Abstract
Laboratory results interpretation for diagnostic accuracy and clinical decision-making in this period of evidence-based medicine requires cut-off values or reference ranges that are reflective of the geographical area where the individual resides. Several studies have shown significant differences between and within populations, emphasizing the need for population-specific reference ranges. This cross-sectional experimental study sought to establish the haematological reference values in apparently healthy individuals in three regions in Ghana. Study sites included Nkenkaasu, Winneba, and Nadowli in the Ashanti, Central, and Upper West regions of Ghana, respectively. A total of 488 healthy participants were recruited using the Clinical and Laboratory Standards Institute (United States National Consensus Committee on Laboratory Standards, NCCLS) Guidance Document C28A2. Medians for haematological parameters were calculated and reference values determined at 2.5th and 97.5th percentiles and compared with Caucasian values adopted by our laboratory as reference ranges and values from other African and Western countries. RBC count, haemoglobin, and haematocrit (HCT) were significantly higher in males compared to females. There were significant intraregional and interregional as well as international variations of haematological reference ranges in the populations studied. We conclude that, for each geographical area, there is a need to establish geography-specific reference ranges if accurate diagnosis and concise clinical decisions are to be made.
Highlights
A reference range is a range of values of a laboratory test usually based on predetermined test results from a group of apparently healthy individuals and is critical for diagnostic accuracy [1]
Reference ranges in haematology are useful in results interpretation and in clinical decision-making in this era of evidence-based medicine
Population-based haematological reference ranges have not been established for many healthcare facilities in Ghana unlike many developing countries [4]
Summary
A reference range is a range of values of a laboratory test usually based on predetermined test results from a group of apparently healthy individuals and is critical for diagnostic accuracy [1]. Reference ranges in haematology are useful in results interpretation and in clinical decision-making in this era of evidence-based medicine. They are used as a guide in clinical trials to set inclusion and exclusion criteria and serve as the basis for safety monitoring for trial participants [2, 3]. Population-based haematological reference ranges have not been established for many healthcare facilities in Ghana unlike many developing countries [4]. Many of the reference ranges in use are those established in the countries of origin of the haematological analyzers in use.
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