Comparing Ethnicity-Specific Reference Intervals for Clinical Laboratory Tests from EHR Data

By Nadav Rappoport, Hyojung Paik, Boris Oskotsky, R. Tor, E. Ziv, Noah A. Zaitlen, Atul J. Butte. 2018

35 citations recorded by the source corpus.

Background: The results of clinical laboratory 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 the central 95% of values occur in healthy individuals. Clinical laboratories often set their own reference intervals to accommodate variation in local population and instrumentation. For some tests, reference intervals change as a function of sex, age, and self-identified race and ethnicity. Methods: In this work, we develop a novel approach, which leverages electronic health record data, to identify healthy individuals and tests for differences in laboratory test values between populations. Results: We found that the distributions of >50% of laboratory tests with currently fixed reference intervals differ among self-identified racial and ethnic groups (SIREs) in healthy individuals. Conclusions: Our results confirm the known SIRE-specific differences in creatinine and suggest that more research needs to be done to determine the clinical implications of using one-size-fits-all reference intervals for other tests with SIRE-specific distributions.

Subfields: Genetics, Physiology