Validation and implementation of an algorithm for reporting the automated absolute neutrophil count from selected...

Area of Science:

• Clinical Hematology
• Laboratory Medicine
• Medical Technology

Background:

• Automated cell counters generate flags requiring manual review, leading to delays in hematology/oncology clinics.
• Unnecessary microscopic reviews of flagged samples contribute to unacceptable patient wait times.

Purpose of the Study:

• To validate ignoring specific flags from Sysmex XE/XT instruments when absolute neutrophil count (ANC) is the primary clinical concern.
• To assess the impact of disregarding non-ANC specific flags on turnaround time and accuracy.

Main Methods:

• Analyzed 518 samples to evaluate 5 flags on Sysmex XE/XT instruments.
• Correlated automated and manual ANC values for samples with non-ANC flags (R²=96.9%).
• Implemented an "ANC-only" test code to disregard non-ANC specific flags.

Main Results:

• A high correlation (R²=96.9%) was observed between automated and manual ANCs for flagged samples.
• Only 0.3% of samples (1 out of 296) showed clinically significant discrepancies.
• Automated ANC reporting reduced review rates by 60% and turnaround time by 100 minutes.

Conclusions:

• Ignoring specific non-ANC flags on Sysmex XE/XT instruments is safe when ANC is the primary clinical question.
• This strategy significantly decreases laboratory turnaround time for ANC analysis.
• Implementation of an "ANC-only" order set improves efficiency in hematology/oncology workflows.