Performance Evaluation of the Sysmex 'RBC Defect Workflow Optimisation' Flag for the Detection of Haemoglobinopathies...

Area of Science:

• Hematology
• Clinical Diagnostics
• Medical Laboratory Science

Background:

• Haemoglobinopathies are common inherited blood disorders globally.
• Early detection of carriers is crucial for diagnosis and genetic counseling.
• Automated screening tools can improve laboratory efficiency.

Purpose of the Study:

• To evaluate the diagnostic performance of the Sysmex 'RBC Defect Workflow Optimisation' (RWO) flag.
• To assess the RWO flag's utility in identifying heterozygous haemoglobinopathies (HGB HTZ), sickle cell disease (SCD), and iron deficiency anaemia (IDA) in routine practice.

Main Methods:

• Prospective evaluation of 405 samples flagged by RWO over 6 months.
• Calculation of positive predictive values (PPVs) for HGB HTZ, SCD, and IDA.
• Retrospective analysis of RWO flags and comparison with an external discriminant index for HGB HTZ β-thalassaemia.

Main Results:

• The RWO flag showed high PPVs: 81.9% for HGB HTZ, 68.7% for IDA, and 100% for SCD.
• Retrospective sensitivity for HGB HTZ and SCD was 25.0%.
• The HGB HTZ β-thalassaemia flag performance was comparable to the %MicroRBC/%HypoHe ratio.

Conclusions:

• The Sysmex RWO flag is a practical and effective screening tool for HGB HTZ and SCD in clinical settings.
• Its high predictive value and efficiency support its use in routine laboratory diagnostics.
• The RWO flag can serve as a trigger for targeted haemoglobin analysis.