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Reference Intervals For Haematology Parameters In Turkey : Reference Intervals For Haematology Parameters In Turkey Yesim Ozarda Ilcol1, Z. Banu Hizli 1, Esma Eroz1, Diler Aslan2 1Department of Biochemistry; Uludag University Medical School; Bursa, 2Department of Biochemistry; Pamukkale University Medical School; Denizli, Turkey e-mail:yesim@uludag.edu.tr


Reference Intervals : Reference Intervals Reference intervals serve as the basis of laboratory testing and aid the physician in differentiating between healthy and diseased population The production of accurate and reliable reference values is very important in clinical chemistry


Slide3 : 2002-2004 Direct reference intervals 41 clinical chemistry analytes 328 healthy reference individuals 18-45 years of age Non-parametric method Yesim Ozarda Ilcol, Diler Aslan. Determining Reference Value of Blood Chemistry Profile in Healthy Subjects in Bursa. Turk J Biochem 2004; 29 (2); 183-192 2004-2005 Indirect reference intervals 40 clinical chemistry analytes 422,919 records 18-45 years of age Bhattacharya procedure Yesim Ozarda Ilcol, Diler Aslan. Use of total patient data for indirect estimation of reference intervals for 40 clinical chemical analytes in Turkey. Clin Chem Lab Med 2006; 44 (7):867–876 2 Background


Aim : Aim Determine laboratory-specific direct reference intervals for haematological quantities using the non-parametric method Compare these values with the manufacturer’s suggestions and values obtained from literature


Materials and Methods : Materials and Methods EDTA anticoagulated venous blood samples 407 healthy subjects (224 female, 183 male) Age range 18-45 Central Laboratory for Clinical Chemistry, Teaching and Research Hospital, Uludag University, Bursa, Turkey


Materials and Methods : Materials and Methods Cell-Dyn 3700 (Abbott) haematology analyzer Internal quality control was performed daily at three concentrations (Abbott) EQAS (Bio-Rad Laboratories) external quality control was performed at three-month intervals


Materials and Methods : Materials and Methods 95% reference intervals (RI) 90% confidence intervals (CI) haemoglobin haematocrit red cell count (RBC) white cell count (WBC) mean corpuscular volume (MCV) mean corpuscular haemoglobin concentration (MCHC) platelet count (PLT) mean platelet volume (MPV) Non-parametric method


Materials and Methods : Materials and Methods Non-parametric method; n must be at least 120 Histograms are drawn Outliers are omitted by Dixon rule (D/R) Lower and upper limits are determined using 2.5 % and 97.5 % percentiles Lower limit=0.025 (n+1) Upper limit=0.975 (n+1) Gender related differences are determined Confidence Intervals (CI) of upper and lower reference limits are determined 2.5 % percentile 97.5 % percentile cı cı


Conclusion : Conclusion Lack of published data about adults Akdağ R, Energin VM, Kalayci AG, Karakelleoğlu. Reference limits for routine haematological measurements in 7-14 year old children living at an intermadiate altitute. Scand J Clin Lab Invest 1996;56(2):103–9 Value of laboratory-specific reference intervals Comparative regional data in Turkey Combine to give national data Local hospital for improved clinical evaluations Greater knowledge leads to improved health care


Thank you for your attention… : Thank you for your attention…