ArticleAnnals of laboratory medicine2020
Clinical Application of Overlapping Confidence Intervals for Monitoring Changes in Serial Clinical Chemistry Test Results.
Article in Annals of laboratory medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The incidence of sleepiness in newer-generation antihistamine users: a systematic review and network meta-analysis.European journal of clinical pharmacology · 2026Pooled it
- Performance of stenting in femoropopliteal disease: a systematic literature review and meta-analysis of proportions.Journal of comparative effectiveness research · 2026Pooled it
- Reliability of Average Daily Steps Measured Through a Consumer Smartwatch in Parkinson Disease Phenotypes, Stages, and Severities: Cross-Sectional Study.JMIR formative research · 2025Article
- Establishing Normative Values to Determine the Prevalence of Biochemical Hyperandrogenism in Premenopausal Women of Different Ethnicities from Eastern Siberia.Diagnostics (Basel, Switzerland) · 2022Article
- Biological variation and reference change values of serum Mac-2-binding protein glycosylation isomer (M2BPGi).Journal of clinical laboratory analysis · 2022Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInterpretation of changes in serial laboratory results is necessary for both clinicians and laboratories; however, setting decision limits is not easy. Although the reference change value (RCV) has been widely used for auto-verification, it has limitations in clinical settings. We introduce the concept of overlapping confidence intervals (CIs) to determine whether the changes are statistically significant in clinical chemistry laboratory test results.
methodsIn total, 1,202,096 paired results for 33 analytes routinely tested in our clinical chemistry laboratory were analyzed. The distributions of delta% absolute values and cut-off values for certain percentiles were calculated. The CIs for each analyte were set based on biological variation, and data were analyzed at various confidence levels. Additionally, we analyzed the data using RCVs and compared their clinical utility.
resultsMost analytes had low indexes of individuality with large inter-individual variability. The 97.5th percentile cut-offs for each analyte were much larger than conventional RCVs. The percentages of results exceeding RCV
conclusionsThe use of overlapping CIs in serial clinical chemistry test results can overcome the limitations of existing RCVs and replace them, especially for analytes with large intra-individual variation.
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