Derivation of gender and age-specific reference intervals from fully normal Japanese individuals and the implications for health screening
With nationwide standardization of laboratory tests among institutions for health screening in Japan, common reference intervals (RIs) were derived from records of 1,500,000 health check attendees. Targets were 20 basic laboratory tests including body mass index (BMI) and systolic and diastolic bloo...
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| Veröffentlicht in: | Clinica chimica acta 2015-07, Vol.447, p.105-114 |
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| creator | Yamakado, Minoru Ichihara, Kiyoshi Matsumoto, Yoshiyuki Ishikawa, Yoshiki Kato, Kiminori Komatsubara, Yusuke Takaya, Norihide Tomita, Shohken Kawano, Reo Takada, Keisuke Watanabe, Kiyoaki |
| description | With nationwide standardization of laboratory tests among institutions for health screening in Japan, common reference intervals (RIs) were derived from records of 1,500,000 health check attendees.
Targets were 20 basic laboratory tests including body mass index (BMI) and systolic and diastolic blood pressures (SBP, DBP). Individuals fulfilling the following strict criteria were chosen: SBP |
| doi_str_mv | 10.1016/j.cca.2015.04.037 |
| format | Article |
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Targets were 20 basic laboratory tests including body mass index (BMI) and systolic and diastolic blood pressures (SBP, DBP). Individuals fulfilling the following strict criteria were chosen: SBP<130, DBP<85mmHg, BMI<25kg/m2, non-smoking, ethanol consumption<20g/day and under no mediation with no remarkable current/past illnesses. The latent abnormal values exclusion (LAVE) method was applied to ensure fully normal results. RIs were derived by parametric method using modified Box–Cox power transformation.
Among all attendees, 23% fulfilled the criteria. Application of the LAVE method further reduced the dataset by 40%–50%. Age-related charts of test results differed greatly between genders in almost all tests. Comparison of derived RIs with clinical decision limits (CDLs) revealed that the upper limits of RIs differed from CDLs according to gender and age.
Implementation of gender and age-specific RIs derived from individuals with fully normal health attributes will (1) enable appropriate interpretation of test results in health screening and (2) promote judicious application of CDLs for therapeutic intervention, taking into account gender, age and other health attributes.
•1.5 million standardized health screening records were gathered nationwide in Japan.•Reference intervals (RIs) were derived from carefully selected “fully normal” subjects.•Age-, sex-specific profiles of RIs were clearly delineated for all screening test items.•Implication of clinical decision limits vs. RIs was discussed in the health screening.</description><identifier>ISSN: 0009-8981</identifier><identifier>EISSN: 1873-3492</identifier><identifier>DOI: 10.1016/j.cca.2015.04.037</identifier><identifier>PMID: 25987309</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Adult ; Age Factors ; Aged ; Clinical decision limit ; Clinical Decision-Making ; Clinical guideline ; Female ; Health - standards ; Health screening ; Humans ; Japan ; Male ; Mass Screening - standards ; Middle Aged ; Reference individual ; Reference interval ; Reference Values ; Sex Factors</subject><ispartof>Clinica chimica acta, 2015-07, Vol.447, p.105-114</ispartof><rights>2015 Elsevier B.V.</rights><rights>Copyright © 2015 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c419t-e39845221c3692649c0a7331676650b3552d04617cdec4ec530fffc983a2107b3</citedby><cites>FETCH-LOGICAL-c419t-e39845221c3692649c0a7331676650b3552d04617cdec4ec530fffc983a2107b3</cites><orcidid>0000-0001-8699-3768</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0009898115002363$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25987309$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yamakado, Minoru</creatorcontrib><creatorcontrib>Ichihara, Kiyoshi</creatorcontrib><creatorcontrib>Matsumoto, Yoshiyuki</creatorcontrib><creatorcontrib>Ishikawa, Yoshiki</creatorcontrib><creatorcontrib>Kato, Kiminori</creatorcontrib><creatorcontrib>Komatsubara, Yusuke</creatorcontrib><creatorcontrib>Takaya, Norihide</creatorcontrib><creatorcontrib>Tomita, Shohken</creatorcontrib><creatorcontrib>Kawano, Reo</creatorcontrib><creatorcontrib>Takada, Keisuke</creatorcontrib><creatorcontrib>Watanabe, Kiyoaki</creatorcontrib><title>Derivation of gender and age-specific reference intervals from fully normal Japanese individuals and the implications for health screening</title><title>Clinica chimica acta</title><addtitle>Clin Chim Acta</addtitle><description>With nationwide standardization of laboratory tests among institutions for health screening in Japan, common reference intervals (RIs) were derived from records of 1,500,000 health check attendees.
