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Normality: the unreachable star?
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Claude Petitclerc
Published/Copyright:
June 1, 2005
Abstract
The concept of reference values is widely accepted, but their application has been quite lax over the years. This is due primarily to the difficulty of properly selecting and documenting samples from a reference population. In the absence of a clear description of reference individuals, reference values lose their meaning, are ambiguous at best, and are often confused with decision limits. The clinical medicine perspective of reference values is to rule out diseases and to define health, while that of preventive medicine is to appreciate the state of health. Defining reference limits and normality in this context is a great challenge. Advances in the fields of genomics and proteomics and the rapid pace of technological advances help highlight the biological diversity among individuals. However, there is a great need for reference values that are representative of healthy humans and presented in a manner that they can be utilized by all laboratories. In addition, as secure information technology becomes available, the goal of using an individual as their own reference during a lifetime is now possible, provided that consistency of databases is ensured.
Published Online: 2005-6-1
Published in Print: 2004-7-5
Copyright © 2004 by Walter de Gruyter GmbH & Co. KG
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Articles in the same Issue
- Editors introduction
- Reference values: from philosophy to a tool for laboratory medicine
- The evolution of the reference value concept
- Normality: the unreachable star?
- Selecting clinically relevant populations for reference intervals
- The IFCC recommendation on estimation of reference intervals. The RefVal Program
- Graphical interpretation of confidence curves in rankit plots
- Partitioning biochemical reference data intosubgroups: comparison of existing methods
- Parametric methods for estimating covariate-dependent reference limits
- Reference regions of two or more dimensions
- Should we maintain the 95 percent reference intervals in the era of wellness testing? A concept paper
- Clinical interpretation of reference intervals and reference limits. A plea for assay harmonization
- Inherent biological variation and reference values
- Intraindividual reference values
- Guideline for the production of multicentre physiological reference values using the same measurement system. A proposal of the Catalan Association for Clinical Laboratory Sciences
- Proposal for guidelines to establish common biological reference intervals in large geographical areas for biochemical quantities measured frequently in serum and plasma
- Reference intervals for plasma proteins: similarities and differences between adult Caucasian and Asian Indian males in Yorkshire, UK
- Diagnostic and epidemiological implications of regional differences in serum concentrations of proteins observed in six Asian cities
- Study of reference values and biological variation: a necessity and a model for Preventive Medicine Centers
- Creation of a low-risk reference group and referenceinterval of fasting venous plasma glucose
- Establishment of a serum thyroid stimulating hormone (TSH) reference interval in healthy adults. The importance of environmental factors, including thyroid antibodies
- Difficulties in establishing reference intervals for special fluids: the example of 5-hydroxyindoleacetic acid and homovanillic acid in cerebrospinal fluids
- Metrological traceability of calibration in the estimation and use of common medical decision-making criteria
- Creation of the necessary analytical quality for generating and using reference intervals
- Analytical quality specifications for common reference intervals
- Design of internal quality control for reference value studies
- The NEXUS vision: an alternative to the reference value concept
- Meetings and Awards
Articles in the same Issue
- Editors introduction
- Reference values: from philosophy to a tool for laboratory medicine
- The evolution of the reference value concept
- Normality: the unreachable star?
- Selecting clinically relevant populations for reference intervals
- The IFCC recommendation on estimation of reference intervals. The RefVal Program
- Graphical interpretation of confidence curves in rankit plots
- Partitioning biochemical reference data intosubgroups: comparison of existing methods
- Parametric methods for estimating covariate-dependent reference limits
- Reference regions of two or more dimensions
- Should we maintain the 95 percent reference intervals in the era of wellness testing? A concept paper
- Clinical interpretation of reference intervals and reference limits. A plea for assay harmonization
- Inherent biological variation and reference values
- Intraindividual reference values
- Guideline for the production of multicentre physiological reference values using the same measurement system. A proposal of the Catalan Association for Clinical Laboratory Sciences
- Proposal for guidelines to establish common biological reference intervals in large geographical areas for biochemical quantities measured frequently in serum and plasma
- Reference intervals for plasma proteins: similarities and differences between adult Caucasian and Asian Indian males in Yorkshire, UK
- Diagnostic and epidemiological implications of regional differences in serum concentrations of proteins observed in six Asian cities
- Study of reference values and biological variation: a necessity and a model for Preventive Medicine Centers
- Creation of a low-risk reference group and referenceinterval of fasting venous plasma glucose
- Establishment of a serum thyroid stimulating hormone (TSH) reference interval in healthy adults. The importance of environmental factors, including thyroid antibodies
- Difficulties in establishing reference intervals for special fluids: the example of 5-hydroxyindoleacetic acid and homovanillic acid in cerebrospinal fluids
- Metrological traceability of calibration in the estimation and use of common medical decision-making criteria
- Creation of the necessary analytical quality for generating and using reference intervals
- Analytical quality specifications for common reference intervals
- Design of internal quality control for reference value studies
- The NEXUS vision: an alternative to the reference value concept
- Meetings and Awards
