Peripheral blood film review: the demise of the eyecount leukocyte differential

Pierre, Robert V.

doi:10.1016/s0272-2712(03)00075-1

Cited by 102 publications

(102 citation statements)

References 2 publications

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“…Automated blood cell counters have undergone a technological evolution, providing more information1 with greater precision than manual determinations 2 3. The traditional microscopic method based on the count of 100 cells suffers from imprecision1 that is greater than that based on cell counts of thousands of cells provided by automated counters.…”

Section: Introductionmentioning

confidence: 99%

Historical data decrease complete blood count reflex blood smear review rates without missing patients with acute leukaemia

Rabizadeh

Pickholtz

Barak³

et al. 2013

J Clin Pathol

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Section: Introductionmentioning

confidence: 99%

Historical data decrease complete blood count reflex blood smear review rates without missing patients with acute leukaemia

Rabizadeh

Pickholtz

Barak³

et al. 2013

J Clin Pathol

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“…Automated laboratory hematology analyzers provide cell counts, flags, cell plots (instrumental morphology) and distributional histograms with greater precision and accuracy than that provided by manual determinations (1,2). However, for pathological conditions such as acute leukemia, a manual peripheral blood smear review is required to make the presumptive diagnosis.…”

Section: Introductionmentioning

confidence: 99%

The rate of manual peripheral blood smear reviews in outpatients

Froom

Havis

Barak

2009

Clinical Chemistry and Laboratory Medicine

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Background: The International Consensus Group for Hematology Review recommends manual blood smears for new findings from automated complete blood cell (CBC) tests. However, in outpatients, the rate of peripheral manual blood smear reviews is uncertain, as is the effect of historical results on this rate. Methods: In a prospective cohort study of 687,955 members of a health maintenance organization, we extracted 39,759 consecutive automated CBC test results and determined the rate of manual peripheral smear reviews that were indicated using different triggering criteria, and historical results. Results: Individual triggering values increased from 10.7% to 19.5% when comparing our criteria to those of the consensus criteria. The proportion of CBC test results with at least one triggering value was 7.2% using our criteria, compared to 13.9% with the inclusion of a mean corpuscular volume -75 and a plus one immature granulocyte flag according to the consensus committee. Availability of historical data decreased our peripheral smear review rate to 2.6%. Conclusions:The peripheral smear review rate in outpatients using the consensus criteria was higher than with our less stringent criteria. If historical data are available and no clinical utility is demonstrated for the additional consensus criteria, an acceptable outpatient review rate might be as low as 2.6%.

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“…However, this approach is labor-intensive and time-consuming because it requires manual examination and an experienced medical technologist. Furthermore, the results may be subjective because of human interpretation, and only a few hundred cells can be analyzed for any given sample (8).…”

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confidence: 99%