Personalized reference intervals - statistical approaches and considerations


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COSKUN A., Sandberg S., Unsal I., GÖKALP YAVUZ F., Cavusoglu C., SERTESER M., ...Daha Fazla

CLINICAL CHEMISTRY AND LABORATORY MEDICINE, cilt.60, sa.4, ss.629-635, 2022 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 60 Sayı: 4
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1515/cclm-2021-1066
  • Dergi Adı: CLINICAL CHEMISTRY AND LABORATORY MEDICINE
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, Agricultural & Environmental Science Database, BIOSIS, CAB Abstracts, Chemical Abstracts Core, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.629-635
  • Anahtar Kelimeler: biological variation, personalized medicine, reference intervals, VALUES
  • Orta Doğu Teknik Üniversitesi Adresli: Evet

Özet

For many measurands, physicians depend on population-based reference intervals (popRI), when assessing laboratory test results. The availability of personalized reference intervals (prRI) may provide a means to improve the interpretation of laboratory test results for an individual. prRI can be calculated using estimates of biological and analytical variation and previous test results obtained in a steady-state situation. In this study, we aim to outline statistical approaches and considerations required when establishing and implementing prRI in clinical practice. Data quality assessment, including analysis for outliers and trends, is required prior to using previous test results to estimate the homeostatic set point. To calculate the prRI limits, two different statistical models based on 'prediction intervals' can be applied. The first model utilizes estimates of 'within-person biological variation' which are based on an individual's own data. This model requires a minimum of five previous test results to generate the prRI. The second model is based on estimates of 'within-subject biological variation', which represents an average estimate for a population and can be found, for most measurands, in the EFLM Biological Variation Database. This model can be applied also when there are lower numbers of previous test results available. The prRI offers physicians the opportunity to improve interpretation of individuals' test results, though studies are required to demonstrate if using prRI leads to better clinical outcomes. We recommend that both popRIs and prRIs are included in laboratory reports to aid in evaluating laboratory test results in the follow-up of patients.