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Related Experiment Videos

On the calculation of reference change values, with examples from a long-term study

J M Queraltó1, J C Boyd, E K Harris

  • 1Servei de Bioquimica, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain.

Clinical Chemistry
|July 1, 1993
PubMed
Summary

Reference change values (RCVs) assess significant changes in test results. A more complex original method, accounting for individual variance and correlations, provides more reliable RCVs than simplified approaches.

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Area of Science:

  • Clinical Chemistry
  • Biostatistics
  • Medical Laboratory Science

Background:

  • Reference change values (RCVs) are crucial for interpreting serial test results.
  • Current simplified methods often assume constant within-subject variance and ignore serial correlations.

Purpose of the Study:

  • To compare RCVs calculated using a simplified method versus the originally proposed procedure.
  • To evaluate the reliability and clinical sensitivity of RCVs derived from both methods.

Main Methods:

  • Collected longitudinal data (2-5 years) from 72 healthy subjects for 18 serum analytes.
  • Calculated RCVs using both a simplified method and the original procedure accounting for true variance variability and serial correlation.

Main Results:

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  • The original method, though more complex, yielded generally larger RCVs.
  • RCVs from the original method demonstrated greater sensitivity to clinically significant individual changes.

Conclusions:

  • The originally proposed method for computing reference change values is more reliable than simplified approaches.
  • Accounting for individual variance and serial correlation enhances the clinical utility of RCVs.