Cardillo Anthony B, Chen Dan, Haghi Nina, O'Donnell Luke, Jhang Jeffrey, Testa Paul A, Genes Nicholas
MCIT Department of Health Informatics, NYU Langone Health, New York, United States.
Department of Pathology, NYU Langone Health, New York, United States.
Appl Clin Inform. 2024 Oct;15(5):1093-1096. doi: 10.1055/s-0044-1791488. Epub 2024 Dec 18.
This study aimed to highlight the necessity of developing and implementing appropriate reference ranges for transgender and nonbinary (TGNB) patient populations to minimize misinterpretation of laboratory results and ensure equitable health care.
We describe a situation where a TGNB patient's abnormal laboratory values were not flagged due to undefined reference ranges for gender "X" in the Laboratory Information System (LIS). Implementation of additional reference ranges mapped to sex label "X" showed significant improvement in flagging abnormal lab results, utilizing sex-invariant reporting as an interim solution while monitoring developments on TGNB-specific reference ranges.
Informatics professionals should assess their institution's policies for registration and lab reporting on TGNB patients as nonimplementation poses significant patient safety risks. Best practices include using TGNB-specific reference ranges emerging in the literature, reporting both male and female reference ranges for clinical interpretation and sex-invariant reporting.
本研究旨在强调为跨性别和非二元性别（TGNB）患者群体制定和实施适当参考范围的必要性，以尽量减少对实验室结果的误解，并确保公平的医疗保健。
我们描述了一种情况，即由于实验室信息系统（LIS）中性别“X”的参考范围未定义，一名TGNB患者的异常实验室值未被标记。实施映射到性别标签“X”的额外参考范围后，在标记异常实验室结果方面有显著改善，在监测TGNB特定参考范围的进展时，将性别不变报告作为临时解决方案。
信息学专业人员应评估其机构关于TGNB患者登记和实验室报告的政策，因为不实施会带来重大的患者安全风险。最佳实践包括使用文献中出现的TGNB特定参考范围，报告男性和女性参考范围以供临床解释以及进行性别不变报告。
