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<p>The term “normal” is conceptually vague but of particular importance in medicine as it underpins diagnostic and therapeutic decisions. Normality is commonly defined statistically through reference intervals (e.g., 95% confidence intervals); however, frequency does not equate to health: common conditions can still have a&#xa0;relevant morbidity, while rare deviations can be benign. Alongside the World Health Organization (WHO) definition of health as a&#xa0;complete well-being, a&#xa0;functional approach emphasizes the absence of the need for medical treatment. Systematic errors can arise through normalization (underdiagnosis) or pathologization (overdiagnosis), particularly when reference samples are not representative. The example of iron deficiency illustrates that physiologically derived threshold values can be more appropriate than purely population-based cut-offs. Thus, medical normality is context-dependent and must take diversity-related factors into account.</p>

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Was ist eigentlich normal? Ein Aufruf zu physiologisch basierten Referenzwerten im Blutbild

  • 期刊论文

  • 发表日期：

    2026年4月27日

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  • Milena Lückemeyer,
  • Anne-Christin Gude,
  • Marie von Lilienfeld-Toal

摘要

The term “normal” is conceptually vague but of particular importance in medicine as it underpins diagnostic and therapeutic decisions. Normality is commonly defined statistically through reference intervals (e.g., 95% confidence intervals); however, frequency does not equate to health: common conditions can still have a relevant morbidity, while rare deviations can be benign. Alongside the World Health Organization (WHO) definition of health as a complete well-being, a functional approach emphasizes the absence of the need for medical treatment. Systematic errors can arise through normalization (underdiagnosis) or pathologization (overdiagnosis), particularly when reference samples are not representative. The example of iron deficiency illustrates that physiologically derived threshold values can be more appropriate than purely population-based cut-offs. Thus, medical normality is context-dependent and must take diversity-related factors into account.