Evidence map›Paper›PMID 37080741›Full record

ReviewAnnals of laboratory medicine2023

Functional Reference Limits: Describing Physiological Relationships and Determination of Physiological Limits for Enhanced Interpretation of Laboratory Results.

Tyng Yu Chuah, Chun Yee Lim, Rui Zhen Tan, Busadee Pratumvinit, Tze Ping Loh, Samuel Vasikaran, Corey Markus, APFCB Harmonization of Reference Intervals Working Group

Abstract readReview
In one paragraph

Review in Annals of laboratory medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Tyng Yu ChuahDepartment of General Medicine (Rheumatology), Sengkang General Hospital,Singapore, Singapore.ORCID 0000-0001-9592-8060
Chun Yee LimEngineering Cluster, Singapore Institute of Technology, Singapore, Singapore.ORCID 0000-0002-1837-2705
Rui Zhen TanEngineering Cluster, Singapore Institute of Technology, Singapore, Singapore.ORCID 0000-0002-7464-5245
Busadee PratumvinitFaculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.ORCID 0000-0002-5220-0552
Tze Ping LohDepartment of Laboratory Medicine, National University Hospital, Singapore, Singapore.ORCID 0000-0002-4272-0001
Samuel VasikaranDepartment of Clinical Biochemistry, PathWest Laboratory Medicine, Adelaide, Australia.ORCID 0000-0002-0831-3031
Corey MarkusFlinders University International Centre for Point-of-Care Testing, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia.ORCID 0000-0002-5594-9737
APFCB Harmonization of Reference Intervals Working Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Functional reference limits describe key changes in the physiological relationship between a pair of physiologically related components. Statistically, this can be represented by a significant change in the curvature of a mathematical function or curve (e.g., an observed plateau). The point at which the statistical relationship changes significantly is the point of curvature inflection and can be mathematically modeled from the relationship between the interrelated biomarkers. Conceptually, they reside between reference intervals, which describe the statistical boundaries of a single biomarker within the reference population, and clinical decision limits that are often linked to the risk of morbidity or mortality and set as thresholds. Functional reference limits provide important physiological and pathophysiological insights that can aid laboratory result interpretation. Laboratory professionals are in a unique position to harness data from laboratory information systems to derive clinically relevant values. Increasing research on and reporting of functional reference limits in the literature will enhance their contribution to laboratory medicine and widen the evidence base used in clinical decision limits, which are currently almost exclusively contributed to by clinical trials. Their inclusion in laboratory reports will enhance the intellectual value of laboratory professionals in clinical care beyond the statistical boundaries of a healthy reference population and pave the way to them being considered in shaping clinical decision limits. This review provides an overview of the concepts related to functional reference limits, clinical examples of their use, and the impetus to include them in laboratory reports.

Indexed as

Clinical Laboratory TechniquesLaboratoriesBiomarkersHumansReference ValuesBiomarkersHomeostasisReference valuesThreshold limit values

Identifiers

PMID37080741
PMCPMC10151278

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.