Ethnicity-based variations in biological reference interval- A systematic scoping review

Area of Science:

• Clinical diagnostics
• Biomarker analysis
• Population health

Background:

• Traditional biological reference intervals (RIs) are often based on homogeneous Western populations.
• Generalized RIs may not accurately reflect diverse genetic, environmental, and lifestyle factors.
• This can lead to diagnostic inaccuracies and health inequities in underrepresented ethnic groups.

Purpose of the Study:

• To conduct a scoping review on ethnicity-based variations in biological reference intervals (RIs).
• To highlight the importance of population-specific RIs for improved clinical decision-making.
• To identify research gaps concerning RIs in diverse ethnic populations.

Main Methods:

• Scoping review adhering to Joanna Briggs Institute (JBI) guidelines.
• Literature search across major databases (MEDLINE, Embase, Scopus, Web of Science) up to December 2024.
• Eligibility assessment using the Population-Concept-Context (PCC) framework for observational studies on ethnicity-specific differences.

Main Results:

• Fifteen studies met inclusion criteria, analyzing multi-ethnic populations.
• Significant variations in biomarker levels (e.g., lipid profiles, vitamin B12, anti-Mullerian hormone) were observed across ethnic groups.
• Gaps in research were identified for underrepresented ethnic populations, indicating the inadequacy of generalized RIs.

Conclusions:

• There is a critical need for ethnicity-specific RIs to enhance diagnostic accuracy.
• Developing inclusive and representative RIs is essential for promoting equitable healthcare outcomes.
• Further research is required to establish robust methodologies for population-specific RIs.