Complete Blood Count Reference Interval Diagrams Derived from NHANES III: Stratification by Age, Sex, and Race
Bibliographic record
Abstract
BACKGROUND: Comprehensive, up-to-date "health-associated" reference interval studies of North American populations are uncommon. The third US National Health and Nutrition Examination Survey (NHANES III) was concluded in 1994 and yielded important reference interval data. OBJECTIVE: To obtain health-associated Coulter counter reference interval data from NHANES III according to age, sex, and race. METHODS: Of the 29,314 civilian noninstitutionalized US citizens who participated in NHANES III, approximately 25,000 had a complete blood count, red cell distribution width (RDW), platelet count, and automated white blood cell (WBC) differential determined on a Coulter S-Plus Jr. To determine health-associated reference intervals, we used the following exclusion criteria: pregnancy, breast feeding, obesity (body mass index [BMI] >40 and >35 for females and males, respectively), diastolic blood pressure >100 mm Hg, any smoking, any drinking of alcohol, recent treatment for anemia, creatinine level >2.5 mg/dL, glucose level >126 mg/dL, excessive thinness (BMI <8), recent surgery or hospitalization, or having antibodies to hepatitis viruses A, B, or C. The Coulter counter data (hemoglobin, hematocrit, red blood cell count, mean corpuscular volume (MCV), mean cell hemoglobin concentration (MCHC), MCH, WBC count, platelet count, granulocyte count, monocyte count, lymphocyte count, RDW, platelet distribution width, and mean platelet volume) were separated into 6 sex/racial categories (female non-Hispanic white, female non-Hispanic black, female Mexican American, male non-Hispanic white, male non-Hispanic black, and male Mexican American) and 9 age groupings (10-14, 14-18, 18-25, 25-35, 35-45, 45-55, 55-65, 65-75, and >75 years). RESULTS: There was a high exclusion rate; for example, of the 20,685 individuals with measured hemoglobin levels, 12,688 (61.3%) were excluded. Percentile estimates could be derived accurately for almost all of the female age/sex categories. A few of the male Mexican American and non-Hispanic black categories contained observations for ages 45 to 75 years. CONCLUSIONS: There are age-dependent trends for many of the tests, notably in RDW, MCMV, platelet count, and granulocyte and lymphocyte percentages. Sex-dependent changes involved hemoglobin values, and race-related trends centered around mononuclear and lymphocyte percentages, hematocrit, MCHC, MCH, and hemoglobin. This study reveals the potential for using data mining of large samples to yield potentially useful reference ranges.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.021 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".