title: A statistical method for assessing change in immunologic parameters in a patient.
abstract: Serial measurement of in vitro immunologic parameters in patients is used to detect change in immune status over time due to disease progression and/or immunodulatory therapy. A statistical method is presented for looking at serial measurements on an individual to detect whether a change in a parameter is outside the bounds of expected within-individual variation. Analysis of variance is used, assuming a normal distribution, to obtain percentiles of the distribution of the absolute difference between consecutive values of immunologic parameters in a healthy population. The assumptions in this analysis are justified from a statistical point of view. We discuss how to use this statistical method to make judgments relevant to clinical immunology, including how to construct a table that can be used to determine quickly if an "interesting" change for some standard immunologic parameters has occurred, whether a linear (additive) or logarithmic (proportional) model for change might be more appropriate for a given parameter, and how to modify the calculations if change is expected in a certain direction or if multiple pre- and/or postevent (clinical change or intervention) measurements are available.
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000920:Antibody-Dependent Cell Cytotoxicity; D001699:Biometry; D003602:Cytotoxicity, Immunologic; D006801:Humans; D007109:Immunity; D007167:Immunotherapy; D007694:Killer Cells, Natural / Q000276:immunology; D007958:Leukocyte Count; D008213:Lymphocyte Activation; D008214:Lymphocytes / Q000276:immunology; D008875:Middle Aged; D009010:Monte Carlo Method