Pediatric Reference Ranges

I. History and 2005 update

1. Started as a question on the PMF Division listserv
2. Initial meeting of interested persons at the the Association for Diagnostics & Laboratory Medicine (formerly AACC) Annual Meeting in Orlando, July 26, 2005 (~25 attendees, see addendum)

II. Proposed Purpose of the Initiative

1. Provide pediatric ranges for the common analytes on an accessible website. (electrolytes, glucose, etc)
   (This would be geared toward anyone needing pediatric ranges, but specifically we were considering those places that don’t do a lot of pediatrics and just need these ranges occasionally, like predominately adult hospitals.)
2. Provide a forum for groups working on pediatric reference ranges to interact
   (This would hopefully provide a comprehensive list of on-going studies, to prevent duplication of effort, and facilitate interaction between groups working on the same or similar projects.)
3. Look into also doing Maternal-Fetal reference ranges
4. Provide support for answering questions related to pediatric reference ranges

III. Results of the Initial Meeting.

1. Common analyte ranges (PMF Division liaison – Patti Jones)
   Two ideas:
   1. Have pediatric institutions send three months worth of data on the specific analyte being worked on.
      1. A common spread sheet for submission of data will be necessary.
      2. If possible, specify data from outpatients and elective surgery patients
      3. May need to check on IRB needs, or remove all identifiers other than age and sex
      4. Data crunching to be done by statisticians and results filtered through the eyes of experienced pediatric clinical chemists
   2. Collect historical ranges that are currently in use from pediatric insitutions
      1. traceability to analyzer may be questionable
      2. ranges validated by years of use and physician acceptance
2. Group for ongoing reference range studies (PMF Division liaisons – Nathalie LePage, Vijay Grey)
   1. Collect a list of current studies, including recently published and ongoing
   2. Define a consensus protocol and approach for designing new studies.
3. Maternal-Fetal – pregnancy ranges (PMF Division liaison – Sharon Geaghan, Carol Lee)
   1. Interest?
4. Question support group (PMF Division liaison – Patti Jones)
   1. Several people signed up as experts to help answer pediatric reference range related questions.