No mathematical shortcuts for standardization or harmonization of laboratory measurements

Letter to the editor by Winter et al.: Reply

“…We welcome the comments by Winter et al [1] on our article about laboratory data standardization. The authors not only emphasize the importance of the topic as such, but also confirm the widespread perception, that no final solutions are currently available and further discussion is needed.…”

Interoperability of laboratory data in Switzerland – a spotlight on Bern

“…An advanced -although still emerging -concept to provide and exchange health information data is called Fast Health Interoperability Resources (FHIR). 13 Although many such attempts have been made in the field of medical and laboratory information management, and different standards have been implemented (e.g. HL7 v2, HL7 v3, Reference Information Model [RIM] and CDA), no such standard is able to comply with the ever-increasing complexity of digitization in healthcare.…”

“…In such cases, an unabridged documentation of all preanalytical steps -including the ones without a corresponding code -is necessary to be able to back match own data later on to an updated code version. The transmission of reference ranges together with the analyte concentrations is an issue of its own [13]: whereas a reference range on a laboratory report might be intended to support the physician in assessing a test result as "normal" or not, its suggested generation at each laboratory site renders it highly dependent on the hospital's patient cohort and thereby per se different between primary and tertiary care providers. Aside from questioning the concept of the monoparametric essence of the current reference ranges itself, reporting reference ranges always sets a patient in context with a "healthy" control group, which might or might not be relevant for the patient's condition or the scientific question of a collaborative project.…”