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bioRxiv · 10.1101/213892

Creating ethnicity-specific reference intervals for lab tests from EHR data

Rappoport, N.·Paik, H.·Oskotsky, B.·Tor, R.·Ziv, E.·Zaitlen, N.·Butte, A. J.
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Abstract

The results of clinical lab tests are an essential component of medical decision-making. To guide interpretation, test results are returned with reference intervals defined by the range in which 95% of values occur in healthy individuals. Clinical laboratories often set their own reference intervals to accommodate local population and instruments variations. This approach is costly and can be biased. We describe a novel data-driven method for using electronic health record data to extract healthy patients information to define reference intervals. We found that the distributions of many clinical lab tests differ among self-identified racial and ethnic groups (SIREs) in healthy patients. Finally, we derived SIRE-specific reference intervals and provide evidence that these intervals have clinical prognostic value. Specifically, we show that for two lab tests, serum creatinine level and hemoglobin A1C, SIRE-specific reference intervals are more predictive for need for dialysis and development type 2 diabetes than existing reference intervals.\n\nOne Sentence SummaryA novel method for defining population-specific reference intervals of common clinical laboratory tests from electronical health records has better prognostic value than existing reference intervals.

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Rappoport, N., Paik, H., Oskotsky, B., Tor, R., Ziv, E., Zaitlen, N., Butte, A. J.. 2017-11-04. Creating ethnicity-specific reference intervals for lab tests from EHR data. https://doi.org/10.1101/213892

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