Abstract Background Reference intervals are either directly established from normal volunteers, adopted from assay manufactures and verified as transferable to the normal population, or indirectly derived using patients’ archived laboratory data. This study describes indirect derivation of reference intervals for albumin, total calcium, and magnesium appropriate to the patient population of Dallas County. The tests were selected due to their often combine measurement in the assessment of calcium and bone mineral metabolism Methods Retrospective reported laboratory results during May 2022 for albumin (n=1342), total calcium (n=1945), and magnesium (n=2148) were obtained. Values were subjected to statistical analysis for nature of distribution, mean, and standard deviation as well as stratified for patients’ characteristics (gender, race, and age). Statistical analysis applied were Hoffman regression analysis, one-way ANOVA, and Tukey-Kramer tests. Results Following removal of outliers, statistically suggested reference intervals for albumin, total calcium, and magnesium were 5.5 to 2.4 g/dL, 10.5 to 7.5 mg/dL, and 2.6 to 1.6 mg/dL respectively. Although there was race specific differences in albumin and calcium levels (p=0.032) and (p=0.002) respectively, differences for magnesium were slightly nonsignificant (p=0.06). Similarly, significant differences due to age were observed for albumin, total calcium, and magnesium (P <0.00 for all). The data suggests that albumin, magnesium, and calcium levels are unequivocally dependent on age and race for patients in Dallas County. The upper limits of population derived, and manufacturer verified reference intervals were 5.45 and 5.2 g/dL for albumin, 10.5 and 10.2 mg/dL for calcium, and 4.6, and 2.6 mg/dL for magnesium respectively, the lower limits were 2.4 and 3.5, 7.5 and 8.4, 1.4, and 1.6 mg/dL respectively. Conclusions Reference intervals for albumin, total calcium, and magnesium appropriate to the patient population of Dallas County were derived. Derived values were statistically different from the manufacturer verified values in use. The study although limited by the small number of acceptable samples, highlights the need for laboratories to derive their respective population-based reference intervals. The study will be expanded to other biochemical parameters utilizing much larger sample volume.
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