The concept of the "index of individuality" was introduced by Eugene Harris
in 1974. The index of individuality, calculated as (CVA2 + CVI2)(1/2)/CVG,
where CVA, CVI, and CVG are analytical, within-subject, and between-subjec
t coefficients of variation respectively, has been used by many to investig
ate the utility of conventional population-based reference values. For a hi
gh index of individuality, > 1.4, it has been said that reference intervals
will be more useful than for a low index, < 0.6. The validity of these con
cepts is investigated here and a number of our findings are at odds with th
e generally held opinion. The index of individuality has no impact on the f
raction of individuals classified using population-based reference values,
as long as the change in concentration from the usual state is of the same
absolute magnitude and one sample is assayed to detect disease. However, wh
en a measurement falling outside a reference limit is repeated in order to
verify the finding, the index of individuality has considerable influence.
For quantities with very low indices, the repeat test result, will be close
to the first and give no new information, whereas for quantities with high
indices, a repeat test will decrease the number of true positives and fals
e positives.