临床化学中的参考间隔的作用和局限性及其对疾病检测的可靠性
1Nutristasis Unit, Synnovis, Guy's and St. Thomas' Hospital NHS Trust, London, United Kingdom.
British journal of biomedical science
|March 14, 2024
概括
参考间隔 (RIs) 为实验室测试解释提供了一个范围,但有局限性. 了解影响RI的因素和改善实验室通信可以提高它们的临床实用性.
科学领域:
- 临床化学 临床化学
- 实验室医学 实验室医学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 参考间隔对于解释实验室测试结果至关重要.
- 历史上被称为"正常范围",RI可能会导致混乱和患者的痛苦.
- 通过各种方法确定RI,包括已发表的研究,直接/间接衍生或制造商验证.
研究的目的:
- 为了突出当前参考区间的局限性.
- 强调需要在临床实践中更好地理解和应用RI.
- 倡导提高RI衍生和通信的透明度.
主要方法:
- 对推导参考区间的既定方法的审查.
- 对影响参考区间精度的统计和生物因素的分析.
- 检查参考区间应用和解释中的挑战.
主要成果:
- 统计方法意味着~5%的健康个体属于RIs之外.
- 增加测试增加了由于机会和回归平均值而导致异常结果的概率.
- 方法偏差,人口差异和个体特征 (年龄,性别,种族) 影响RI可转移性.
结论:
- 参考间隔具有固有的局限性,需要临床医生的意识.
- 提高培训,了解影响因素和透明的实验室沟通对于有效的RI使用至关重要.
- 解决个体患者的需求,包括那些具有非二元性别认同的患者,可能需要定制RI.
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