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@ARTICLE{Anker:186555,
      author       = {S. C. Anker and J. Morgenstern and J. Adler and M. Brune
                      and S. Brings and T. Fleming and E. Kliemank and M. Zorn and
                      A. Fischer$^*$ and J. Szendroedi and L. Kihm and J. Zemva},
      title        = {{V}erification of sex- and age-specific reference intervals
                      for 13 serum steroids determined by mass spectrometry:
                      evaluation of an indirect statistical approach.},
      journal      = {Clinical chemistry and laboratory medicine},
      volume       = {61},
      number       = {3},
      issn         = {1434-6621},
      address      = {Berlin [u.a.]},
      publisher    = {De Gruyter},
      reportid     = {DKFZ-2023-00007},
      pages        = {452-463},
      year         = {2022},
      note         = {2022 Dec 20;61(3):452-463},
      abstract     = {Conventionally, reference intervals are established by
                      direct methods, which require a well-characterized,
                      obviously healthy study population. This elaborate approach
                      is time consuming, costly and has rarely been applied to
                      steroid hormones measured by mass spectrometry. In this
                      feasibility study, we investigate whether indirect methods
                      based on routine laboratory results can be used to verify
                      reference intervals from external sources.A total of 11,259
                      serum samples were used to quantify 13 steroid hormones by
                      mass spectrometry. For indirect estimation of reference
                      intervals, we applied a 'modified Hoffmann approach', and
                      verified the results with a more sophisticated statistical
                      method (refineR). We compared our results with those of four
                      recent studies using direct approaches.We evaluated a total
                      of 81 sex- and age-specific reference intervals, for which
                      at least 120 measurements were available. The overall
                      agreement between indirectly and directly determined
                      reference intervals was surprisingly good as nearly every
                      fourth reference limit could be confirmed by narrow
                      tolerance limits. Furthermore, lower reference limits could
                      be provided for some low concentrated hormones by the
                      indirect method. In cases of substantial deviations, our
                      results matched the underlying data better than reference
                      intervals from external studies.Our study shows for the
                      first time that indirect methods are a valuable tool to
                      verify existing reference intervals for steroid hormones. A
                      simple 'modified Hoffmann approach' based on the general
                      assumption of a normal or lognormal distribution model is
                      sufficient for screening purposes, while the refineR
                      algorithm may be used for a more detailed analysis.},
      keywords     = {liquid-chromatography (Other) / liquid–liquid-extraction
                      (Other) / mass spectrometry (Other) / reference intervals
                      (Other) / steroids (Other)},
      cin          = {A270},
      ddc          = {610},
      cid          = {I:(DE-He78)A270-20160331},
      pnm          = {311 - Zellbiologie und Tumorbiologie (POF4-311)},
      pid          = {G:(DE-HGF)POF4-311},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:36537103},
      doi          = {10.1515/cclm-2022-0603},
      url          = {https://inrepo02.dkfz.de/record/186555},
}