Pediatric reference intervals for alkaline phosphatase

Zierk, Jakob; Arzideh, Farhad; Haeckel, Rainer; Cario, Holger; Frühwald, Michael C.; Groß, Hans‐Jürgen; Gscheidmeier, Thomas; Hoffmann, Reinhard; Krebs, Alexander; Lichtinghagen, Ralf; Neumann, Michael; Ruf, Hans-Georg; Steigerwald, Udo; Streichert, Thomas; Rascher, Wolfgang; Metzler, Markus; Rauh, Manfred

doi:10.1515/cclm-2016-0318

Cited by 81 publications

(48 citation statements)

References 24 publications

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“…As large numbers of test results are readily available from laboratory information systems, this enables the establishment of reference intervals specific to different populations, age-groups, analytical devices, and even batches and reagents. Extensive experience with these methods exists in children, where unique ethical challenges limit access to blood samples to create reference intervals 8,[10][11][12] and in challenging adult populations with a high proportion of patients with substantial morbidity and mortality 13 .…”

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confidence: 99%

“…However, both of these methods assume a Gaussian distribution of physiological test results, and require visual identification of a proportion of purely physiological test results, a process which is prone to bias and prevents integration into automated pipelines. Recently, a method developed by Arzideh et al 9,[16][17][18][19] has been used to establish reference intervals for adults 13 and children 8,[10][11][12]20 . This method uses a truncation interval of the range of test results in the input dataset after Box-Cox transformation to estimate a distribution of supposedly physiological test results, and can therefore estimate non-Gaussian distributions.…”

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confidence: 99%

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Reference Interval Estimation from Mixed Distributions using Truncation Points and the Kolmogorov-Smirnov Distance (kosmic)

Zierk

Arzideh

Kapsner

et al. 2020

Sci Rep

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Appropriate reference intervals are essential when using laboratory test results to guide medical decisions. Conventional approaches for the establishment of reference intervals rely on large samples from healthy and homogenous reference populations. However, this approach is associated with substantial financial and logistic challenges, subject to ethical restrictions in children, and limited in older individuals due to the high prevalence of chronic morbidities and medication. We implemented an indirect method for reference interval estimation, which uses mixed physiological and abnormal test results from clinical information systems, to overcome these restrictions. The algorithm minimizes the difference between an estimated parametrical distribution and a truncated part of the observed distribution, specifically, the Kolmogorov-Smirnov-distance between a hypothetical Gaussian distribution and the observed distribution of test results after Box-Cox-transformation. Simulations of common laboratory tests with increasing proportions of abnormal test results show reliable reference interval estimations even in challenging simulation scenarios, when <20% test results are abnormal. Additionally, reference intervals generated using samples from a university hospital's laboratory information system, with a gradually increasing proportion of abnormal test results remained stable, even if samples from units with a substantial prevalence of pathologies were included. A highperformance open-source c++ implementation is available at https://gitlab.miracum.org/kosmic.

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confidence: 99%

Reference Interval Estimation from Mixed Distributions using Truncation Points and the Kolmogorov-Smirnov Distance (kosmic)

Zierk

Arzideh

Kapsner

et al. 2020

Sci Rep

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“…Um die Versorgung mit Substrat zum Knochenaufbau zu überprüfen, sollten die Serumwerte von Kalzium und Phosphat gemessen werden. Um die Möglichkeit zum Einbau der Mineralien in den Knochen zu beurteilen, sollte auf die Aktivität der "Alkalischen Phosphatase", unter Berücksichtigung der altersspezifischen Normwerte, geachtet werden (5). Zur Evaluierung der Auf-und Umbauvorgänge dient die Bestimmung von Parathormon und Vitamin D (6).…”

Section: Laborunclassified

Diagnostik und Therapie bei Erkrankungen mit erhöhtem Frakturrisiko

Semler¹,

Rehberg²,

Stark³

et al. 2018

Kinder- und Jugendmedizin

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ZusammenfassungFrakturen treten im Kindes- und Jugendalter bei vielen Kindern auf und sind meist durch adäquate Traumata verursacht. Sie können jedoch auch im Zusammenhang mit einer Kindesmisshandlung oder als Zeichen einer systemischen Skeletterkrankung beobachtet werden. Die diagnostischen Schritte umfassen neben Anamnese und klinischer Untersuchung, bildgebende Verfahren, Laboruntersuchungen und Knochendichtemessungen. In der Kinder- und Jugendmedizin ist bei allen diesen Methoden auf die Verwendung von alters- und größenkorrelierten Normwerten zu achten. Hierdurch können primäre und sekundäre Osteoporosen sowie Mineralisierungs- Synthese- und Abbaustörungen voneinander getrennt werden. Im Falle angeborener Erkrankungen können genetische Untersuchungen zur Diagnosesicherung beitragen. Eine sichere Diagnosestellung ist erforderlich, um eine kostenbewusste Diagnostik durchzuführen und letzten Endes eine zielgerichtete Therapie initiieren zu können.

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“…The interpretation of alkaline phosphatase activity in children is complex because of extensive changes connected with growth and puberty, which leads to distinctive behavioural and age-related dynamics. Continuous diagrams of changes in its activity from birth to adulthood give the possibility to accurately take this dynamics into account (Zierk, 2018).…”

Section: Introductionmentioning

confidence: 99%

Peculiarities of functional-vegetative homeostasis of preschool-age females (first childhood)

Yermishev¹

2019

biologija

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In the process of ontogenesis, individual organs and systems mature gradually completing their development in different periods of life. This heterochrony of maturation determines the features of organism-functioning in children of different ages. However, the data in scientific literature do not reveal the features of the vegetative status of preschool children. Therefore, the goal of our work was to determine the level of vegetative homeostasis, which indicates the ratio of sympathetic (YANG) and parasympathetic (YIN) functional activity of the autonomic nervous system in preschool children. The methodology of functional-vegetative diagnostics (FVD) elaborated by Professor V. G. Makats (2016) allowed identifying acupunctural channels and discovered a previously unknown human functional-vegetative system. The diagnostic complex “BIOTEST-12M” (Diagnostic complexes VITA-01-M and computerized system VITA-01-Biotest) serves as the technical tool of the FVD. The specific dynamics of increasing systemic-functional stabilization indicates the formation of age-related mechanisms of functional-vegetative homeostasis and the peculiarities of physiological development of preschool children. We found 28.5% of the surveyed preschool children in the zone of vegetative equilibrium, and 50% have parasympathicotonia. The sympathetic orientation of the levels of vegetative equilibrium by the years of life of preschool children in the female group (FG) is identical and indicates the multi-directional activity of individual systemic complexes.

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Pediatric reference intervals for alkaline phosphatase

Cited by 81 publications

References 24 publications

Reference Interval Estimation from Mixed Distributions using Truncation Points and the Kolmogorov-Smirnov Distance (kosmic)

Reference Interval Estimation from Mixed Distributions using Truncation Points and the Kolmogorov-Smirnov Distance (kosmic)

Diagnostik und Therapie bei Erkrankungen mit erhöhtem Frakturrisiko

Peculiarities of functional-vegetative homeostasis of preschool-age females (first childhood)

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