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Data mining of medical information systems

Data mining of medical information systems to improve pediatric decision-making guided by laboratory test results

Laboratory tests are an important tool for health assessment and essential for the majority of diagnostic and therapeutic decisions in modern healthcare. To enable the interpretation of numerical laboratory test results, comparison to reference intervals is performed, i.e. values expected in a comparable group of healthy control persons. When evaluating children’s laboratory test results, complex dynamics due to extensive physiological change with age have to be considered – however, lack of comprehensive reference intervals reflecting these dynamics limits the usefulness of laboratory tests in children and negatively impacts pediatric healthcare.
In the PEDREF study, we have established an approach to create pediatric reference intervals using data mining of laboratory information systems, which circumvents the ethical and practical challenges of conventional approaches and enables the interpretation of laboratory test results in children with unprecedented accuracy.

 

Accurate pediatric reference intervals are essential when using laboratory test results to guide clinical decisions. Data mining of laboratory information systems overcomes current ethical and practical restrictions and allows the construction of accurate pediatric reference intervals.
Exemplary boys’ hemoglobin reference intervals from the PEDREF study showing the 50th percentile, 25th and 75th percentiles, 10th and 90th percentiles, and 2.5th and 97.5th percentiles of hemoglobin concentration with age.

Collaborations

https://www.pedref.org/collaborators.html 

Selected publications

Blood counts in adult and elderly individuals: defining the norms over eight decades of life.
Zierk J, Krebs A, Rauh M, Metzler M, Löscher A, Strasser E, Krause SW. Br J Haematol. 2020 May;189(4):777-789.

Reference Interval Estimation from Mixed Distributions using Truncation Points and the Kolmogorov-Smirnov Distance (kosmic).
Zierk J, Arzideh F, Kapsner LA, Prokosch HU, Metzler M, Rauh M. Sci Rep. 2020 Feb 3;10(1):1704

Next-generation reference intervals for pediatric hematology.
Zierk J, Hirschmann J, Toddenroth D, Arzideh F, Haeckel R, Bertram A, Cario H, Frühwald MC, Groß HJ, Groening A, Grützner S, Gscheidmeier T, Hoff T, Hoffmann R, Klauke R, Krebs A, Lichtinghagen R, Mühlenbrock-Lenter S, Neumann M, Nöllke P, Niemeyer CM, Razum O, Ruf HG, Steigerwald U, Streichert T, Torge A, Rascher W, Prokosch HU, Rauh M, Metzler M. Clin Chem Lab Med. 2019 Sep 25;57(10):1595-1607

Age- and sex-specific dynamics in 22 hematologic and biochemical analytes from birth to adolescence.
Zierk J, Arzideh F, Rechenauer T, Haeckel R, Rascher W, Metzler M, Rauh M. Clin Chem. 2015 Jul;61(7):964-73