric care.

Purpose of the Study:

  • To review biomarker-specific pediatric reference intervals and their clinical utility.
  • To assess how well existing intervals reflect physiological changes during child development.
  • To identify gaps in current pediatric reference interval data and application.

Main Methods:

  • A narrative review of pediatric reference intervals was conducted.
  • Literature search included PubMed-indexed articles (Jan 2015-Apr 2021), commercial lab websites, study cohorts, and reference interval books.
  • Analysis focused on biomarker changes during development and interval accuracy.

Main Results:

  • Numerous pediatric reference intervals exist for some biomarkers, but few are clinically utilized.
  • Biomarker changes during development are highly variable and often not captured by current reference intervals.
  • Significant inconsistencies exist between established reference intervals, impacting their reliability.

Conclusions:

  • There is a critical need to accurately describe child development biochemistry.
  • Developing accurate and consistent pediatric reference intervals is vital for enhancing pediatric care.
  • Improved reference intervals will support better clinical decision-making and patient outcomes.
Abstract

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