Journal ArticleDOI
Pediatric reference intervals for alkaline phosphatase.
Jakob Zierk,Farhad Arzideh,Rainer Haeckel,Holger Cario,Michael C. Frühwald,Hans-Jürgen Groß,Thomas Gscheidmeier,Reinhard Hoffmann,Alexander Krebs,Ralf Lichtinghagen,Michael H. Neumann,Hans-Georg Ruf,Udo Steigerwald,Thomas Streichert,Wolfgang Rascher,Markus Metzler,Manfred Rauh +16 more
TLDR
The percentile charts provided enable the appropriate differential diagnosis of changes in alkaline phosphatase activity due to disease and changes due to physiological development, and facilitates precise assessment of alkalineosphatase dynamics in pediatrics.Abstract:
Background Interpretation of alkaline phosphatase activity in children is challenging due to extensive changes with growth and puberty leading to distinct sex- and age-specific dynamics. Continuous percentile charts from birth to adulthood allow accurate consideration of these dynamics and seem reasonable for an analyte as closely linked to growth as alkaline phosphatase. However, the ethical and practical challenges unique to pediatric reference intervals have restricted the creation of such percentile charts, resulting in limitations when clinical decisions are based on alkaline phosphatase activity. Methods We applied an indirect method to generate percentile charts for alkaline phosphatase activity using clinical laboratory data collected during the clinical care of patients. A total of 361,405 samples from 124,440 patients from six German tertiary care centers and one German laboratory service provider measured between January 2004 and June 2015 were analyzed. Measurement of alkaline phosphatase activity was performed on Roche Cobas analyzers using the IFCC's photometric method. Results We created percentile charts for alkaline phosphatase activity in girls and boys from birth to 18 years which can be used as reference intervals. Additionally, data tables of age- and sex-specific percentile values allow the incorporation of these results into laboratory information systems. Conclusions The percentile charts provided enable the appropriate differential diagnosis of changes in alkaline phosphatase activity due to disease and changes due to physiological development. After local validation, integration of the provided percentile charts into result reporting facilitates precise assessment of alkaline phosphatase dynamics in pediatrics.read more
Citations
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Journal ArticleDOI
Indirect methods for reference interval determination - review and recommendations.
Graham R D Jones,Graham R D Jones,Rainer Haeckel,Tze Ping Loh,Ken Sikaris,Thomas Streichert,Alex Katayev,Julian H. Barth,Yesim Ozarda,Decision Limits +9 more
TL;DR: The IFCC C-RIDL aims to encourage the use of indirect methods to establish and verify reference intervals, to promote publication of such intervals with clear explanation of the process used and also to support the development of improved statistical techniques for these studies.
Journal ArticleDOI
Distinguishing reference intervals and clinical decision limits - A review by the IFCC Committee on Reference Intervals and Decision Limits.
TL;DR: The C-RIDL now aims to emphasize the importance of the correct use of both RIs and CDLs and to encourage laboratories to specify the appropriate information to clinicians as needed and clearly explains the processes used to define them.
Journal ArticleDOI
Alkaline phosphatase: a potential biomarker for stroke and implications for treatment.
TL;DR: This review will examine the basic biology of AP, and its most common isoenzyme, tissue nonspecific alkaline phosphatase (TNAP), with a specific focus on the central nervous system and suggests potential mechanism(s) of action for AP isoenzymes in stroke.
Journal ArticleDOI
Reference Interval Estimation from Mixed Distributions using Truncation Points and the Kolmogorov-Smirnov Distance (kosmic)
Jakob Zierk,Farhad Arzideh,Lorenz A. Kapsner,Hans-Ulrich Prokosch,Markus Metzler,Manfred Rauh +5 more
TL;DR: Simulations of common laboratory tests with increasing proportions of abnormal test results show reliable reference interval estimations even in challenging simulation scenarios, when <20% test results are abnormal.
Journal ArticleDOI
Next-generation reference intervals for pediatric hematology.
Jakob Zierk,Johannes Hirschmann,Dennis Toddenroth,Farhad Arzideh,Rainer Haeckel,Alexander Bertram,Holger Cario,Michael C. Frühwald,Hans-Jürgen Groß,Arndt Groening,Stefanie Grützner,Thomas Gscheidmeier,Torsten Hoff,Reinhard Hoffmann,Rainer Klauke,Alexander Krebs,Ralf Lichtinghagen,Sabine Mühlenbrock-Lenter,Michael H. Neumann,Peter Nöllke,Charlotte M. Niemeyer,Oliver Razum,Hans-Georg Ruf,Udo Steigerwald,Thomas Streichert,Antje Torge,Wolfgang Rascher,Hans-Ulrich Prokosch,Manfred Rauh,Markus Metzler +29 more
TL;DR: Age-specific percentiles and z-scores, compared with absolute test results, improve the identification of children with blood count abnormalities and the discrimination between different hematological diseases.
References
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Journal ArticleDOI
Closing the Gaps in Pediatric Laboratory Reference Intervals: A CALIPER Database of 40 Biochemical Markers in a Healthy and Multiethnic Population of Children
David Colantonio,Lianna Kyriakopoulou,Man Khun Chan,Caitlin H. Daly,Davor Brinc,Allison A. Venner,Maria D. Pasic,David Armbruster,Khosrow Adeli +8 more
TL;DR: A new comprehensive database of pediatric reference intervals is established from a healthy, nonhospitalized, and multiethnic pediatric population and should assist laboratorians and pediatricians in interpreting test results more accurately and thereby lead to improved diagnosis of childhood diseases and reduced patient risk.
Journal ArticleDOI
Age- and Sex-Specific Dynamics in 22 Hematologic and Biochemical Analytes from Birth to Adolescence
Jakob Zierk,Farhad Arzideh,Tobias Rechenauer,Rainer Haeckel,Wolfgang Rascher,Markus Metzler,Manfred Rauh +6 more
TL;DR: Continuous reference intervals are provided to capture the population changes in laboratory analytes during pediatric development more accurately than age groups.
Journal ArticleDOI
Serum alkaline phosphatase levels in healthy children and evaluation of alkaline phosphatase z-scores in different types of rickets.
Serap Turan,Burcu Topcu,Ibrahim Gökce,Tulay Guran,Zeynep Atay,Anjumanara Omar,Teoman Akcay,Abdullah Bereket +7 more
TL;DR: In this article, the authors used a colorimetric assay using p-nitrophenyl phosphate as substrate and diethanolamine as buffer to evaluate serum alkaline phosphatase (ALP) levels in children and adolescents.
Harmonising adult and paediatric reference intervals in australia and new zealand: an evidence-based approach for establishing a first panel of chemistry analytes
Jillian R Tate,Ken Sikaris,Graham R D Jones,Tina Yen,Gus Koerbin,Julie E. Ryan,Maxine Reed,Janice Gill,George Koumantakis,Peter E. Hickman,Peter Graham +10 more
TL;DR: The aim of this report is to describe the processes that the AACB and the Royal College of Pathologists of Australasia have taken towards recommending the implementation of a first panel of common RIs for use in Australasia.
Journal ArticleDOI
Establishment of reference intervals for bone markers in children and adolescents.
TL;DR: Vitamin D status, age and gender are important for establishing reference intervals of bone markers in healthy children and all the bone marker levels, except total alkaline phosphatase, were significantly higher in puberty with vitamin D(3) >75nmol/L.