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Clinical Applicability of Automated Hematology Analyzer Research Parameters for Disease Diagnosis: a Reference
Insights
Establishing reference intervals for complete blood cell count (CBC) research parameters revealed limited diagnostic utility for diseases like iron deficiency anemia and sepsis. Most research parameter values fell within established ranges, suggesting caution in their application.
Area of Science:
- Hematology
- Clinical Pathology
- Diagnostic Medicine
Background:
- Reference intervals for complete blood cell count (CBC) research parameters were established.
- The study aimed to assess the diagnostic usefulness of these parameters for specific diseases.
Purpose of the Study:
- To establish comprehensive reference intervals for CBC research parameters across different age and gender groups.
- To evaluate the diagnostic performance of these research parameters in patients with iron deficiency anemia (IDA), appendicitis, sepsis, and myelodysplastic syndromes (MDS).
Main Methods:
- Reference intervals were determined for 26 basic and 38 research CBC parameters in a large cohort of men and women across two age groups (20-59 and ≥60 years).
- Patient data for IDA, appendicitis, sepsis, and MDS were compared against gender- and age-matched reference values.
Main Results:
- Age-specific partitioning was necessary for some parameters in men and women, but gender-specific partitioning was not required.
- Abnormal values were observed in a subset of patients: 67% of IDA patients had micro red blood cell ratios above reference limits; 3-5% of appendicitis patients had elevated immature granulocytes; 12-42% of sepsis patients showed numerous out-of-range values; and 67-100% of MDS patients had abnormal neutrophil cell complexity and dispersion.
Conclusions:
- Despite identifying specific abnormalities in disease cohorts, overall, less than 60% of research parameter values were outside reference ranges for most patients.
- The diagnostic usefulness of many CBC research parameters appears limited when applied broadly across these conditions.
Background:
We established reference intervals for research parameters of complete blood cell count and examined their usefulness for diagnosing certain diseases.
Methods:
Reference intervals for 26 basic and 38 research parameters were established for 3,457 and 1,325 men and 2,742 and 830 women aged 20 - 59 and ≥ 60 years, respectively. Research parameter values for patients with iron deficiency anemia (IDA), appendicitis, sepsis, and myelodysplastic syndromes (MDS) were compared against gender- and age-matched reference values.
Results:
Seven basic and 10 research parameters among men and one research parameter among women required partitioning by age. No partitioning by gender was required. Further, 67% patients with IDA showed micro red blood cell ratio values above the upper reference limits of their corresponding age and gender subgroups; 3% and 5% patients with appendicitis showed immature granulocyte percentages and counts above the upper reference limits, respectively; 12% - 42% of patients with sepsis showed numerous values exceeded their reference limits, and 67% and 100% patients with MDS showed neutrophil cell complexity and structural dispersion values outside their reference ranges, respectively.
Conclusions:
Overall, < 60% of research parameter values were outside their reference ranges among most patients, indicating their limited diagnostic usefulness.
