{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T06:47:58Z","timestamp":1782456478000,"version":"3.54.5"},"reference-count":19,"publisher":"Croatian Society for Medical Biochemistry and Laboratory Medicine","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biochem. med. (Online)"],"published-print":{"date-parts":[[2026,6,15]]},"abstract":"<jats:p>\n                    <jats:bold>Introduction:<\/jats:bold>\n                    The study of harmonized reference intervals (RIs) in Croatia was published in 2004. Since then, notable methodology and population characteristics changes have occurred in the Croatian population, highlighting the need for re-evaluation. This study aimed to verify harmonized RIs for hematology, coagulation, and clinical chemistry laboratory tests and assess their applicability in one clinical hospital center.\n                    <jats:bold>Materials and methods:<\/jats:bold>\n                    This verification study included 100 apparently healthy adults (40 males, 60 females; aged 22 to 75 years), selected using both a priori and a posteriori exclusion criteria following CLSI EP28-A3c guidelines. Blood samples were collected under standardized preanalytical conditions. Hematology analysis was performed on the Sysmex XN1000 analyzer (Sysmex, Kobe, Japan), coagulation testing on the Sysmex CS2500 analyzer (Siemens Healthcare Diagnostics Inc., Marburg, Germany), and clinical chemistry analysis on the Beckman Coulter DxC700AU (Beckman Coulter, Brea, USA) and Radiometer ABL90 FLEX (Radiometer, Br\u00f8nsh\u00f8j, Denmark) analyzers. Reference intervals were considered verified if at least 90% of results (18\/20) fell within the predefined RIs.\n                    <jats:bold>Results:<\/jats:bold>\n                    All tested hematology and coagulation RIs were successfully verified. Among 27 tested biochemical analytes, 25 RIs were verified in the first sample set. Total calcium and alkaline phosphatase RIs required additional verification. International harmonized RIs were adopted and successfully verified for both tests using two independent sample sets.\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Most harmonized RIs in use in Croatia remain applicable to the adult population of one clinical hospital center. However, periodic re-evaluation is needed due to changes in analytical methods and population characteristics. Reference intervals from international harmonization projects can provide a valid alternative when local verification fails.\n                  <\/jats:p>","DOI":"10.11613\/bm.2026.020706","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T07:43:42Z","timestamp":1781163822000},"page":"311-322","source":"Crossref","is-referenced-by-count":0,"title":["Verification of harmonized reference intervals in Croatia"],"prefix":"10.11613","volume":"36","author":[{"given":"Mirjana Mariana","family":"Kardum Paro","sequence":"first","affiliation":[{"name":"Department of Medical Biochemistry and Laboratory Medicine, Merkur University Hospital, Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonja","family":"Perkov","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry and Laboratory Medicine, Merkur University Hospital, Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Radeljak","sequence":"additional","affiliation":[{"name":"Department for Clinical Laboratory Diagnostics, Children\u2019s Hospital Srebrnjak, Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ida","family":"Burazer","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry and Laboratory Medicine, Merkur University Hospital, Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iva","family":"Fri\u0161\u010di\u0107","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry and Laboratory Medicine, Merkur University Hospital, Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4885","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"key20260611074336_r1","doi-asserted-by":"crossref","first-page":"5","DOI":"10.11613\/BM.2016.001","article-title":"Reference intervals: current status, recent developments and future considerations.","volume":"26","author":"Ozarda","year":"2016","journal-title":"Biochem Med (Zagreb)"},{"key":"key20260611074336_r2","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1080\/10408363.2023.2196746","article-title":"Reference intervals: past, present, and future.","volume":"60","author":"Doyle","year":"2023","journal-title":"Crit Rev Clin Lab Sci"},{"key":"key20260611074336_r3","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1080\/10408363.2023.2195496","article-title":"Current status and challenges in establishing reference intervals based on real-world data.","volume":"60","author":"Ma","year":"2023","journal-title":"Crit Rev Clin Lab Sci"},{"key":"key20260611074336_r4","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1093\/clinchem\/hvad099","article-title":"Reference interval harmonization: harnessing the power of big data analytics to derive common reference intervals across populations and testing platforms.","volume":"69","author":"Bohn","year":"2023","journal-title":"Clin