Indirect reference intervals using an R pipeline

Abstract

Background: Indirect reference intervals require robust statistical approaches to separate the pathological and healthy values. This can be achieved with a data pipeline created in R, a freely available statistical programming language. Methods: A data pipeline was created to ingest, partition, normalize, remove outliers, and identify reference intervals for testosterone (Testo; n = 7,207) and aspartate aminotransferase (AST; n = 5,882) using data sets from NHANES. Results: The estimates for AST and Testo determined by this pipeline approximated current RIs. Care should be taken when using this pipeline as there are limitations that depend on the pathology of the analyte and the data set being used for RI estimation. Conclusions: R can be used to create a robust statistical reference interval pipeline.

Keywords

• Reference interval
• R markdown tutorial
• Mixtools