Abstract
Objectives
Establishing direct reference intervals for pediatric patients is a costly, challenging, and time-consuming enterprise. Indirectly established reference intervals can help to ameliorate this situation. It was our objective to establish population-specific reference intervals for automated white blood cell differentials via data mining and non-parametric percentile method.
Methods
Blood counts and automated white blood cell differentials of patients aged 0 days to 18 years, performed from the 1st of January 2018 until the 30th of June 2022, were identified in our laboratory information system. Reference intervals were established in accordance with IFCC and CLSI recommendations as well as the propositions by Haeckel et al.
Results
Initially, 47,173 blood counts on our SYSMEX XN-9000 were identified. 11,707 data sets were excluded, leaving 35,466 sample sets for analysis. Of these, 17,616 contained automated white blood cell differentials. Due to insufficient patient numbers, no reference intervals for automated white blood cell differentials could be established for children aged <7 months. In comparison to the corresponding reference intervals published by Herklotz et al., reference intervals determined by us showed relevant differences throughout all age groups.
Conclusions
The combination of non-parametric percentile method and the propositions by Haeckel et al. utilizing conscientious data mining appears to be potent alternative to direct reference interval determination.
Acknowledgments
The authors thank Christin Renner and Paul Nentwig for data retrieval from the laboratory information system.
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Research funding: None to declared.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Not applicable.
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Ethical approval: Research involving human subjects complied with all relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration (as revised in 2013), and has been approved by the authors’ Institutional Review Board (Ärztekammer Berlin) or equivalent committee. (Register-Nr.: 225128: 03/2021).
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Supplementary Material
This article contains supplementary material (https://doi.org/10.1515/cclm-2022-1265).
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