Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark.
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Clin Chem Lab Med. 2021 Dec 3;60(2):252-260. doi: 10.1515/cclm-2021-0987. Print 2022 Jan 27.
Indirect data mining methods have been proposed for review of published reference intervals (RIs), but methods for identifying patients with a low likelihood of disease are needed. Many indirect methods extract test results on patients with a low frequency blood sampling history to identify putative healthy individuals. Although it is implied there has been no attempt to validate if patients with a low frequency blood sampling history are healthy and if test results from these patients are suitable for RI review.
Danish nationwide health registers were linked with a blood sample database, recording a population of 316,337 adults over a ten-year period. Comorbidity indexes were defined from registrations of hospital diagnoses and redeemed prescriptions of drugs. Test results from patients identified as having a low disease burden were used for review of RIs from the Nordic Reference Interval Project (NORIP).
Blood sampling frequency correlated with comorbidity Indexes and the proportion of patients without disease conditions were enriched among patients with a low number of blood samples. RIs based on test results from patients with only 1-3 blood samples per decade were for many analytes identical compared to NORIP RIs. Some analytes showed expected incongruences and gave conclusive insights into how well RIs from a more than 10 years old multi-center study (NORIP) performed on current pre-analytical and analytical methods.
Blood sampling frequency enhance the selection of healthy individuals for reviewing reference intervals, providing a simple method solely based on laboratory data without the addition of clinical information.
已经提出了间接数据挖掘方法来审查已发表的参考区间（RI），但仍需要确定疾病可能性低的患者的方法。许多间接方法提取具有低频率采血史的患者的测试结果，以识别可能的健康个体。尽管暗示没有尝试验证具有低频率采血史的患者是否健康，以及这些患者的测试结果是否适合 RI 审查。
丹麦全国健康登记与一个血样数据库相链接，记录了 316337 名成年人在十年期间的情况。从医院诊断记录和药物处方兑换中定义了合并症指数。从被认为疾病负担低的患者中识别出的测试结果用于审查北欧参考区间项目（NORIP）的 RI。
采血频率与合并症指数相关，并且具有低数量采血的患者中无疾病状况的患者比例得到了丰富。基于每十年仅 1-3 次采血的患者的测试结果建立的 RI 对于许多分析物与 NORIP RI 相比是相同的。一些分析物显示出预期的不一致性，并深入了解了超过 10 年的多中心研究（NORIP）的 RI 在当前的前分析和分析方法上的表现如何。
采血频率增强了对健康个体进行参考区间审查的选择，提供了一种仅基于实验室数据的简单方法，而无需添加临床信息。
