Reference Intervals for Blood Chemistry Parameters in the Pakistani Population: A Systematic Review of Published Literature.

Background: Reference intervals (RI) are a vital part of information provided with laboratory results. It is recommended that RI should be established by each laboratory following pre-laid guidelines. In this systemic review, we aim to comprehensively analyze and summarize all the published literature about establishment of RI for biochemical parameters in Pakistani population.

Methodology: We conducted a comprehensive search using Medline (PubMed interface) and PakMediNet literature, adhering to PRISMA guidelines. The search spanned from January 1984 to February 2024. All studies done for establishment of RI of biochemical parameters were included, while were nonhuman studies, case studies, preprints, no full text and articles in languages other than English were excluded. Rigorous evaluation ensured the robustness of their study analysis.

Results: Database search reveled 161 studies, 30 were analyzed as per inclusion criteria. The accumulated sample size of the studies comprised 108,563 individuals. Most of the studies were carried out on adults in Punjab and Sindh provinces. A wide variation was noted among the RIs established and units used in each study. Gaps were identified regarding description of healthy population, patient preparation sample handing and quality control.

Conclusion: In this review, critical gaps in data, methodology and reporting were identified. To enhance future studies, researchers should clearly define healthy populations, incorporate rigorous sample handling and quality control, and collaborate across centers.