Comparing Ethnicity-Specific Reference Intervals for Clinical Laboratory Tests from EHR Data. (1st November 2018)

• Record Type: Journal Article
• Authors: Rappoport, Nadav; Paik, Hyojung; Oskotsky, Boris; Tor, Ruth; Ziv, Elad; Zaitlen, Noah; Butte, Atul J
• Is Part Of: Journal of applied laboratory medicine. Volume 3:Number 3(2018)
• Page Start: 366
• Page End: 377
• Publication Date: 2018-11-01
• Subjects: Clinical chemistry -- Periodicals; Diagnosis, Laboratory -- Periodicals; 616.0756
• DOI: 10.1373/jalm.2018.026492
• Languages: English
• ISSNs: 2576-9456

Abstract

Abstract: Background: The results of clinical laboratory tests are an essential component of medical decision-making. To guide interpretation, test results are returned with reference intervals defined by the range in which the central 95% of values occur in healthy individuals. Clinical laboratories often set their own reference intervals to accommodate variation in local population and instrumentation. For some tests, reference intervals change as a function of sex, age, and self-identified race and ethnicity. Methods: In this work, we develop a novel approach, which leverages electronic health record data, to identify healthy individuals and tests for differences in laboratory test values between populations. Results: We found that the distributions of >50% of laboratory tests with currently fixed reference intervals differ among self-identified racial and ethnic groups (SIREs) in healthy individuals. Conclusions: Our results confirm the known SIRE-specific differences in creatinine and suggest that more research needs to be done to determine the clinical implications of using one-size-fits-all reference intervals for other tests with SIRE-specific distributions.