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Personalized reference intervals: from theory to practice.

Abdurrahman Coskun^1,2, Sverre Sandberg^3,4,5, Ibrahim Unsal¹

¹Acibadem Labmed Clinical Laboratories, Istanbul, Turkey.

Critical Reviews in Clinical Laboratory Sciences

|May 17, 2022

Summary

Personalized reference intervals (prRI) offer a superior alternative to population-based data for interpreting lab results. This approach enhances individual patient diagnosis and monitoring by comparing results to a unique baseline.

Keywords:

Biological variation index of individuality personalized reference intervals population-based reference intervals prediction interval reference change value

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Area of Science:

Clinical Chemistry
Medical Diagnostics
Personalized Medicine

Background:

Population-based reference intervals (RI) have limitations for individual patient diagnosis and monitoring.
Comparing laboratory test results to an individual's own data is preferable for accurate assessment.

Approach:

The personalized reference interval (prRI) concept is based on the homeostatic model.
prRI calculation utilizes an individual's past test results, analytical variation (CV_A), and biological variation (BV).
Statistical prediction intervals are key for calculating prRI from historical data.

Key Points:

prRI can be derived using population data (CV_I) or individual data (CV_P) for biological variation.
Information technology enables the storage and processing of vast patient data for personalized laboratory medicine.
prRI should be integrated into laboratory information systems and continuously updated.

Conclusions:

This review outlines the limitations of population-based RI and the prRI concept.
It discusses methods for prRI determination, including statistical considerations.
Further research is needed before widespread clinical implementation of prRI.