3rd ed, edited by Steven J. Soldin, Carlo Brugnara, and Jocelyn M. Hicks, 232 pp, Washington, DC, American Association for Clinical Chemistry, 1999.The third edition of this text provides reference values for approximately 150 clinical chemistry parameters and 25 hematology parameters in children. The values that are presented were obtained either from the recent literature or from original investigations in the authors' own laboratories. The ranges presented for each analyte are typically partitioned by age and sex (where appropriate) and have been derived from reference samples of between 50 and 100 subjects. When available, literature references to articles in which the original studies were published are presented. In addition, the entry for each analyte includes the specimen type used for analysis and some information about the reference subjects and the methods of analysis. A laboratory director might consult a reference like this to compare a reference value that was estimated in his or her laboratory with an established value from the literature or to evaluate the validity of transferring a published reference value to her or his laboratory. Therefore, a text that facilitates these goals would be of great value.Although this book presents a large collection of pediatric reference values, references of this type are often of limited value to laboratorians. One flaw that decreases my enthusiasm for this type of book in general (and a shortcoming of this particular book) is that the protocols used in the original reference studies are not described in enough detail to allow the reader to evaluate the quality or the applicability of the reference values that are presented. In the absence of a complete set of specifications for the original reference study (for the details that should be provided, see Sunderman FW Jr. Clin Chem. 1973;21:1873.), the reader must go back to the primary literature to obtain the necessary information. Thus, a reader might just as well start with primary references (which can be readily found using simple search strategies in public domain databases such as PubMed) that are available on the Internet. A second limitation of this particular text is that many of the reference values presented are estimated by an indirect method using results determined in hospitalized patients. The validity of indirect methods for the establishment of reference values (especially ones that are suitable for transfer to other populations) is still not widely accepted in the field of laboratory medicine.In the book's preface, one of the authors states that “…reference ranges are guidelines for the clinician and cannot be used as definitive indicators of health or pathological states.” Yet, one of the claims printed on the book's back cover states that “…this book will allow you to interpret patient results….” Such a claim misrepresents the utility of the information that the book contains, especially in view of the deficiencies I have mentioned.
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