A combined approach to generate laboratory reference intervals using unbalanced longitudinal data
-
Mandy Vogel
,
Toralf Kirsten
Abstract
Background:
The interpretation of individual laboratory test results requires the availability of population-based reference intervals. In children, reference interval estimation has to consider frequently the strong age-dependency. Generally, for the construction of reference intervals, a sufficiently large number of independent measurement values is required. Data selections from hospitals or cohort studies often comprise dependencies violating the independence assumption.
Methods:
In this article, we propose a combination of LMS-like (mean, M; coefficient of variation, S; skewness, λ or L) and resampling methods to overcome this drawback. The former is recommended by the World Health Organization (WHO) for the construction of continuous reference intervals of anthropometric measurements in children. The approach allows the inclusion of dependent measurements, for example, repeated measurements per subject. It also provides pointwise confidence envelopes as a measure of reliability.
Results and conclusions:
The combination of LMS-type methods and resampling provides a feasible approach to estimate age-dependent percentiles and reference intervals using unbalanced longitudinal data.
Acknowledgments
We would like to thank David Petroff for his valuable comments during the writing process.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: This publication is supported by the Leipzig Research Center for Civilization Diseases, University of Leipzig. LIFE is funded by means of the European Union, the European Regional Development Fund (ERDF), (Grant/Award Number: ‘LIFE-013: 100232872/713-3000634982’) and the Free State of Saxony within the framework of the excellence initiative.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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©2017 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Original Articles
- High prevalence of organ specific autoantibodies in Indian type 1 diabetic patients
- Improved metabolic control in tetrahydrobiopterin (BH4), responsive phenylketonuria with sapropterin administered in two divided doses vs. a single daily dose
- Excessive weight gain in exclusively breast-fed infants
- Comparison of Tanner staging of HIV-infected and uninfected girls at the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria
- Joint association of screen time and physical activity with anthropometric measures in Iranian children and adolescents: the weight disorders survey of the CASPIAN-IV study
- Assessment of insulin like growth factor-1 and IGF binding protein-3 in healthy Indian girls from Delhi and their correlation with age, pubertal status, obesity and thyroid hormonal status
- Impact of discontinuation of growth hormone treatment on lipids and weight status in adolescents
- Clinical, biochemical and genetic features with nonclassical 21-hydroxylase deficiency and final height
- A combined approach to generate laboratory reference intervals using unbalanced longitudinal data
- Clinical evaluation and mutational analysis of GALK and GALE genes in patients with galactosemia in Greece: one novel mutation and two rare cases
- Case Reports
- Pediatric toxic polycystic thyroid
- In utero virilization secondary to a maternal Krukenberg tumor: case report and review of literature
- Postprandial hyperinsulinemic hypoglycemia in a child as a late complication of esophageal reconstruction
- Long-term follow-up of a child with Klinefelter syndrome and achondroplasia from infancy to 16 years
Articles in the same Issue
- Frontmatter
- Original Articles
- High prevalence of organ specific autoantibodies in Indian type 1 diabetic patients
- Improved metabolic control in tetrahydrobiopterin (BH4), responsive phenylketonuria with sapropterin administered in two divided doses vs. a single daily dose
- Excessive weight gain in exclusively breast-fed infants
- Comparison of Tanner staging of HIV-infected and uninfected girls at the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria
- Joint association of screen time and physical activity with anthropometric measures in Iranian children and adolescents: the weight disorders survey of the CASPIAN-IV study
- Assessment of insulin like growth factor-1 and IGF binding protein-3 in healthy Indian girls from Delhi and their correlation with age, pubertal status, obesity and thyroid hormonal status
- Impact of discontinuation of growth hormone treatment on lipids and weight status in adolescents
- Clinical, biochemical and genetic features with nonclassical 21-hydroxylase deficiency and final height
- A combined approach to generate laboratory reference intervals using unbalanced longitudinal data
- Clinical evaluation and mutational analysis of GALK and GALE genes in patients with galactosemia in Greece: one novel mutation and two rare cases
- Case Reports
- Pediatric toxic polycystic thyroid
- In utero virilization secondary to a maternal Krukenberg tumor: case report and review of literature
- Postprandial hyperinsulinemic hypoglycemia in a child as a late complication of esophageal reconstruction
- Long-term follow-up of a child with Klinefelter syndrome and achondroplasia from infancy to 16 years
