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Paediatric Reference Intervals

Diagnosis and monitoring of almost all paediatric diseases require the measurement of a wide range of disease biomarkers. These biomarkers are commonly measured in clinical laboratories and the results interpreted based on established reference (or normal) intervals.

In children, physiological changes associated with growth and development may necessitate separate reference intervals for different ages. In addition, the physiological changes associated with growth and development may be different for male and female children. Biomarkers may also be affected by ethnicity.

As a result, age, sex and ethnic group-specific reference intervals may be necessary for different biomarkers. This allows comparison of an individual's result with a reference interval derived from the corresponding reference group. Whether age, sex, and ethnicity-based partitions are required can vary among biomarkers. Biomarkers may also be affected by other physiological factors, such as body mass index (BMI) and sexual development (Tanner) stage. Therefore, additional partitions may be informative.

Analyte measurements in different clinical laboratories are conducted on different analytical platforms. However, standardization and harmonization of measurements across all platforms for all analytes has not been achieved. As a result, adoption of reference intervals established on one analytical platform for test results obtained on another platform is not immediate but requires previous transference tests. In cases when the results obtained on different analytical platforms are not comparable and the transference test fails, separate intervals need to be established for each platform.