实验室参考间隔 - - 改善实用性的历史和现代方法
Tony Badrick1, Joe M El-Khoury2, Elvar Theodorsson3
1RCPA Quality Assurance Programs, St Leonards, Sydney, Australia.
概括
使用参考间隔的实验室结果进行诊断是常见的,但有缺陷. 这种方法忽略了测量不确定性,生物标志物度,疾病流行率和成本,促使人们探索更好的诊断方法.
科学领域:
- 临床化学 临床化学
- 实验室医学 实验室医学
- 生物标记分析 生物标记分析
背景情况:
- 目前的实验室诊断主要依赖于生物标志物解释的参考间隔.
- 这种统计决策理论方法将结果分为"正常"或"异常".
- 这种方法忽略了影响诊断准确性和临床实用性的关键因素.
研究的目的:
- 批判性地评估实验室诊断中传统参考间隔的局限性.
- 讨论参考区间的历史,特性,优点和缺点.
- 探索和介绍用于生物标志物解释的替代诊断策略.
主要方法:
- 对参考区间的历史发展和统计基础的回顾.
- 分析二分化实验室结果的缺点.
- 检查生物标志物解释的替代统计方法.
主要成果:
- 参考间隔无法考虑测量不确定性,生物标志物度极端,疾病流行率和诊断错误的成本效益分析.
- 参考极限的二分性可能导致误解和非最佳临床决策.
- 像标准分数,百分比和概率比率这样的替代方法提供了更细致的解释.
结论:
- 传统的参考间隔是一种过于简单的实验室诊断方法.
- 重新思考诊断策略对于提高实验室结果的准确性和实用性至关重要.
- 采用先进的统计方法可以提高生物标志物解释和患者护理.
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