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Indirectly determined reference intervals for automated white blood cell differentials of pediatric patients in Berlin and Brandenburg

  • Ingo Mrosewski EMAIL logo , Tobias Dähn , Jörg Hehde , Elena Kalinowski , Ilona Lindner , Thea Maria Meyer , Michael Olschinsky-Szermer , Jana Pahl , Monika Puls , Kristin Sachse and Rafael Switkowski
Published/Copyright: January 23, 2023
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 61 Issue 6

Abstract

Objectives

Establishing direct reference intervals for pediatric patients is a costly, challenging, and time-consuming enterprise. Indirectly established reference intervals can help to ameliorate this situation. It was our objective to establish population-specific reference intervals for automated white blood cell differentials via data mining and non-parametric percentile method.

Methods

Blood counts and automated white blood cell differentials of patients aged 0 days to 18 years, performed from the 1st of January 2018 until the 30th of June 2022, were identified in our laboratory information system. Reference intervals were established in accordance with IFCC and CLSI recommendations as well as the propositions by Haeckel et al.

Results

Initially, 47,173 blood counts on our SYSMEX XN-9000 were identified. 11,707 data sets were excluded, leaving 35,466 sample sets for analysis. Of these, 17,616 contained automated white blood cell differentials. Due to insufficient patient numbers, no reference intervals for automated white blood cell differentials could be established for children aged <7 months. In comparison to the corresponding reference intervals published by Herklotz et al., reference intervals determined by us showed relevant differences throughout all age groups.

Conclusions

The combination of non-parametric percentile method and the propositions by Haeckel et al. utilizing conscientious data mining appears to be potent alternative to direct reference interval determination.

Keywords: data mining; differential blood count; hematology; indirect reference interval; indirect reference range; pediatric; white blood cell differential
Corresponding author: Dr. Ingo Mrosewski, Department of Laboratory Medicine, MDI Limbach Berlin GmbH, Aroser Allee 84, 13407 Berlin, Berlin, Germany, Phone: +49 30 443364 533, Fax: +49 30 443364 111, E-mail:

Acknowledgments

The authors thank Christin Renner and Paul Nentwig for data retrieval from the laboratory information system.

  1. Research funding: None to declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Not applicable.

  5. Ethical approval: Research involving human subjects complied with all relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration (as revised in 2013), and has been approved by the authors’ Institutional Review Board (Ärztekammer Berlin) or equivalent committee. (Register-Nr.: 225128: 03/2021).

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Supplementary Material

This article contains supplementary material (https://doi.org/10.1515/cclm-2022-1265).

Received: 2022-11-09
Accepted: 2023-01-12
Published Online: 2023-01-23
Published in Print: 2023-05-25

© 2023 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2022-1265
Keywords for this article
data mining; differential blood count; hematology; indirect reference interval; indirect reference range; pediatric; white blood cell differential

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Improving access to diagnostic testing in conflict-affected areas: what is needed?
  4. Review
  5. Deciphering the role of monocyte and monocyte distribution width (MDW) in COVID-19: an updated systematic review and meta-analysis
  6. Opinion Paper
  7. From research cohorts to the patient – a role for “omics” in diagnostics and laboratory medicine?
  8. EFLM Paper
  9. The European Register of Specialists in Clinical Chemistry and Laboratory Medicine: code of conduct, version 3 – 2023
  10. Guidelines and Recommendations
  11. Cardiac troponin measurement at the point of care: educational recommendations on analytical and clinical aspects by the IFCC Committee on Clinical Applications of Cardiac Bio-Markers (IFCC C-CB)
  12. Genetics and Molecular Diagnostics
  13. A new and improved method of library preparation for non-invasive prenatal testing: plasma to library express technology
  14. Multiplex proteomics using proximity extension assay for the identification of protein biomarkers predictive of acute graft-vs.-host disease in allogeneic hematopoietic cell transplantation
  15. General Clinical Chemistry and Laboratory Medicine
  16. Assessment of laboratory capacity in conflict-affected low-resource settings using two World Health Organization laboratory assessment tools
  17. Challenge in hyponatremic patients – the potential of a laboratory-based decision support system for hyponatremia to improve patient’s safety
  18. Evaluation of hemolysis, lipemia, and icterus interference with common clinical immunoassays
  19. Serum bicarbonate stability study at room temperature – influence of time to centrifugation and air exposure on bicarbonate measurement reported according to the CRESS checklist
  20. Effects of lipemia on capillary serum protein electrophoresis in native ultra-lipemic material and intravenous lipid emulsion added sera
  21. C-reactive protein interacts with amphotericin B liposomes and its potential clinical consequences
  22. Evaluation of analytical performance of homocysteine LC-MS/MS assay and design of internal quality control strategy
  23. A reliable and high throughput HPLC–HRMS method for the rapid screening of β-thalassemia and hemoglobinopathy in dried blood spots
  24. Dynamics of the vitamin D C3-epimer levels in preterm infants
  25. Comparison of ANA testing by indirect immunofluorescence or solid-phase assays in a low pre-test probability population for systemic autoimmune disease: the Camargo Cohort
  26. Reference Values and Biological Variations
  27. LMS-based continuous reference percentiles for 14 laboratory parameters in the CALIPER cohort of healthy children and adolescents
  28. Indirectly determined reference intervals for automated white blood cell differentials of pediatric patients in Berlin and Brandenburg
  29. Infectious Diseases
  30. Evaluation of a high-sensitivity SARS-CoV-2 antigen test on the fully automated light-initiated chemiluminescent immunoassay platform
  31. Letters to the Editor
  32. Non-esterified fatty acids (NEFA): sample stability and effect of haemolysis and icterus
  33. Frozen serum sample pool should not be used as internal quality assessment for lipemia (L) index
  34. Stability of SARS-CoV-2 respiratory samples in non-freezing condition: importance for tropical countries under heavy diagnostic demand
  35. A rare case of both macro-TSH and macro-LH: laboratory analysis of the pathogenesis
  36. A new method for early cancer detection based on platelet transcriptomics will have low positive predictive value
  37. Comparison of near-infrared and UV–vis-based non-contact hematocrit prediction of dried blood spots from patients on immunosuppressants
  38. The diagnostics of heparin-induced thrombocytopenia in Italy and the possible impact of vaccine-induced immune thrombotic thrombocytopenia on it
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  42. 43rd annual conference of the association of clinical biochemists in Ireland (ACBI 2021)
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