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Related Concept Videos

EDTA: Indirect and Alkalimetric Titration01:23

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Unlike direct titration, back-titration, and displacement titration, indirect titration is an EDTA titration method for quantifying anions. In the indirect titration method, anions are precipitated as their insoluble salts with excess metal ions. The filtrate containing the excess metal ions is directly titrated with standard EDTA until the endpoint is achieved. Another approach involves extracting the metal ion and back-titrating with standard EDTA to obtain the endpoint. In this way, the...
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Absolute Quantification of Aβ1-42 in CSF Using a Mass Spectrometric Reference Measurement Procedure
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Calculation of reference intervals using an indirect approach from laboratory database.

Victor Martin-Riera1, Pablo Gabriel-Medina1, Albert Blanco-Grau1

  • 1Clinical Biochemistry Department, Drug Delivery and Therapy Research Group, Vall d'Hebron Research Institute (VHIR), Vall d'Hebron University Hospital, Barcelona, Spain.

Advances in Laboratory Medicine
|March 19, 2026
PubMed
Summary
This summary is machine-generated.

Establishing reference intervals (RIs) for biochemical tests using an indirect approach with routine samples is feasible. This method provides robust RIs, enhancing diagnostic accuracy and healthcare efficiency.

Keywords:
adult populationindirect approachlaboratory testsreference intervals

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Area of Science:

  • Clinical Biochemistry
  • Laboratory Medicine
  • Diagnostic Accuracy

Background:

  • Accurate interpretation of laboratory test results relies on established reference intervals (RIs).
  • Traditional RI determination requires recruiting healthy individuals, which can be resource-intensive.
  • An indirect approach using routine clinical samples offers a potential alternative for RI establishment.

Purpose of the Study:

  • To evaluate the feasibility of determining reference intervals (RIs) using an indirect approach.
  • To leverage large datasets from routine clinical samples for RI calculation.
  • To ensure the quality and adequacy of sample sizes while excluding pathological values.

Main Methods:

  • A prospective study analyzing routine primary care samples.
  • Inclusion of biochemical markers such as creatinine, esterified bilirubin, ferritin, and transferrin.
  • Implementation of a patient exclusion protocol to identify and remove pathological results.
  • Comparison of newly calculated RIs with manufacturer-provided laboratory RIs.

Main Results:

  • The indirect approach yielded robust reference intervals (RIs).
  • No statistically significant differences were observed between newly calculated RIs and existing laboratory RIs.
  • Data quality and sufficient sample size were maintained throughout the study.

Conclusions:

  • The indirect approach is an effective method for determining reference intervals (RIs).
  • Rigorous data quality standards and adequate sample sizes are essential for success.
  • Adoption of these RIs can improve diagnostic accuracy and optimize healthcare resource utilization.