解释实验室测试的正常值和参考范围。

IF 2.4 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Nancy Doles, May Ye Mon, Arika Shaikh, Samantha Mitchell, Disha Patel, Dean Seehusen, Gurmukh Singh
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引用次数: 0

摘要

实验室检测结果左右着70%的临床决策,在诊断、预后、排除病症、检测疾病倾向和监测病程方面具有重要意义。向患者发布实验室结果的要求已经改变了医患互动的动态。被实验室标记为低/高/异常的实验室检测结果的微小变化可能会给患者带来不必要的担忧。超出“正常范围”的实验室结果数量远远超过临床有意义的异常结果,这是由于通常接受的确定“正常值”/参考范围的方法、不同实验室检测方法的变化、年龄、性别、种族、季节性和随机变化引起的变化。确定“正常值/参考范围”的通常程序需要对特定年龄组、性别、种族、检测方法和相关健康问题的至少120名健康人进行检测。通常采用中间95%的值作为正常范围。根据定义,这种做法将5%的健康个体标记为实验室结果异常。这篇综述讨论了影响实验室检测结果和对这些结果的解释的各种问题。它还解决了医生和病人对评估和报告实验室结果的担忧。除了报告正常值和患者结果外,简单来说,包括检查结果的临床意义可能是有用的,例如,没有立即关注,需要在下次就诊时与医生讨论,建议联系医生采取进一步行动。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Interpretating Normal Values and Reference Ranges for Laboratory Tests.

Laboratory test results drive about 70% of clinical decisions and are important in making diagnosis, prognosis, ruling out conditions, testing for propensity to disease and monitoring the course of illnesses. The requirement for releasing laboratory results to patients has altered the dynamics of doctor patient interaction. Minor variations in laboratory test results that are labeled by the laboratory as low/high/abnormal may cause unwarranted worry to the patients. The number of laboratory results that are outside the "normal range" far exceeds the clinically meaningful abnormal results due to the usually accepted methodology for ascertaining "normal values"/reference ranges, variations in methods of testing at different laboratories, variations due to age, gender, ethnicity, seasonality, and random variations. The usual process for establishing "normal values/reference ranges" entails testing at least 120 healthy individuals in a given age-group, gender, ethnicity, testing method and related health issues. The central 95% of the values is usually adopted as the normal range. This practice, by definition, labels 5% of healthy individuals as having abnormal laboratory results. This review addresses various issues that affect laboratory test results and interpretation of such results. It also addresses doctor and patient concerns about assessing and reporting laboratory results. In addition to reporting normal values along with patient results, it may be useful to include clinical significance of the findings, in simple terms, such as, no immediate concern, warrants discussion with doctor at the next visit, recommend contacting your doctor for further action.

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来源期刊
CiteScore
4.90
自引率
6.90%
发文量
168
审稿时长
4-8 weeks
期刊介绍: Published since 1988, the Journal of the American Board of Family Medicine ( JABFM ) is the official peer-reviewed journal of the American Board of Family Medicine (ABFM). Believing that the public and scientific communities are best served by open access to information, JABFM makes its articles available free of charge and without registration at www.jabfm.org. JABFM is indexed by Medline, Index Medicus, and other services.
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