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Reference Intervals

Background

One of the strategic priorities for the AACB is to encourage and assist laboratories to achieve harmonised reference intervals for the common analytes where we have sound calibration and traceability in place.

Other countries have already achieved this goal and perhaps most significantly for Australia, Sonic Health laboratories have moved to harmonised intervals across their Australian operation. In addition, in New Zealand, a practical model developed by the Auckland Regional Quality Assurance Group (ARQAG) more than 35 years ago provides a mechanism by which reference intervals can be harmonised across laboratories within a region.

As you know the profession has been talking about common reference intervals for some years and several AACB members are actively involved in various projects related to this desired goal. However there is now an urgent need for action and to reduce the confusion in this area for both doctors and patients. A fresh imperative for action is the development of a personalised electronic health record for all Australian citizens which is scheduled to be introduced in 2013.

Having emphasised the importance of achieving harmonised reference intervals the AACB does not want laboratories to blindly accept this proposition and it is critically important that everyone in the profession has an understanding of the scientific basis of any particular interval.

Critical questions affecting laboratories about reference intervals are:

  • What are the best reference intervals available for your methods?
  • Do your staff have enough time to derive or review all your reference intervals?
  • Are your reference limits different to other laboratories using the same methods?
  • Could your reference intervals for children be improved?
  • Could your reference intervals for pregnancy be improved?