A closed-form zlog transformation and continuous reference intervals for high-sensitivity cardiac troponin T were established for children aged 0-10 years, effectively removing age dependency.
Observational (n=1,635)
Yes
The establishment of continuous, age-dependent reference intervals and a zlog transformation for hsTnT in children aged 0-10 years enables age-independent interpretation and longitudinal monitoring in pediatric cardiology.
Abstract Objectives Age-dependent physiology makes interpreting high-sensitivity cardiac troponin T (hsTnT) challenging in early childhood. Values below the analytical limit create left-censored data, complicating reference interval (RI) estimation. Methods We combined two paediatric cohorts (CALIPER, n=277; LIFE Child, n=1, 358; ages 0–10 years) to derive continuous, age-dependent hsTnT RIs. Empirical quantiles were estimated using a sliding-window approach and fitted with four-parameter logistic functions. To address the high proportion of values below the analytical limit of detection (LOD; 3 ng/L), the 2. 5th percentile was inferred from the 65th and 97. 5th percentiles assuming lognormal distribution. A closed-form zlog transformation was established to standardise hsTnT values. Pointwise 95 % bootstrap confidence bands (100, 000 stratified resamples) were computed for both reference limits. Results HsTnT concentrations declined steeply during infancy and stabilised at low levels thereafter, with 46 % of samples below the analytical limit. The closed-form approach modelled reference limits according to the following logistic equation f x = 1 1 + e − a + b · x · maxv − minv + minv f (x) = (11+{e^- (a+b x) }) (maxv-minv) +minv with parameters: a=−1. 15 and 0. 47, b=−4. 13 and −6. 64, minv=1. 13 and 7. 50 and maxv=124. 13 and 210. 3 for lower and upper limits, respectively. Bootstrap confidence bands were widest in the first six months of life and narrowed substantially thereafter. The zlog transformation effectively removed age dependency, with >95 % of values within the theoretical RI (−1. 96 to +1. 96). Conclusions We present the first continuously modelled, closed-form RIs and corresponding zlog-transformation for paediatric hsTnT (ages 0–10 years). This framework enables direct LIS/EHR deployment without specialized software and facilitates age-independent interpretation and longitudinal monitoring in paediatric cardiology.
Trulson et al. (Fri,) reported a observational. High-sensitivity cardiac troponin T (hsTnT) measurement was evaluated on Continuous, age-dependent hsTnT reference intervals. A closed-form zlog transformation and continuous reference intervals for high-sensitivity cardiac troponin T were established for children aged 0-10 years, effectively removing age dependency.