A new proposed strategy recommends focusing on the most reliable, available tests, and looking at the vaccines market as a guide to developing new assays.

How do labs report “reference ranges” for total cholesterol, LDL, etc. given that a reference range should be the 95% range of normal people, not a recommended ideal number? Respondents agree that for many tests, labs should not use a reference interval, and should instead use clinical decision points to drive flagging in the EMR—with the caveat that some labs do give reference intervals in these cases anyway, even though they aren’t needed, to satisfy CAP/CLIA requirements.

The recommended method for establishing age and sex-specific reference intervals requires obtaining results from at least 120 healthy individuals for each age range and sex category. These numbers are often difficult to achieve by traditional direct sampling.