基于电子健康记录数据比较临床检验项目的特定种族参考区间
Comparing Ethnicity-Specific Reference Intervals for Clinical Laboratory Tests from EHR Data.
作者信息
Rappoport Nadav, Paik Hyojung, Oskotsky Boris, Tor Ruth, Ziv Elad, Zaitlen Noah, Butte Atul J
机构信息
Institute for Computational Health Sciences, University of California, San Francisco, CA.
Department of Pediatrics, University of California, San Francisco, San Francisco, CA.
出版信息
J Appl Lab Med. 2018 Nov 1;3(3):366-377. doi: 10.1373/jalm.2018.026492.
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.
背景
临床实验室检测结果是医疗决策的重要组成部分。为指导解读，检测结果会附带参考区间，该区间由健康个体中95%的中心值范围确定。临床实验室通常会设定自己的参考区间，以适应当地人群和仪器设备的差异。对于某些检测，参考区间会因性别、年龄以及自我认定的种族和民族而有所变化。
方法
在这项研究中，我们开发了一种利用电子健康记录数据的新方法，以识别健康个体并检测不同人群之间实验室检测值的差异。
结果
我们发现，在健康个体中，目前具有固定参考区间的50%以上的实验室检测在自我认定的种族和民族群体（SIREs）之间分布存在差异。
结论
我们的结果证实了已知的肌酐在不同种族和民族群体中的差异，并表明需要进行更多研究，以确定对其他具有种族和民族群体特定分布的检测使用一刀切的参考区间的临床意义。
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