Reference Intervals For Haematology Parameters In Turkey

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Reference Intervals For Haematology Parameters In
Turkey

• Yesim Ozarda Ilcol1, Z. Banu Hizli 1, Esma Eroz1,
  
• Diler Aslan2
• 1Department of Biochemistry Uludag University
  Medical School Bursa,
• 2Department of Biochemistry Pamukkale University
  Medical School Denizli,
• Turkey
• e-mailyesim_at_uludag.edu.tr

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Reference Intervals

• Reference intervals serve as the basis of
  laboratory testing and aid the physician in
  differentiating between healthy and diseased
  population
• The production of accurate and reliable
  reference values is very important in clinical
  chemistry

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Background

• 2002-2004
• Direct reference intervals
• 41 clinical chemistry analytes
• 328 healthy reference individuals
• 18-45 years of age
• Non-parametric method
• Yesim Ozarda Ilcol, Diler Aslan. Determining
  Reference Value of Blood Chemistry Profile in
  Healthy Subjects in Bursa. Turk J Biochem 2004
  29 (2) 183-192
• 2004-2005
• Indirect reference intervals
• 40 clinical chemistry analytes
• 422,919 records
• 18-45 years of age
• Bhattacharya procedure
• Yesim Ozarda Ilcol, Diler Aslan. Use of total
  patient data for indirect estimation of reference
  intervals for 40 clinical chemical analytes in
  Turkey. Clin Chem Lab Med 2006 44 (7)867876
• 2

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Aim

• Determine laboratory-specific direct reference
  intervals for haematological quantities using the
  
• non-parametric method
• Compare these values with the manufacturers
  suggestions and values obtained from
  literature

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Materials and Methods

• EDTA anticoagulated venous blood samples
• 407 healthy subjects (224 female, 183 male)
• Age range 18-45
• Central Laboratory for Clinical Chemistry,
• Teaching and Research Hospital,
• Uludag University,
• Bursa, Turkey
• 
  
  

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Materials and Methods

• Cell-Dyn 3700 (Abbott) haematology analyzer
• Internal quality control was performed daily at
  three concentrations (Abbott)
• EQAS (Bio-Rad Laboratories) external quality
  control was performed at three-month intervals
• 
  
  

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Materials and Methods

• 95 reference intervals (RI)
• 90 confidence intervals (CI)
• haemoglobin
• haematocrit
• red cell count (RBC)
• white cell count (WBC)
• mean corpuscular volume (MCV)
• mean corpuscular haemoglobin concentration (MCHC)
• platelet count (PLT)
• mean platelet volume (MPV)
• Non-parametric method

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Materials and Methods
2.5 percentile
97.5 percentile

• Non-parametric method
• n must be at least 120
• Histograms are drawn
• Outliers are omitted by Dixon rule (D/R)
• Lower and upper limits are determined using 2.5
  and 97.5 percentiles
• Lower limit0.025 (n1)
• Upper limit0.975 (n1)
• Gender related differences are determined
• Confidence Intervals (CI) of upper and lower
  reference limits are determined

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Conclusion

• Lack of published data about adults
• Akdag R, Energin VM, Kalayci AG, Karakelleoglu.
  Reference limits for routine haematological
  measurements in 7-14 year old children living at
  an intermadiate altitute. Scand J Clin Lab Invest
  199656(2)1039
• Value of laboratory-specific reference intervals
• Comparative regional data in Turkey
• Combine to give national data
• Local hospital for improved clinical evaluations
• Greater knowledge leads to improved health care
  
  
  

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Thank you for your attention