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Pooled normal values, a useful technic

M K Schauble, J M Becktel, H D Gullick

American Journal of Clinical Pathology

|April 1, 1977

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Pooling laboratory data is valid for establishing normal values when non-random variables are removed. This approach identifies issues through interlaboratory variance, yielding reliable results comparable to single-lab studies.

Area of Science:

Clinical Chemistry
Hematology
Laboratory Medicine

Background:

Establishing accurate reference ranges for laboratory tests is crucial but labor-intensive.
Many individual laboratories face challenges in generating their own normal values due to resource constraints.

Purpose of the Study:

To investigate the feasibility of pooling normal values from multiple laboratories.
To determine if collaborative data collection can yield reliable reference ranges applicable to a larger group.

Main Methods:

Twenty Veterans Affairs (VA) hospital laboratories each collected approximately 20 fasting specimens from healthy men (aged 20-29).
Routine chemistry tests (16) were performed using Technicon AutoAnalyzers, and hematology tests (5) using Coulter Counters.
Within-day, day-to-day, and interlaboratory variance were analyzed to identify non-random variables.

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Main Results:

Pooling normal values from different laboratories is statistically valid when non-random variables are controlled or eliminated.
Increased interlaboratory variance effectively identifies non-random variables, regardless of obvious differences in methods or equipment.
Derived normal values demonstrated strong agreement with those established by large, single-center studies.

Conclusions:

Collaborative efforts in data collection can overcome the resource burden of establishing laboratory normal values.
Identifying and mitigating interlaboratory variance is key to successful data pooling.
This multi-laboratory approach provides a viable and accurate method for generating reference ranges.