Targets were 20 basic laboratory tests including body mass index (BMI) and systolic and diastolic blood pressures (SBP, DBP). Individuals fulfilling the following strict criteria were chosen: SBP<130, DBP<85mmHg, BMI<25kg/m2, non-smoking, ethanol consumption<20g/day and under no mediation with no remarkable current/past illnesses. The latent abnormal values exclusion (LAVE) method was applied to ensure fully normal results. RIs were derived by parametric method using modified Box–Cox power transformation.
Among all attendees, 23% fulfilled the criteria. Application of the LAVE method further reduced the dataset by 40%–50%. Age-related charts of test results differed greatly between genders in almost all tests. Comparison of derived RIs with clinical decision limits (CDLs) revealed that the upper limits of RIs differed from CDLs according to gender and age.
Implementation of gender and age-specific RIs derived from individuals with fully normal health attributes will (1) enable appropriate interpretation of test results in health screening and (2) promote judicious application of CDLs for therapeutic intervention, taking into account gender, age and other health attributes.
•1.5 million standardized health screening records were gathered nationwide in Japan.•Reference intervals (RIs) were derived from carefully selected “fully normal” subjects.•Age-, sex-specific profiles of RIs were clearly delineated for all screening test items.•Implication of clinical decision limits vs. RIs was discussed in the health screening.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Clinical decision limit</subject><subject>Clinical Decision-Making</subject><subject>Clinical guideline</subject><subject>Female</subject><subject>Health - standards</subject><subject>Health screening</subject><subject>Humans</subject><subject>Japan</subject><subject>Male</subject><subject>Mass Screening - standards</subject><subject>Middle Aged</subject><subject>Reference individual</subject><subject>Reference interval</subject><subject>Reference Values</subject><subject>Sex Factors</subject><issn>0009-8981</issn><issn>1873-3492</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcuO1DAQRS0EYnoGPoAN8pJNgl95WKzQ8BjQSGxgbbnL5W63EifYSUvzC3w1Dj2wZGXZOvdW-V5CXnFWc8bbt6cawNaC8aZmqmaye0J2vO9kJZUWT8mOMaarXvf8ilznfCpXxVr-nFyJRheM6R359QFTONslTJFOnh4wOkzURkftAas8IwQfgCb0mDAC0hAXTGc7ZOrTNFK_DsMDjVMa7UC_2tlGzBvkwjm4dcM2r-VY3sZ5CPBnUtFOiR7RDsuRZkiIMcTDC_LMFwG-fDxvyI9PH7_f3lX33z5_uX1_X4HieqlQ6l41QnCQrRat0sBsJyVvu7Zt2F42jXBMtbwDh6AQGsm896B7aQVn3V7ekDcX3zlNP1fMixlDBhyGsvu0ZsOLbVcGiKag_IJCmnIuIZg5hdGmB8OZ2SowJ1MqMFsFhilTKiia14_2635E90_xN_MCvLsAWD55DphMhrBl60JCWIybwn_sfwOvUphZ</recordid><startdate>20150720</startdate><enddate>20150720</enddate><creator>Yamakado, Minoru</creator><creator>Ichihara, Kiyoshi</creator><creator>Matsumoto, Yoshiyuki</creator><creator>Ishikawa, Yoshiki</creator><creator>Kato, Kiminori</creator><creator>Komatsubara, Yusuke</creator><creator>Takaya, Norihide</creator><creator>Tomita, Shohken</creator><creator>Kawano, Reo</creator><creator>Takada, Keisuke</creator><creator>Watanabe, Kiyoaki</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8699-3768</orcidid></search><sort><creationdate>20150720</creationdate><title>Derivation of gender and age-specific reference intervals from fully normal Japanese individuals and the implications for health screening</title><author>Yamakado, Minoru ; Ichihara, Kiyoshi ; Matsumoto, Yoshiyuki ; Ishikawa, Yoshiki ; Kato, Kiminori ; Komatsubara, Yusuke ; Takaya, Norihide ; Tomita, Shohken ; Kawano, Reo ; Takada, Keisuke ; Watanabe, Kiyoaki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c419t-e39845221c3692649c0a7331676650b3552d04617cdec4ec530fffc983a2107b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Clinical decision limit</topic><topic>Clinical Decision-Making</topic><topic>Clinical guideline</topic><topic>Female</topic><topic>Health - standards</topic><topic>Health screening</topic><topic>Humans</topic><topic>Japan</topic><topic>Male</topic><topic>Mass Screening - standards</topic><topic>Middle