RCH1000 has supported the RCH Haematology Department in a world-first study to determine normal levels of childhood blood tests across the whole spectrum, for all appropriate age groups.
RCH houses the only laboratory in the country with this kind of comprehensive data for tests of bleeding and clotting, and is seeking to expand this initiative across all common tests and share its knowledge to help children across the world get the best care.
No child likes to have a blood test. Parents don’t like watching their children have blood tests either, but believe that the blood test will help diagnose if their child is sick, monitor the progress of their child’s illness and treatment, or confirm that their child is ‘normal’.
But, what is ‘normal’? In scientific terms, we usually define it as being the range of test results in which 95% of the normal population will lie when in good health. However, for most blood tests which we measure clinically, the normal range changes with the age of the patient and what is normal for an adult may be very abnormal for a child. For example, in some blood clotting tests one third of children will be called abnormal if you compare their blood test result to the adult normal values instead of the age appropriate child normal values.
Unfortunately, to determine ‘normal’ one needs to take blood from normal children and test it under the same conditions as one performing the tests in sick children. This means that each laboratory needs to know what is normal for the equipment and chemicals they are using in their laboratory, because every method gives slightly different results that might be clinically important. These studies have rarely been done before, primarily because they are so hard to do. Not many normal, healthy children volunteer for blood tests. Currently, when we do blood tests in sick children, our decision as to whether they are normal or not and what the test result means, is an educated guess rather than a factual one.
The Happi Kids, or Age Appropriate Pathology, study was designed to fix this dilemma by collecting blood from normal, healthy children and doing all the clinically relevant blood tests across biochemistry, immunology, haematology and coagulation laboratories used to diagnose and monitor children in current medical practice. With RCH1000’s support, the RCH team is working with The Royal Women’s Hospital, Sunshine Hospital and Northern Hospital to collect blood from healthy newborn babies, and normal, healthy children coming in for minor day procedures. Then, the RCH Division of Laboratory Services with the support of Melbourne Pathology, Dorevitch Pathology, and Australian Clinical Laboratories, is determining what is normal for children from birth to 18 years for all common biochemical, immunological, haematology and coagulation assays. For the first time ever these tests are being carried out on the same samples in multiple laboratories allowing for direct comparison of different labs to see if the variation in methods affects the results.
The outcome of this study will mean better care for RCH children, because every test will have normal data for each age group. It will also help children across Victoria and Australia, as the large private pathology providers will have accurate data on children for the first time. It is likely that the Happi Kids study will set the standards for how the issue of normal ranges is approached for laboratories around the world, influencing regulatory policy and practice worldwide.
To date, over 5,000 families have been invited to participate in this study, with over 2,000 agreeing to participate. Over 1,700 samples have been successfully collected and used to test the first group of biochemistry and immunology parameters. The analysis of this data will be completed over the coming months.
This is an enormous project, which would not be possible without the generous support of RCH1000 and the goodwill of the many families and their children at participating hospitals. The outcomes will improve the quality of pathology tests for children locally, nationally and globally. We believe that if a sick child must have a blood test, we owe it to them to get maximum information from that test to enable doctors to make the best decisions in interpreting the results.Join RCH1000