对个性化参考区间和参考变化值的参数实证贝叶斯方法
Eirik Åsen Røys1,2, Kristin Viste1,2, Christopher-John Farrell3
1Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway.
个性化参考间隔 (RIper) 通过考虑个体变化来提高诊断精度. 参数实证贝叶斯 (PEB) 框架使得使用人口数据的RIper可靠,即使个体结果有限.
科学领域:
- 实验室医学
- 生物标志物分析
- 个性化诊断
背景情况:
- 全种群的参考间隔 (RIpop) 可能不反映个体的同位素范围.
- 个性化参考间隔 (RIper) 可以提高诊断精度.
- 一个参数实证贝叶斯 (PEB) 框架稳定了可靠RIper的个人估计.
研究的目的:
- 将PEB框架用于估计九个关键生物标志物的RIper.
- 将基于PEB的RIper与传统的RIpop和参考变化值 (RCV) 进行比较.
- 评估使用常规实验室信息系统 (LIS) 或生物变异 (BV) 数据来确定PEB参数的可行性.
主要方法:
- 应用PEB框架来估计白蛋白,肌素,酸盐,皮质素,,二,17-基和11-脱氧皮质醇的RIper.
- 从LIS数据和本地BV研究得出的PEB参数.
- 评估标记结果,并使用健康成年人的序列样本将RIper与RIpop和RCV进行比较.
主要成果:
- 基于PEB的RIper总是比RIpop更窄,减少了对白蛋白,酸盐和皮质素的标记结果.
- 对17- 基孕激素的标记增加,但仍接近预期的5%.
- 调整PEB值以回归到平均值,证明比标准RCV估计更窄,而没有增加标记结果.
结论:
- 即使个人数据有限,PEB框架也有效地为实验室测试提供了个性化的切断值.
- 可以从LIS或BV数据中得出PEB参数,说明可行的实施途径.
- 这种方法提供了一种经济有效的方法,通过个性化的参考间隔来提高诊断精度.
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