Marith van Schrojenstein Lantman

Consistent clinical decision-making is hampered by inadequate reference intervals

Appropriate clinical decision-making relies on the interpretation of equivalent measurement results in light of a valid clinical decision-limit. Besides guideline-based decision-limits, reference intervals (RI) are commonly used to discriminate between abnormal results and results from 'healthy' individuals. In order to adequately discern between these two categories, the RI needs to be appropriate considering the population it serves. However, different facilities can adopt disparate RIs and can claim justification from the analytical bias at the level of the lower- and upper reference limit. We evaluated external quality assurance (EQA) data of participants from the SKML, and compared the obtained bias with the used reference intervals by these participants.