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Licensed Unlicensed Requires Authentication Published by De Gruyter December 14, 2021

Indirectly determined hematology reference intervals for pediatric patients in Berlin and Brandenburg

  • Ingo Mrosewski EMAIL logo , Tobias Dähn , Jörg Hehde , Elena Kalinowski , Ilona Lindner , Thea Marie Meyer , Michael Olschinsky-Szermer , Jana Pahl , Monika Puls , Kristin Sachse and Rafael Switkowski

Abstract

Objectives

Establishing direct reference intervals (RIs) for pediatric patients is a very challenging endeavor. Indirectly determined RIs can address this problem by utilization of existing clinical laboratory databases. In order to provide better laboratory services to the local pediatric population, we established population-specific hematology RIs via data mining.

Methods

Our laboratory information system (LIS) was searched for pediatric blood counts of patients aged from 0 days to 18 years, performed from 1st of January 2018 until 31st of March 2021. In total, 27,554 blood counts on our SYSMEX XN-9000 were initially identified. After application of pre-defined exclusion criteria, 18,531 sample sets remained. Age- and sex-specific RIs were established in accordance with International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) and Clinical & Laboratory Standards Institute (CLSI) recommendations.

Results

When compared to pediatric RIs supplied by other authors, the RIs determined specifically for pediatric patients from Berlin and Brandenburg showed several relevant differences, especially with regard to white blood cell counts (WBCs), red blood cell counts (RBCs), red cell distribution widths (RDW) and platelet counts (PLTs) within the distinct age groups. Additionally, alterations to several published age-specific partitions had to be made, while new sex-specific partitions were introduced for WBCs and PLTs.

Conclusions

Generic RIs from textbooks, manufacturer information and medical publications – even from nationwide or multicenter studies – commonly used in many laboratories might not reflect the specifics of local patient populations properly. RIs should be tailored to the serviced patient population whenever possible. Careful data mining appears to be suitable for this task.


Corresponding author: Dr. Ingo Mrosewski, Department of Laboratory Medicine, MDI Limbach Berlin GmbH, Aroser Allee 84, 13407 Berlin, Germany, Phone: +49 30 443364 533, Fax: +49 30 443364 111, E-mail:

Acknowledgments

The authors thank Christin Renner for data retrieval from the laboratory information system.

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Not applicable.

  5. Ethical approval: Research involving human subjects complied with all relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration (as revised in 2013), and has been approved by the authors’ Institutional Review Board (Ärztekammer Berlin) or equivalent committee. (Register-Nr.: 225128: 03/2021).

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Received: 2021-07-30
Accepted: 2021-12-02
Published Online: 2021-12-14
Published in Print: 2022-02-23

© 2021 Walter de Gruyter GmbH, Berlin/Boston

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