CLSI-Based Validation of Manufacturer-Derived Reference Intervals on the Cobas 8000 Platform

Lab Med. 2017 May 1;48(2):e30-e35. doi: 10.1093/labmed/lmx020.

Abstract

Background: Reference intervals provided by diagnostic test manufacturers should be transferred to clinical laboratories after validation. Although protocols exist, laboratories rarely perform and report on results of validation studies.

Methods: We validated reference intervals (RIs) of 87 analytes on a Cobas 8000 platform according to standards published by the Clinical and Laboratory Standards Institute (CLSI).

Results: For 8 analytes, decision limits were provided in the package inserts. Among the 79 RIs subjected to transference validation, 8 were found not valid for transference, including lactate dehydrogenase (LDH) among women, and the following among both sexes: potassium, homocysteine, immunoglobulin E (IgE), free lambda light chain (FLC λ), C3 complement (C3c), folate, and 25-hydroxy vitamin D (25[(OH]D). For LDH, potassium, homocysteine, C3c, folate, and 25(OH)D, RIs or thresholds suitable for transference were available in the literature; however, this was not the case for IgE and FLC λ.

Conclusion: The present study demonstrates that validation of RIs provided in the manufacturer provided package inserts is indispensable.

Keywords: analytical system; decision limit; guideline; reference values; test provider; transference.

MeSH terms

  • Blood Chemical Analysis* / instrumentation
  • Blood Chemical Analysis* / methods
  • Blood Chemical Analysis* / standards
  • Humans
  • Laboratories / standards*
  • Limit of Detection
  • Reference Values
  • Reproducibility of Results