Aged</topic><topic>Reference individual</topic><topic>Reference interval</topic><topic>Reference Values</topic><topic>Sex Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yamakado, Minoru</creatorcontrib><creatorcontrib>Ichihara, Kiyoshi</creatorcontrib><creatorcontrib>Matsumoto, Yoshiyuki</creatorcontrib><creatorcontrib>Ishikawa, Yoshiki</creatorcontrib><creatorcontrib>Kato, Kiminori</creatorcontrib><creatorcontrib>Komatsubara, Yusuke</creatorcontrib><creatorcontrib>Takaya, Norihide</creatorcontrib><creatorcontrib>Tomita, Shohken</creatorcontrib><creatorcontrib>Kawano, Reo</creatorcontrib><creatorcontrib>Takada, Keisuke</creatorcontrib><creatorcontrib>Watanabe, Kiyoaki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinica chimica acta</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yamakado, Minoru</au><au>Ichihara, Kiyoshi</au><au>Matsumoto, Yoshiyuki</au><au>Ishikawa, Yoshiki</au><au>Kato, Kiminori</au><au>Komatsubara, Yusuke</au><au>Takaya, Norihide</au><au>Tomita, Shohken</au><au>Kawano, Reo</au><au>Takada, Keisuke</au><au>Watanabe, Kiyoaki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Derivation of gender and age-specific reference intervals from fully normal Japanese individuals and the implications for health screening</atitle><jtitle>Clinica chimica acta</jtitle><addtitle>Clin Chim Acta</addtitle><date>2015-07-20</date><risdate>2015</risdate><volume>447</volume><spage>105</spage><epage>114</epage><pages>105-114</pages><issn>0009-8981</issn><eissn>1873-3492</eissn><abstract>With nationwide standardization of laboratory tests among institutions for health screening in Japan, common reference intervals (RIs) were derived from records of 1,500,000 health check attendees.
Targets were 20 basic laboratory tests including body mass index (BMI) and systolic and diastolic blood pressures (SBP, DBP). Individuals fulfilling the following strict criteria were chosen: SBP<130, DBP<85mmHg, BMI<25kg/m2, non-smoking, ethanol consumption<20g/day and under no mediation with no remarkable current/past illnesses. The latent abnormal values exclusion (LAVE) method was applied to ensure fully normal results. RIs were derived by parametric method using modified Box–Cox power transformation.
Among all attendees, 23% fulfilled the criteria. Application of the LAVE method further reduced the dataset by 40%–50%. Age-related charts of test results differed greatly between genders in almost all tests. Comparison of derived RIs with clinical decision limits (CDLs) revealed that the upper limits of RIs differed from CDLs according to gender and age.
Implementation of gender and age-specific RIs derived from individuals with fully normal health attributes will (1) enable appropriate interpretation of test results in health screening and (2) promote judicious application of CDLs for therapeutic intervention, taking into account gender, age and other health attributes.
•1.5 million standardized health screening records were gathered nationwide in Japan.•Reference intervals (RIs) were derived from carefully selected “fully normal” subjects.•Age-, sex-specific profiles of RIs were clearly delineated for all screening test items.•Implication of clinical decision limits vs. RIs was discussed in the health screening.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>25987309</pmid><doi>10.1016/j.cca.2015.04.037</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-8699-3768</orcidid></addata></record> |
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| ispartof | Clinica chimica acta, 2015-07, Vol.447, p.105-114 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adult Age Factors Aged Clinical decision limit Clinical Decision-Making Clinical guideline Female Health - standards Health screening Humans Japan Male Mass Screening - standards Middle Aged Reference individual Reference interval Reference Values Sex Factors |
| title | Derivation of gender and age-specific reference intervals from fully normal Japanese individuals and the implications for health screening |
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