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Record W4412450607 · doi:10.1016/j.plabm.2025.e00492

Differential Distributions: A refined methodology to indirect reference interval estimation by including Patient's health status according to associated ICD-10 codes

2025· article· en· W4412450607 on OpenAlex

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.

Bibliographic record

VenuePractical Laboratory Medicine · 2025
Typearticle
Languageen
FieldMedicine
TopicClinical Laboratory Practices and Quality Control
Canadian institutionsArtificial Intelligence in Medicine (Canada)
Fundersnot available
KeywordsStatisticsInterval (graph theory)EstimationInterval estimationDifferential (mechanical device)Interval dataMathematicsMedicineConfidence intervalComputer scienceCombinatoricsEngineering

Abstract

fetched live from OpenAlex

Background: Traditional methods for estimating reference intervals (RIs) using patient's blood test results from the clinical routine, typically remove outliers without considering the nuanced health statuses of patients. This removes a vast majority of test results for reference interval estimation without considering the actual health status of the patient. Methods: We introduce the Differential Distribution Method (DDM) which uses laboratory routine data coded with ICD-10 to approximate an underlying non-diseased age and sex stratified population from mixed clinical data. By removing test results that stem from subpopulations significantly different from the general population, reference intervals can be generated stratified by sex and age, taking into account the associated health conditions of the patients as derived by the ICD-10 coding system. Results: Applying the DDM to blood plasma potassium levels demonstrated its ability to adjust RIs dynamically across different patient groups. The method effectively differentiated RIs in a decade-based stratification, showing significant variability and tighter confidence intervals, particularly in older (above 60 years old) adults. The RIs were slightly wider with advancing age in both males and females, while their standard deviation was reduced by removing large portions of test results differing significantly, grouped by either their individual ICD-10 code or clusters of ICD-10 codes. Conclusions: This DDM data mining approach offers a robust framework for RI inference by generating adjusted RIs that incorporate clinical nuances reflected in ICD-10 codes. This approach not only enhances the accuracy of patient diagnostics but also facilitates the identification of potential multimorbidities affecting laboratory results.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.004
metaresearch head score (Gemma)0.146
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch, Meta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.464
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0040.146
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0020.000
Bibliometrics0.0000.002
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0010.000

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.

Opus teacher head0.177
GPT teacher head0.502
Teacher spread0.325 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it