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The band count imprecision - a Croatian multicentric pilot study
Vanja Radišić Biljak1,2,3, Višnja Jureša3,4, Valentina Vidranski3,5
1Department of Medical Laboratory Diagnostics, University Hospital Sveti Duh, Zagreb, Croatia.
Biochemia Medica
|June 17, 2024
Summary
Inter-observer variability in counting band neutrophils remains high in Croatian laboratories, despite international recommendations to group them with segmented neutrophils. This inconsistency necessitates national-level action to standardize white blood cell differential analysis.
Area of Science:
- Hematology
- Clinical Pathology
- Laboratory Medicine
Background:
- International Council for Standardization in Haematology (ICSH) 2015 recommendations advise counting band neutrophils as segmented neutrophils due to high inter-observer variability.
- Despite recommendations, many Croatian laboratories continue to report band neutrophils separately in white blood cell (WBC) differentials.
- This practice may lead to inconsistencies in patient diagnosis and treatment.
Purpose of the Study:
- To assess the degree of inter-observer variability in enumerating band neutrophils within the WBC differential in Croatian laboratories.
- To evaluate the current practices in hematology laboratories regarding band neutrophil counting.
- To provide data for potential national standardization efforts.
Main Methods:
- A multicentric study involving seven large Croatian hospital laboratories.
- Analysis of blood smears flagged by analyzers for potential band neutrophils.
- Evaluation of band neutrophil counts by all participating laboratory personnel.
- Calculation of between-observer reproducibility using coefficient of variation (CV).
Main Results:
- Very high inter-observer variability was observed in enumerating band neutrophils, with CVs ranging from 15.4% to 62.4%.
- CVs for segmented neutrophils were generally lower, ranging from 7.4% to 32.2%.
- No correlation was found between CVs and the number of staff members in participating hospitals.
Conclusions:
- The study confirms significant inter-observer variability in band neutrophil counts among Croatian laboratories.
- There is a clear need for national-level action to standardize the enumeration of band neutrophils.
- Standardization would improve the reliability and consistency of WBC differential analysis in Croatia.
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