Members of the University of Toronto’s Department of Laboratory Medicine and Pathobiology (LMP) Quality Council joined colleagues from across Canada in Halifax this month to lead a national workshop on advancing harmonized laboratory reference intervals across Canadian healthcare systems.
Held during the 2026 Canadian Society of Clinical Chemists (CSCC) Annual Conference, the workshop, “Advancing Reference Interval Harmonization in Canada: Implementation of CSCC Best Practice Guidelines,” highlighted years of collaborative work led in part by members of the LMP Quality Council and the CSCC Working Group on Reference Interval Harmonization.
The LMP Quality Council brings together laboratory medicine experts from hospitals, academia and clinical laboratories to support quality improvement, standardization and best practices across the field of laboratory medicine. Through guideline development, collaborative research and educational initiatives, the council works to improve consistency and quality in laboratory testing and patient care.
The workshop opened with a presentation from Dr. Khosrow Adeli, Chair of the LMP Quality Council and co-chair of the CSCC Working Group on Reference Interval Harmonization, who outlined the national need for harmonized reference intervals across Canadian laboratories. Reference intervals - the ranges used to interpret laboratory test results - can vary between laboratories, potentially creating confusion for clinicians and patients and contributing to inconsistencies in care.
The session reviewed the working group’s multi-year effort, including national surveys, large-scale data analysis, verification studies and guideline development aimed at establishing evidence-based harmonized reference intervals for routine clinical chemistry tests.
Dr. Mary Kathryn Bohn, a recent graduate of LMP’s Postdoctoral Training Program in Clinical Chemistry and a member of the Quality Council, delivered the workshop’s second presentation, “Diving into the Data: Establishing Harmonized Recommendations & Local Verification.” Her presentation explored the data-driven approaches used to derive and verify harmonized reference interval recommendations, including the use of large-scale laboratory data and verification studies conducted across multiple jurisdictions.
Additional presentations explored the broader implementation challenges facing laboratories across the country and the growing need for consistent laboratory result interpretation regardless of testing site. Discussions highlighted the potential benefits of harmonization for patients, clinicians and the healthcare system, including more standardized care, reduced unnecessary repeat testing and improved consistency in clinical decision-making across Canada.
To date, much of the harmonization and verification work connected to the Quality Council has been concentrated within hospitals and laboratories in the Greater Toronto Area. Presenting the initiative at the CSCC conference provided an opportunity to share the work with laboratory professionals from across Canada and build momentum toward broader national implementation.
The workshop generated strong engagement from attendees and support for continued collaboration, including the proposed formation of a new CSCC working group to advance the next phase of harmonized reference interval implementation across Canada.
