A Call for Better Pediatric Reference Ranges

Seeking to fill a void left when the National Institutes of Health (NIH) National Children’s Study ended in 2014, AACC is calling on Congress to mandate and fund a national repository of specimens from healthy children to develop pediatric reference ranges. The AACC position statement recommends that the repository maintain a comprehensive database of pediatric reference intervals and make the reference intervals accessible to healthcare providers and patients.

“AACC is concerned that the laboratory community does not have the resources necessary to establish and maintain pediatric reference intervals that reflect normal ranges in healthy pediatric populations,” the position statement says. “Policymakers have the responsibility to provide access to samples from healthy individuals of all ages, developmental stages, and both sexes to ensure the health of the nation’s children.”

A number of programs already working on the problem include the Children’s Health Improvement Through Laboratory Diagnostics (CHILDx) and the Canadian Laboratory Initiative in Pediatric Reference Intervals (CALIPER). But the need remains for funding and samples from healthy children, the position statement emphasizes.

The association recommends that samples in a national repository be collected with informed consent and be available to both in vitro diagnostic manufacturers and clinical laboratories; reference interval study results also should be public. Data should be standardized across the laboratory community, which must collaborate to share and transfer existing reference intervals across clinical laboratories and evolutions of technology. In addition, de-identified residual specimens should continue to be available without informed consent for quality improvement activities, AACC recommends. The full statement is available at www.myadlm.org/health-and-science-policy/advocacy.

Report: Americans Spend More Than $30 Billion on Alternative Medicine

Americans spent $30.2 billion—including $1.9 billion for children—on out-of-pocket alternative medicine, according to a nationwide analysis released by the National Center for Complementary and Integrative Health (NCCIH).

The agency included under what it calls "complementary approaches" a group of diverse practices and products, such as herbal supplements, meditation, and chiropractic services. The $30.2 billion figure represents 9.2% of Americans’ out-of-pocket spending on healthcare and 1.1% of healthcare spending overall. The findings come from data in the 2012 National Health Interview Survey.

“With so many Americans using and spending money on complementary health approaches, it is extremely important for us to provide the public with evidence-based information to help inform decisions,” said NCCIH director Josephine Briggs, MD. “This underscores the importance of conducting rigorous research to know whether the products and practices being used are safe and effective.”

About 30% of alternative medicine spending goes to pay for visits to complementary practitioners such as chiropractors, acupuncturists, or massage therapists, the analysis found, totaling $14.7 billion. The mean annual out-of-pocket expenditure for these visits was $433. The second-largest category of spending was natural product supplements, at $12.8 billion—about one-quarter of what Americans spent out-of-pocket on prescription drugs.