Application of adult reference intervals in children

Abstract

The aim of this study was to evaluate to which extend adult reference intervals (RIs) could be applied in children. A local paediatric population (aged 1 to < 20years), based on first draw samples from general practitioners (GPs), was established. Children with samples taken at a hospital or > 3 samples from GPs were excluded. Analytes evaluated included haematological, liver and pancreatic function, kidney function, electrolytes, and metabolism parameters. Applicability of adult RIs in children aged 1-17years was evaluated using individuals aged 18-19years as reference groups for the adult RIs. The local population consisted of 31,024 children with 282,721 analyses in total. For each analyte, 17 age strata and two gender strata were established. Partitioning was not warranted in 51% of the male strata and in 69% of the female strata. Adult RIs could be applied in 42% for children aged 1-< 10years, 57% for children aged 10-< 15years, and 85% for children aged 15-<18years.Conclusion: for certain analytes, there is no need to partition between adult and paediatric RIs, but a need for age- and gender-specific RIs remains for several clinical laboratory tests.What is Known:• Establishing paediatric reference intervals (RIs) is time consuming, costly, and not feasible for many laboratories. Transference of RIs established elsewhere often leads to misclassification of paediatric laboratory results.• Adult RIs are often more easily established and validated.What is New:• Adult RIs can be applied to children as young as 2years for some analytes. Conversely, for some analytes, adult RIs cannot be applied in children aged 1-17years.• Laboratory data can be applied in evaluating the need for partitioning in reference intervals.