Estimation of healthy reference intervals for elderly people through the use of outpatient data

: It is important to determine transferable reference intervals as well as uniformity in measured values for inter-regional and inter-institutional availability of clinical test results. For that purpose, the National Committee for Clinical Laboratory Standards (NCCLS) issued forth guidelines in 1995. Some regional institutions in Japan are making efforts to determine normal reference intervals based on these guidelines. We, the Fukuoka Five Hospitals Group, have selected 3,375 healthy reference individuals and have determined the normal reference intervals for the age groups of 20-29, 30-39, 40-49, and 50-59 years old. The rapidly increasing percentage of elderly people gives rise to ever increasing health-care needs for the elderly, which requires normal reference intervals for older age groups. However, we were unable to collect the required number of the reference individuals above 60 years of age. To obtain reference intervals with adequate reliability and usefulness temporally, we made use of the laboratory data of outpatients at Kyushu University Hospital, and were then easily able to collect the required number of elderly individuals. By performing a very simple selection from among the outpatients, our outpatient group became virtually indistinguishable from the group of healthy reference individuals established by us, with regard to many clinical tests, thus enabling us to estimate reference intervals for older age groups. This approach could be adopted in other regions.