Reference Values Based on Hospital Admission Laboratory Data FREE

Steven J. Harwood, MD, PhD; G. William Cole, MD

[+] Author Affiliations

Reprint requests to Nuclear Medicine Service, Veterans Administration Hospital, Augusta, GA 30904 (Dr Harwood).

Edited by M. Therese Southgate, MD, Deputy Editor.

JAMA. 1978;240(3):270-274. doi:10.1001/jama.1978.03290030088035

Text Size: A A A

Published online

Article

References

ABSTRACT

ABSTRACT | REFERENCES

Laboratory values taken from more than 13,000 newly admitted patients to the University of Alabama Hospital were analyzed using a percentile ranking system, and histograms for 24 laboratory tests were prepared. The percentile system is a better way to express test results than the classic normal range. The ability to correlate a test result with a clinical problem rises proportional to the degree of deviation from the midrange. Minor deviations frequently are without explanation, even after intensive clinical investigation. Invariably, great deviations are explainable. If one limits the interpretation of results to three ranges—abnormally low, abnormally high, and normal—much of the value of laboratory test interpretation is lost.

(JAMA 240:270-274, 1978)

REFERENCES

ABSTRACT | REFERENCES

Wooton IDP, King EJ, Smith JM: The quantitative approach to hospital biochemistry . Br Med Bull 7:307-311, 1957;.

Collen MF, Siegelaub AB, Cutler JL, et al: Aspects of normal values in medicine . Ann NY Acad Sci 161:572-580, 1969;.

Gaddum JH: Lognormal distributions . Nature 156:463-466, 1945;.

Murphy EA, Abbey H: The normal range: A common misuse . J Chronic Dis 20:79-88, 1967;.

Elveback LR, Guillier CL, Keating FR Jr: Health, normality, and the ghost of Gauss . JAMA 211:69-75, 1970;.

Burnett RW: Accurate estimation of standard deviations for quantitative methods used in clinical chemistry . Clin Chem 21:1935-1938, 1975;.

Reed AH, Wu GT: Evaluation of a transformation method for estimation of normal range . Clin Chem 20:576-581, 1974;.

Harris EK, Demets DL: Estimation of normal ranges and cumulative proportions by transforming observed distribution to Gaussian form . Clin Chem 18:605-612, 1972;.

Gabrieli ER: Standardized interpretation of laboratory data . Ann NY Acad Sci 161:460-476, 1969;.

Herrera L: The precision of percentiles in establishing normal limits in medicine . J Lab Clin Med 52:34-42, 1958;.

Mainland D: Normal values in medicine . Ann NY Acad Sci 161:527-537, 1969;.

Sunderman FW Jr: Computer applications in laboratory medicine: The delineation of normal values . Ann NY Acad Sci 161:549-571, 1969;.

Sunderman FW Jr: Current concepts of 'normal values,' 'reference values,' and 'discrimination values' in clinical chemistry . Clin Chem 21:1873-1877, 1975;.

Werner M, Marsh WL: Normal values: Theoretical and practical aspects . CRC Crit Rev Clin Lab Sci 6:81-100, 1975;

Casey AE, Downey E: Further use of statens in the recording, reporting, analysis, and retrieval of automated computerized laboratory and clinical data . Am J Clin Pathol 53:748-754, 1970;.

Hoffmann RG, Waid ME: A new scale of normal values for physicians . GP 30:112-121, 1964;.

McNeil BJ, Keeler E, Adelstein SJ: Primer on certain elements of medical decision-making . N Engl J Med 293:211-215, 1975;.

Sebag J, Hall P: Decision-making in medical research and clinical practice: Theory and methodology of laboratory data evaluation by predictors, indicators and indices . Methods Inf Med 14:113-117, 1975;.

Teather D, Hilder W: The analysis of diagnostic data . J R Coll Physicians Lond 9:219-225, 1975;.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal