Summary
Methods are presented for qualifying clinical reference intervals, for individuals as well as peer groups, according to circadian and other rhythms, using chronobiologically-defined single samples or time series.
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The term is derived from ‘chronos’, time, and ‘desmos’, bond, even if ‘desmos’ is here taken to denote something more like ‘bound’ or ‘band’ than like ‘bond’. Unless a more appropriate and succinct term can be proposed, the word chronodesm may be used with poetic (if not scientific) license. Names may also be appropriate for different kinds of chronodesms. The term ‘monodesm’ may indicate that all data used to derive a chronodesm were obtained at a) a single timepoint or b) during a single timespan shorter than the period of a particular rhythm under consideration. Thus, a monodesm would be a conventional reference interval applicable to a single timepoint or timespan. The term ‘rhythmodesm’ may refer generally to a chronodesm based on any satisfactory mathematical model for a given rhythm, applicable to all stages of the rhythm. If a single cosine curve is an appropriate model, one may use a more specific term: ‘cosinordesm’. If a statistically-significant model with normally-distributed residuals cannot be found, with or without data transformation, one may resort to constructing a ‘merodesm’, in which reference intervals are computed separately at each of several different timepoints or stages of a given rhythm, i.e., as a set of monodesms. The terms may be eventually qualified as to whether it applies to an individual-idiochronodesm — or to a population — panchronodesm. The term may be further qualified as to the model used.
The subscript capital i (I) denotes a time used for prediction, which may or may not coincide with an actual sampling time denoted by a small i (i).
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On practical grounds, the much more generally applicable tolerance interval is preferred to a prediction interval. However, for unique decisions such as those concerning the surgical removal of an organ (or for some other unique or very rare inference) the prediction interval (estimating the interval in which a very few or only a single future observation might fall) may yield at least theoretically a narrower band8. In such rare cases, a prediction interval may be preferable to a tolerance interval. If, then, a time-qualified prediction interval is given the term predictionchronodesm and the variations of this term described above can be advocated. The term chronodesm, without further qualification, will invariably refer to a time-qualified tolerance (rather than prediction) interval.
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Supported by the Hoechst Italia Foundation, US Environmental Protection Agency (R804512-01-0), US Public Health Service (5-K6-GM-13, 981), National Cancer Institute (1R01-CA-14446-01), Cancer Supplement (CA-14445-01S1), National Institute of Aging (A6-00158) and National Institute of Occupational Safety and Health (OH 00631).
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Halberg, F., Lee, J.K. & Nelson, W. Time-qualified reference intervals — chronodesms. Experientia 34, 713–716 (1978). https://doi.org/10.1007/BF01947276
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DOI: https://doi.org/10.1007/BF01947276