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March 12, 2012

Filling the gaps: New diagnostic tool reflects today’s diverse Canadian paediatric population

TORONTO – A major tool has been developed that will directly contribute to improved diagnosis and assessment of children and youth with medical concerns across Canada.

When a child undergoes blood tests to diagnose a specific medical condition, physicians, laboratory specialists and the family have one shared goal: to obtain accurate test results. If the test results are positive, the clinical team can then determine the best treatment options and provide the necessary care.

The ability of lab specialists to interpret the results accurately is dependent upon several important factors, including the availability of accurate reference values, which provide the “normal” result for a healthy child in the general population.

These crucial reference values have existed in Canada, but until now, these numbers have had significant demographic gaps, experts say. Much of the current data is outdated and includes some reference values that were obtained in the 1980s, when the technology was not as advanced as it is today. In addition, there has been a need to obtain a more accurate representation of the current population of children in Canada; including children of all paediatric age groups (birth to 18 years), both genders, and a variety of ethnicities that make up the multicultural Canadian population. These often previously-overlooked factors can affect the interpretation of test results.

A new, comprehensive database of 40 biochemical markers (substances that can be detected in blood, urine or other bodily fluids that can reveal diseases or abnormalities) in an ethnically-diverse Canadian paediatric population is now available to hospitals and paediatricians, and will soon be available to the general public online. A national team of researchers led by The Hospital for Sick Children (SickKids) spent four years developing the tool.

Through the Canadian Laboratory Initiative on Paediatric Reference Intervals (CALIPER) Project, healthy children and teens of varying ages, genders and ethnicities were invited to participate. Nearly 2,200 participants, who were recruited through community outreach initiatives, provided blood samples and information that were used to determine reference values for 40 serum biochemical markers. The CALIPER project operates within the Department of Paediatric Laboratory Medicine at SickKids.

In a recent online publication of Clinical Chemistry, the CALIPER team reports on the development of this new national database, which is expected to help lab specialists and paediatricians across the country to more accurately interpret test results, which may lead to improved diagnosis and monitoring of childhood diseases.

“Age, gender and ethnicity can profoundly influence levels of biochemical markers,” says Dr. Khosrow Adeli, Head of the Division of Clinical Biochemistry in the Department of Paediatric Laboratory Medicine and Senior Associate Scientist at SickKids. “We hope this new database of healthy Canadian children and youth will help improve diagnosis and treatment for a variety of medical conditions. Since treatment can depend upon lab test results – and treatment efficacy is also usually monitored by doing these tests – accurate analysis of these results is critically important.”

While similar databases exist in the adult population, obtaining sufficient data from a general population of children is much more challenging. This is due to the significant differences between children at different ages, Dr. Adeli explains. For example, a two-year-old would not have the same results as a 10-year-old or a 17-year-old.

“Kids are constantly growing and changing,” says Adeli, who is also Professor in the Departments of Biochemistry and Laboratory Medicine & Pathobiology at the University of Toronto. “These differences are now documented in a more comprehensive way, which is a major step toward filling the gaps that exist in this area.”

Next steps in this research will include testing study participants for an additional 30 biochemical markers. The scientists will then use transference studies to run tests on different equipment in various hospitals across the country. This would account for any variations between hospitals and help ensure consistent results, regardless of the patient’s geographic location. Moving forward, the database is expected to be updated once every decade to account for technological and population changes.

In addition to SickKids, six other Canadian hospitals from coast to coast are collaborating on the CALIPER Project: Eastern Health/Janeway Children’s Health & Rehabilitation Centre, CHU Sainte-Justine, Children’s Hospital of Eastern Ontario, McMaster Children’s Hospital, Royal University Hospital and BC Children’s Hospital.

The study was supported by the Canadian Institutes of Health Research, Abbott Diagnostics and SickKids Foundation.

About The Hospital for Sick Children
The Hospital for Sick Children (SickKids) is recognized as one of the world’s foremost paediatric health-care institutions and is Canada’s leading centre dedicated to advancing children’s health through the integration of patient care, research and education. Founded in 1875 and affiliated with the University of Toronto, SickKids is one of Canada’s most research-intensive hospitals and has generated discoveries that have helped children globally.  Its mission is to provide the best in complex and specialized family-centred care; pioneer scientific and clinical advancements; share expertise; foster an academic environment that nurtures health-care professionals; and champion an accessible, comprehensive and sustainable child health system.  SickKids is proud of its vision of Healthier Children. A Better World.™ For more information, please visit www.sickkids.ca. 

About Peter Gilgan Centre for Research and Learning 
The Peter Gilgan Centre for Research and Learning will bring together researchers from different scientific disciplines and a variety of clinical perspectives, to accelerate discoveries, new knowledge and their application to child health — a different concept from traditional research building designs. The facility will physically connect SickKids science, discovery and learning activities to its clinical operations. Designed by award-winning architects Diamond Schmitt Architects Inc. and HDR Inc. with a goal to achieve LEED® Gold Certification for sustainable design, the Gilgan Centre will create an architectural landmark as the eastern gateway to Toronto’s Discovery District. The Peter Gilgan Centre for Research and Learning is funded by a grant from the Canada Foundation for Innovation, the Government of Ontario, philanthropist Peter Gilgan and community support for the ongoing fundraising campaign. For more information, please visit www.sickkidsfoundation.com/bepartofit.

For more information, please contact:

Matet Nebres
The Hospital for Sick Children
Phone: 416-813-6380
email: matet.nebres@sickkids.ca

Suzanne Gold
The Hospital for Sick Children
Phone: 416-813-7654 ext. 2059
email: suzanne.gold@sickkids.ca