Chem"},{"key":"key20260611074336_r5","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1093\/clinchem\/hvad098","article-title":"Reference interval harmonization: will big data provide a solution?","volume":"69","author":"Ceriotti","year":"2023","journal-title":"Clin Chem"},{"key":"key20260611074336_r6","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1373\/clinchem.2015.243055","article-title":"Transference and validation of reference intervals.","volume":"61","author":"Tate","year":"2015","journal-title":"Clin Chem"},{"key":"key20260611074336_r7","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1080\/00365513.2021.1907858","article-title":"Reference interval transference of common clinical biomarkers.","volume":"81","author":"Xu","year":"2021","journal-title":"Scand J Clin Lab Invest"},{"key":"key20260611074336_r8","unstructured":"Commission for Laboratory Results Harmonization of the Croatian Chamber of Medical Biochemists. Harmonizacija laboratorijskih nalaza u podru\u010dju op\u0107e, specijalne i visokodiferentne medicinske biokemije. Zagreb: Croatian Chamber of Medical Biochemists; 2004. Available at: https:\/\/homunizam.wordpress.com\/wp-content\/uploads\/2020\/03\/harmonizacija-laboratorijskih-nalaza.pdf. Accessed June 22nd 2025. (in Croatian)"},{"key":"key20260611074336_r9"},{"key":"key20260611074336_r10","first-page":"163","article-title":"Reference intervals of 56 haematological and biochemical constituents of blood and serum for reference individuals corresponding to reference state - population of Zagreb, Croatia.","volume":"34","author":"Flegar-Me\u0161tri\u0107","year":"1993","journal-title":"Croat Med J"},{"key":"key20260611074336_r11","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1080\/10408363.2017.1379945","article-title":"The Canadian laboratory initiative on pediatric reference intervals a CALIPER white paper.","volume":"54","author":"Adeli","year":"2017","journal-title":"Crit Rev Clin Lab Sci"},{"key":"key20260611074336_r12","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1515\/CCLM.2010.054","article-title":"Applicability of common reference intervals for serum creatinine concentrations to the Croatian population.","volume":"48","author":"Flegar-Me\u0161tri\u0107","year":"2010","journal-title":"Clin Chem Lab Med"},{"issue":"1","key":"key20260611074336_r13","doi-asserted-by":"crossref","first-page":"93","DOI":"10.5662\/wjm.v6.i1.93","article-title":"Standardization in laboratory medicine: Adoption of common reference intervals to the Croatian population.","volume":"6","author":"Flegar-Me\u0161tri\u0107","year":"2016","journal-title":"World J Methodol"},{"key":"key20260611074336_r14","article-title":"CLSI-based verification and de novo establishment of reference intervals for common biochemical assays in Croatian newborns.","volume":"34","author":"Fri\u0161\u010di\u0107","year":"2024","journal-title":"Biochem Med (Zagreb)"},{"key":"key20260611074336_r15"},{"key":"key20260611074336_r16"},{"key":"key20260611074336_r17","doi-asserted-by":"crossref","first-page":"2015","DOI":"10.1515\/cclm-2018-0602","article-title":"Working Group for Preanalytical Phase (WG-PRE), of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and Latin American Working Group for Preanalytical Phase (WG-PRE-LATAM) of the Latin America Confederation of Clinical Biochemistry (COLABIOCLI). Joint EFLM-COLABIOCLI Recommendation for venous blood sampling.","volume":"56","author":"Simundic","year":"2018","journal-title":"Clin Chem Lab Med"},{"key":"key20260611074336_r18","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1258\/acb.2011.011078","article-title":"Lane, V. Pathology Harmony; a pragmatic and scientific approach to unfounded variation in the clinical laboratory.","volume":"48","author":"Berg","year":"2011","journal-title":"Ann Clin Biochem"},{"key":"key20260611074336_r19","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1515\/CCLM.2011.621","article-title":"IFCC primary reference procedures for the measurement of catalytic activity concentrations of enzymes at 37\u202f\u00b0C. Part 9: Reference procedure for the measurement of alkaline phosphatase activity.","volume":"49","author":"Schumann","year":"2011","journal-title":"Clin Chem Lab Med"}],"container-title":["Biochemia medica"],"original-title":[],"link":[{"URL":"https:\/\/www.biochemia-medica.com\/assets\/images\/upload\/xml_tif\/bm-36-2-020706.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T06:23:21Z","timestamp":1782455001000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.biochemia-medica.com\/en\/journal\/36\/2\/10.11613\/BM.2026.020706"}},"subtitle":["is it time for a change?"],"short-title":[],"issued":{"date-parts":[[2026,6,15]]},"references-count":19,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,6,24]]},"published-print":{"date-parts":[[2026,6,15]]}},"URL":"https:\/\/doi.org\/10.11613\/bm.2026.020706","relation":{},"ISSN":["1846-7482","1330-0962"],"issn-type":[{"value":"1846-7482","type":"electronic"},{"value":"1330-0962","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6,15]]}}}