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Cited by 49Clinical Laboratory Practices and Quality ControlRace, Genetics, and SocietyMachine Learning in Healthcare

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

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Rappoport, Nadav, Paik, Hyojung, Oskotsky, Boris, Tor, Ruth, Ziv, Elad, Zaitlen, Noah, Butte, Atul J·2018·The Journal of Applied Laboratory Medicine
DOI 10.1373/jalm.2018.026492PMC PMC8404742

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Abstract

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.

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Authors
Rappoport, N., Paik, H., Oskotsky, B., Tor, R., Ziv, E., Zaitlen, N., & Butte, A. J.
Affiliations
  • University of California, San Francisco (US)
  • Institute for Computational Health Sciences , University of California, San Francisco, CA
  • Rabin Medical Center (IL)
Corresponding author
Butte, Atul J
ORCID
Venue
The Journal of Applied Laboratory Medicine
Publisher
Oxford University Press (OUP)
Published
2018-11-01
Volume
3
Issue
3
Pages
366-377
ISSN
  • 2475-7241 (ISSN-L)
  • 2576-9456
DOI
10.1373/jalm.2018.026492
PMC
PMC8404742
OpenAlex
W2808914039
Cited by
49
References
3
Citations by year
2026: 5 · 2025: 10 · 2024: 6 · 2023: 7 · 2022: 4 · 2021: 9 · 2020: 1 · 2019: 3 · 2018: 4
FWCI
2.92
Type
journal article
Language
en
Open access
Licence
academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations
  • The Journal of Applied Laboratory Medicine (publishedVersion)
  • bioRxiv (Cold Spring Harbor Laboratory) (acceptedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • National Institute of General Medical Sciences
  • National Institutes of Health (R01GM079719)
Topics
  • Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Race, Genetics, and Society
  • Physical Sciences › Computer Science › Artificial Intelligence › Machine Learning in Healthcare
Keywords
reference values, healthy individuals, electronic health records, creatinine

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