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基于群体数据与个性化数据的诊断:检验医学中不断演变的范式

Diagnosis Based on Population Data versus Personalized Data: The Evolving Paradigm in Laboratory Medicine.

作者信息

Coskun Abdurrahman

机构信息

Department of Medical Biochemistry, School of Medicine, Acıbadem Mehmet Ali Aydinlar University, 34752 Istanbul, Turkey.

出版信息

Diagnostics (Basel). 2024 Sep 25;14(19):2135. doi: 10.3390/diagnostics14192135.

Abstract

The diagnosis of diseases is a complex process involving the integration of multiple parameters obtained from various sources, including laboratory findings. The interpretation of laboratory data is inherently comparative, necessitating reliable references for accurate assessment. Different types of references, such as reference intervals, decision limits, action limits, and reference change values, are essential tools in the interpretation of laboratory data. Although these references are used to interpret individual laboratory data, they are typically derived from population data, which raises concerns about their reliability and consequently the accuracy of interpretation of individuals' laboratory data. The accuracy of diagnosis is critical to all subsequent steps in medical practice, making the estimate of reliable references a priority. For more precise interpretation, references should ideally be derived from an individual's own data rather than from population averages. This manuscript summarizes the current sources of references used in laboratory data interpretation, examines the references themselves, and discusses the transition from population-based laboratory medicine to personalized laboratory medicine.

摘要

疾病诊断是一个复杂的过程,涉及整合从各种来源获得的多个参数,包括实验室检查结果。实验室数据的解读本质上是比较性的,需要可靠的参考标准来进行准确评估。不同类型的参考标准,如参考区间、决策限、行动限和参考变化值,是解读实验室数据的重要工具。尽管这些参考标准用于解读单个实验室数据,但它们通常来自总体数据,这引发了对其可靠性以及由此导致的个体实验室数据解读准确性的担忧。诊断的准确性对于医疗实践中的所有后续步骤至关重要,因此估计可靠的参考标准成为当务之急。为了更精确地解读,理想情况下参考标准应来自个体自身的数据,而非总体平均值。本文总结了当前实验室数据解读中使用的参考标准来源,审视了参考标准本身,并讨论了从基于总体的检验医学向个性化检验医学的转变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a156/11475514/efa371435874/diagnostics-14-02135-g001.jpg

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