Within-subject biological variation in disease: collated data and clinical consequences

Ann Clin Biochem 2007;44:343-352
doi:10.1258/000456307780945633
© 2007 Royal Society of Medicine

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Original Articles


Carmen Ricós,
Natalia Iglesias,
José-Vicente García-Lario,
Margarita Simón,
Fernando Cava,
Amparo Hernández,
Carmen Perich,
Joanna Minchinela,
Virtudes Alvarez,
Maria-Vicenta Doménech,
Carlos-Victor Jiménez,
Carmen Biosca and
Raquel Tena


Analytical Quality Commission of the Spanish Society of Clinical Biochemistry and Molecular Pathology (SEQC), Barcelona; Laboratoris Clínics Hospital Universitari Vall d’Hebron, Barcelona;
Laboratoris Clínics Hospital Universitari Vall d’Hebron, Barcelona;
Analytical Quality Commission of the Spanish Society of Clinical Biochemistry and Molecular Pathology (SEQC), Barcelona; Servicio de Análisis Clínicos, Hospital de Motril, Granada;
Analytical Quality Commission of the Spanish Society of Clinical Biochemistry and Molecular Pathology (SEQC), Barcelona; Consorci Laboratori Intercomarcal, Vilafranca del Penedés;
Analytical Quality Commission of the Spanish Society of Clinical Biochemistry and Molecular Pathology (SEQC), Barcelona; Laboratorio Fundación Hospital Alcorcón, Madrid;
Analytical Quality Commission of the Spanish Society of Clinical Biochemistry and Molecular Pathology (SEQC), Barcelona; Laboratori Clínic de L’Hospitalet, Barcelona;
Analytical Quality Commission of the Spanish Society of Clinical Biochemistry and Molecular Pathology (SEQC), Barcelona; Laboratori Clínic Bon Pastor, Barcelona;
Analytical Quality Commission of the Spanish Society of Clinical Biochemistry and Molecular Pathology (SEQC), Barcelona; Laboratori Clínic Barcelonès Nord, Barcelona;
Analytical Quality Commission of the Spanish Society of Clinical Biochemistry and Molecular Pathology (SEQC), Barcelona;
Analytical Quality Commission of the Spanish Society of Clinical Biochemistry and Molecular Pathology (SEQC), Barcelona; Laboratori Clínic Manso, Barcelona;
Analytical Quality Commission of the Spanish Society of Clinical Biochemistry and Molecular Pathology (SEQC), Barcelona; Laboratori Clínic Barcelonès Nord, Barcelona;
Servei Aanàlisi Clíniques Hospital Germans Trias i Pujol, Badalona;
Laboratoris Clínics Hospital Universitari Vall d’Hebron, Barcelona

Quantitative data on the components of biological variation (BV) are used for several purposes, including calculating the reference change value (RCV) required for the assessment of the significance of changes in serial results in an individual. Pathology may modify the set point in diseased patients and, more importantly, the variation around that set-point. Our aim was to collate all published BV data in situations other than health. We report the within-subject coefficient of variation (CVI) for 66 quantities in 34 disease states. We compared the results with the CVI determined in healthy individuals and examined whether the data derived in specific diseases could be useful for clinical applications. For the majority of quantities studied, CVI values are of the same order in disease and health: thus the use of RCV derived from healthy subjects for monitoring patients would be reasonable. However, for a small number of quantities considered to be disease specific markers, the CVI differed from those in health. This could mean that RCV derived from healthy CVI may be inappropriate for monitoring patientsin certain diseases. Hence, disease-specific RCVs may be clinicallyuseful.


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