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Appl Clin Inform 2024; 15(05): 1093-1096
DOI: 10.1055/s-0044-1791488
Case Report

Reference Ranges for All: Implementing Reference Ranges for Transgender and Nonbinary Patients

Anthony B. Cardillo
1   MCIT Department of Health Informatics, NYU Langone Health, New York, United States
2   Department of Pathology, NYU Langone Health, New York, United States
,
Dan Chen
2   Department of Pathology, NYU Langone Health, New York, United States
,
Nina Haghi
2   Department of Pathology, NYU Langone Health, New York, United States
,
Luke O'Donnell
3   Department of Medicine, NYU Langone Health, New York, United States
,
Jeffrey Jhang
2   Department of Pathology, NYU Langone Health, New York, United States
,
Paul A. Testa
1   MCIT Department of Health Informatics, NYU Langone Health, New York, United States
,
Nicholas Genes
1   MCIT Department of Health Informatics, NYU Langone Health, New York, United States
4   Department of Emergency Medicine, NYU Langone Health, New York, United States
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Abstract

Objectives This study aimed to highlight the necessity of developing and implementing appropriate reference ranges for transgender and nonbinary (TGNB) patient populations to minimize misinterpretation of laboratory results and ensure equitable health care.

Case Report We describe a situation where a TGNB patient's abnormal laboratory values were not flagged due to undefined reference ranges for gender “X” in the Laboratory Information System (LIS). Implementation of additional reference ranges mapped to sex label “X” showed significant improvement in flagging abnormal lab results, utilizing sex-invariant reporting as an interim solution while monitoring developments on TGNB-specific reference ranges.

Conclusion Informatics professionals should assess their institution's policies for registration and lab reporting on TGNB patients as nonimplementation poses significant patient safety risks. Best practices include using TGNB-specific reference ranges emerging in the literature, reporting both male and female reference ranges for clinical interpretation and sex-invariant reporting.

Keywords

transgender health - nonbinary - laboratory reference ranges - electronic health records - clinical informatics

Protection of Human Subjects

This study did not involve human subjects directly. The case report is based on anonymized data handled according to ethical standards concerning privacy rights.




Publikationsverlauf

Eingereicht: 19. März 2024

Angenommen: 02. September 2024

Artikel online veröffentlicht:
18. Dezember 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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