CALIPER database of paediatric reference intervals: key milestones and future directions

Abstract

Accurately established reference intervals are essential to interpret laboratory test results and assess patient health. Poorly established reference intervals can lead to misdiagnosis, subjecting patients to anxiety, unnecessary testing, and/or infection risk. The clinical importance of reference intervals is well recognised. However, establishing robust reference intervals is a complex process, especially for the paediatric population. Therefore, available reference intervals are often incomplete, cover a limited paediatric age interval, and/or do not consider gender differences. CALIPER, a collaborative study among Canadian paediatric centres, is addressing these critical gaps by determining age- and sex-specific paediatric reference intervals for over 80 biomarkers using samples collected from over 8,500 children and adolescents. These reference intervals established on the Abbott ARCHITECT have been transferred to other major analytical platforms, broadening the utility of the CALIPER database. The effect of diurnal variation, post-prandial effects, biological variation, and storage temperature on analyte concentration has also been assessed. Knowledge translation initiatives, including peer-reviewed publications, an online database, and a smartphone application, allow physicians and laboratory technicians worldwide to easily access the CALIPER database. This project has made great progress in addressing critical knowledge gaps in paediatric reference intervals, ultimately benefiting paediatric healthcare across Canada and globally.