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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
    PubMed
    Summary
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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.