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Determining reference (‘normal’) limits in medicine: An application
Author(s) -
Bezemer P. D.,
Netelenbos J. C.,
Mulder C.,
Theune J. A.,
Stamhuis I. H.,
Straus J. P.
Publication year - 1983
Publication title -
statistics in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.996
H-Index - 183
eISSN - 1097-0258
pISSN - 0277-6715
DOI - 10.1002/sim.4780020213
Subject(s) - percentile , reference values , statistics , computer science , selection (genetic algorithm) , sample (material) , reference data , process (computing) , medical physics , medicine , data mining , mathematics , artificial intelligence , chemistry , chromatography , operating system
We provide an account of a study to assess reference limits for eight routine laboratory determinations at the Academic Hospital of the Free University, Amsterdam and emphasize methodological issues rather than results. We argue that reference limits have use mainly in the first phase of the diagnostic process. Reference and target populations should be grossly comparable, and therefore patients (after slight selection) could well serve as references. However, we found major differences between in and out‐patients, so we suggest that this factor, together with age and sex, be taken into account. To arrive at reliable limits, the size of the reference sample should be at least 100. Laboratory reports should provide percentiles, which enable a more flexible decision than do fixed limits.