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Unlimited volumes of laboratory data

A confusing and diagnostically deceptive product of modern technology

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Abstract

The large volumes of laboratory data currently available in clinical practice can lead to erroneous conclusions. Our current statistical interpretation of these data is univariate (one variable at a time) and often not age-and sex-corrected. Using an optimal technique of multivariate analysis, a SMAC® profile of 19 tests performed on normal subjects resulted in over a 500% improvement in defining the reference range. Using physiologic subsets of the SMAC profile for patients, improvements in interpretation of between 100% and 300% are possible. Results indicate a serious clinical problem that will require modification of laboratory reports using modern technology as an adjunct for diagnostic medicine.

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References

  1. Grams, R.R., and Pastor, E.L., New concepts in the design of a clinical laboratory informations system (LIS),Am. J. Clin. Pathol. 65:662–674, 1976.

    Google Scholar 

  2. Grams, R.R., A laboratory information system (LIS) in a tertiary care teaching hospital and clinic.Examination of Case Studies and Productivity Improvement in Clinical Laboratories Center for Hospital Management Engineering, American Hospital Association, 1977, pp. 73–91.

  3. Sisson, J.C., Shoemaker E.B., and Ross, J.C., Clinical decision analysis—the hazard of using additional data.J. Am Med. Assoc. 236: 1259–1263, 1976.

    Article  Google Scholar 

  4. Anderson, T.W.,An Introduction to Multivariate Statistical Analysis. Wiley, New York, 1958, pp. 1–38.

    Google Scholar 

  5. Morris, D.F.,Multivariate Statistical Methods, McGraw-Hill, New York, 1967, pp. 1–415.

    Google Scholar 

  6. Grams, R.R., Lezotte D.C., and Gudat, J.C., Establishing “reference values” for the futureJ. Med. Syst. 2:355–362.

  7. Sunderman, F.W., Current concepts of “normal values,” “reference values” and “discrimination values” in clinical chemistry.Clin. Chem. 21:1873–1877, 1975.

    Google Scholar 

  8. Schoen, I., and Books, S., Judgement based on 95% confidence limits a statistical dilemma involving multitest screening and proficiency testing of multiple specimens.Am. J. Clin. Pathol. 53:190–193, 1970.

    Google Scholar 

  9. Elseback, L.R., Crallier, L., and Keating, F.R., Health, normality, and the ghost of Gauss.J. Am. Med. Assoc. 211:69–75, 1970.

    Article  Google Scholar 

  10. Grasbuck, R., and Saris, N.E., Establishment and use of normal values.Scand. J. Clin. Lab. Invest. 24:62, 1969.

    Google Scholar 

  11. Grams, R.R., and Lezotte, D., Determining clinical significance in repeated laboratory measurements — the “Clinical Delta Range” (to be published).

  12. Grams, R.R., A proposal for laboratory data reporting (in review).

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Authors and Affiliations

  1. Medical Systems Division, Department of Pathology, University of Florida, Gainesville, Florida

    Ralph R. Grams M.D. & Dennis Lezotte Ph.D.

Authors
  1. Ralph R. Grams M.D.
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  2. Dennis Lezotte Ph.D.
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Grams, R.R., Lezotte, D. Unlimited volumes of laboratory data. J Med Syst 2, 343–353 (1978). https://doi.org/10.1007/BF02221900

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  • DOI: https://doi.org/10.1007/BF02221900

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