ReviewBritish journal of biomedical science2024
The Role and Limitations of the Reference Interval Within Clinical Chemistry and Its Reliability for Disease Detection.
Review in British journal of biomedical science, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed.
- Beyond single cut-off values in ultrasound: limitations and implications for context-aware radiology reporting.Insights into imaging · 2026Review
- Reference Values for Biochemical Analytes in An Iranian Population: The Tehran Lipid and Glucose Study.International journal of endocrinology and metabolism · 2026Review
- Impacts of new sex- and age-specific TSH and FT4 reference ranges on thyroid status and metabolic disorder associations.Journal of the Endocrine Society · 2026Article
- Automated Metrics for the Diagnosis of Instability Between the 2nd and 7th Cervical Vertebrae.Bioengineering (Basel, Switzerland) · 2026Article
- Beyond the diagnostic threshold: paradigm shift in laboratory medicine from passive reaction to predictive capability.Frontiers in medicine · 2026Article
- Are accreditation standards fit for measurement uncertainty in clinical laboratories? An analysis of Saudi Arabia's accreditation.Frontiers in medicine · 2026Article
- Article
- A multi-omics-empowered framework for precision diagnosis and treatment of lysosomal diseases.Journal of pharmaceutical analysis · 2025Review
- Early Screening for Developmental Dysplasia of the Hip: Sonographic Reference Values, Risk Factors, and Treatment Considerations.International journal of neonatal screening · 2025Article
- Reference Intervals and Cut-Off Values for Thyroid Tests in the Croatian Adult Population on the Snibe MAGLUMI X6 Immunoassay Analyzer.Diagnostics (Basel, Switzerland) · 2025Article
- Deep phenotyping of health-disease continuum in the Human Phenotype Project.Nature medicine · 2025Article
- Evolution of reference intervals for renal-hepatic biomarkers and micronutrients in normal pregnancy during Covid-19 pandemic (2021-2022) in some hospitals of Kinshasa, Democratic Republic of the Congo.Practical laboratory medicine · 2025Article
- Reference intervals of haematological indices for young adults with sickle cell anaemia in Southwestern Nigeria.BMC research notes · 2025Article
- Hematology, Biochemistry, and Blood Gas Reference Intervals for Captive Anesthetized Long-Tailed Goral (Animals : an open access journal from MDPI · 2025Article
- Hematological reference intervals for adult population of Debre Berhan town, North East Ethiopia.Scientific reports · 2025Article
- Determination of reference intervals for common liver function tests among healthy adults.Scientific reports · 2025Article
- The effect of combined oral contraceptives on thrombin generation assessed on ST Genesia- a paired clinical study.Thrombosis journal · 2025Article
- Article
- Gadoteric Acid and Gadolinium: Exploring Short- and Long-Term Effects on Healthy Animals.Journal of xenobiotics · 2025Article
- Spectral analysis of gastric aspirates obtained shortly after birth predicts the need for prolonged respiratory support in neonates in a development cohort.Frontiers in pediatrics · 2025Article
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Authors and funding
1 author.
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Abstract
Reference intervals (RIs) are a range of values that are supplied alongside laboratory measurements for comparison to allow interpretation of this data. Historically, RIs were referred to as the normal range. However, the perception of what is normal can lead to confusion in clinicians and unnecessary emotional distress in patients. RIs can be acquired using several methods. Laboratories may quote published studies or derive their own using established direct or indirect methods. Alternatively, laboratories may verify RIs provided by assay manufacturers using in-house studies. RIs have several limitations that clinicians should be aware of. The statistical methodology associated with establishment of RIs means that approximately 5% of "disease free" individuals will fall outside the RI. Additionally, the higher the number of tests requested, the higher the probability that one will be abnormal, and repeat results in an individual may show regression to the mean. Completion of studies for establishment of RIs can be expensive, difficult, and time consuming. Method bias and differences in populations can greatly influence RIs and prevent them from being transferable between some laboratories. Differences in individual characteristics such as age, ethnicity, and sex can result in large variation in some analytes. Some patients, such as those whose gender differs from that which was presumed for them at birth, may require their own RIs. Alternatively, a decision will need to be made about which to use. Overall, the issue common to these factors lies within interpretation. As such, RIs can be improved with better training in their use, combined with a better understanding of influences that affect them, and more transparent communication from laboratories in how RIs were derived.
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