Evaluation of QBC Autoread performance in an emergency department setting

The objective of the study was to examine the accuracy and clinical utility of technology using a quantitative buffy coat analysis in determining complete blood cell count results in an emergency department. A prospective observational study was done at an urban pediatric emergency department. One hundred ninety-one patients who had a complete blood cell count (CBC) ordered by the managing emergency physician from 11 AM to 3 AM participated. A blood analysis was performed in the emergency department on the QBC Autoread System for hemoglobin (Hgb), hematocrit (Hct), white blood cell count (WBC), absolute and percent granulocytes (Gr), absolute and percent lymphocytes/monocytes (L/M), and platelets (PTLS). Results were compared with a CBC analysis on the hospital laboratory system (Coulter S-8-80). Time from specimen collection to results were compared for QBC and laboratory CBC. Emergency physicians completed a clinical utility survey after reviewing QBC results. Linear regression curves revealed a high correlation between the two methods for all parameters studied (Hgb: R = 0.911, Hct: R = 0.868, natural log WBC: R = 0.938, % Gr: R = 0.932, % L/M: R = 0.939, and natural log PTLS: R = 0.877). The mean time for collection to QBC result was 17.3 +/- 11.6 minutes compared with 42.2 +/- 17.9 minutes for collection to CBC result. One hundred thirty-five clinical utility forms were completed by the managing physicians after a review of their patient's QBC result. In 20% of cases, physicians felt the QBC result would have shortened the patient's length of stay in the emergency department, and in 85% they felt the result confirmed their clinical impression.(ABSTRACT TRUNCATED AT 250 WORDS)