Combined hematologic parameters to optimize review criteria on XE-5000

Area of Science:

• Hematology
• Clinical Laboratory Science
• Medical Diagnostics

Background:

• International Consensus Group for Hematology Review established 41 consensus rules.
• Previous research focused on adjusting individual parameter thresholds.
• Optimization of review criteria is crucial for laboratory efficiency.

Purpose of the Study:

• To optimize review criteria by combining hematologic parameters.
• To improve efficiency and reduce slide review rates.
• To validate optimized criteria using a Sysmex XE-5000 analyzer.

Main Methods:

• Used 662 nucleated red blood cell (NRBC) and 406 atypical lymphocyte (AL) flagged samples.
• Established hematologic parameters associated with NRBC and AL.
• Validated optimized criteria on 1423 samples, comparing efficiency and slide review rates.

Main Results:

• Optimized NRBC criteria reduced slide review rate from 30.26% to 14.42% and increased efficiency from 75.65% to 91.02%.
• Optimized AL criteria reduced slide review rate from 40.60% to 11.80% and increased efficiency from 64.02% to 93.00%.
• Combined parameters significantly improved efficiency and reduced review rates (P < .001).

Conclusions:

• Adjusting Q-flag values by combining parameters optimizes criteria.
• Optimal criteria achieve higher efficiency with a low false-negative rate.
• This approach significantly reduces the slide review rate in hematology laboratories.