Creating ethnicity-specific reference intervals for lab tests from EHR data

By Nadav Rappoport, Hyojung Paik, Boris Oskotsky, R. Tor, E. Ziv, Noah A. Zaitlen, Atul J. Butte. 2017

6 citations recorded by the source corpus.

The results of clinical lab tests are an essential component of medical decision-making. To guide interpretation, test results are returned with reference intervals defined by the range in which 95% of values occur in healthy individuals. Clinical laboratories often set their own reference intervals to accommodate local population and instruments variations. This approach is costly and can be biased. We describe a novel data-driven method for using electronic health record data to extract healthy patients’ information to define reference intervals. We found that the distributions of many clinical lab tests differ among self-identified racial and ethnic groups (SIREs) in healthy patients. Finally, we derived SIRE-specific reference intervals and provide evidence that these intervals have clinical prognostic value. Specifically, we show that for two lab tests, serum creatinine level and hemoglobin A1C, SIRE-specific reference intervals are more predictive for need for dialysis and development type 2 diabetes than existing reference intervals. One Sentence Summary A novel method for defining population-specific reference intervals of common clinical laboratory tests from electronical health records has better prognostic value than existing reference intervals.

Subfields: Clinical Biochemistry, Genetics, Molecular Biology

Citations in the corpus

• The critical needs and challenges for genetic architecture studies in Africa (2018, unknown): “common clinical lab tests will more easily ensure better prognostic value than existing 5 reference intervals [87].”