Karbasy Kimiya, Ariadne Petra, Gaglione Stephanie, Nieuwesteeg Michelle, Adeli Khosrow
CALIPER program, Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.
CALIPER program, Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
J Med Biochem. 2015 Jan;34(1):23-30. doi: 10.2478/jomb-2014-0063. Epub 2014 Oct 8.
Clinical laboratory reference intervals provide valuable information to medical practitioners in their interpretation of quantitative laboratory test results, and therefore are critical in the assessment of patient health and in clinical decision-making. The reference interval serves as a health-associated benchmark with which to compare an individual test result. Unfortunately, critical gaps currently exist in accurate and up-to-date pediatric reference intervals for accurate interpretation of laboratory tests performed in children and adolescents. These critical gaps in the available laboratory reference intervals have the clear potential of contributing to erroneous diagnosis or misdiagnosis of many diseases. To address these important gaps, several initiatives have begun internationally by a number of bodies including the KiGGS initiative in Germany, the Aussie Normals in Australia, the AACC-National Children Study in USA, the NORICHILD Initiative in Scandinavia, and the CALIPER study in Canada. In the present article, we will review the gaps in pediatric reference intervals, challenges in establishing pediatric norms in healthy children and adolescents, and the major contributions of the CALIPER program to closing the gaps in this crucial area of pediatric laboratory medicine. We will also discuss the recently published CALIPER reference interval database (www.caliperdatabase.com) developed to provide comprehensive age and gender specific pediatric reference intervals for a larger number of biochemical markers, based on a large and diverse healthy children cohort. The CALIPER database is based on a multiethnic population examining the influence of ethnicity on laboratory reference intervals. Thus the database has proved to be of global benefit and is being adopted by hospital laboratories worldwide.
临床实验室参考区间为医学从业者解读定量实验室检测结果提供了有价值的信息，因此在评估患者健康状况和临床决策中至关重要。参考区间作为一个与健康相关的基准，用于比较个体检测结果。不幸的是，目前在准确且最新的儿科参考区间方面存在关键差距，这对于准确解读儿童和青少年所进行的实验室检测至关重要。现有实验室参考区间中的这些关键差距显然有可能导致许多疾病的误诊或漏诊。为了填补这些重要差距，包括德国的KiGGS计划、澳大利亚的Aussie Normals、美国的AACC - 国家儿童研究、斯堪的纳维亚的NORICHILD计划以及加拿大的CALIPER研究在内的多个机构已在国际上启动了多项举措。在本文中，我们将回顾儿科参考区间的差距、在健康儿童和青少年中建立儿科标准所面临的挑战，以及CALIPER计划在填补儿科检验医学这一关键领域差距方面的主要贡献。我们还将讨论最近发布的CALIPER参考区间数据库（www.caliperdatabase.com），该数据库基于一个庞大且多样化的健康儿童队列，为大量生化标志物提供了全面的按年龄和性别的儿科参考区间。CALIPER数据库基于一个多民族人群，研究了种族对实验室参考区间的影响。因此，该数据库已被证明具有全球益处，并正在被世界各地的医院实验室采用。
