| Abstract [eng] |
Expediency Assessment of Cytomorphological Blood Smear Analysis Ordered by a Customer Currently the review of cytomorphological smear in Lithuania’s VUH SK is performed the ordering physician’s decision. In Lithuania no research has been carried out to assess suitability and usage of the automated CBC review criteria. Therefore, this first of a kind research is aiming to evaluate reasonability of blood smear testing by ordering physician against international automated CBC review criteria in VUH SK departments. The study included 7977 patients` CBC’s where in 925 cases cytomorphological blood smear testing was ordered by physician. Moreover, 240 patients cytomorphological blood smear testing data from the Intensive care units (ICU) and hematology – oncology outpatient departments were analysed separately and compared to the results in General departments. Obtained results were processed using Microsoft Office Excel 2016 and RStudio ver. 3.3.3 computer programs. It has been found that the cytomorphologic blood smears ordered by physician represent 1/8 of all VUH SK's complete blood count (CBC) tests and its ordering procedure is not rational. Furthermore, it was found that the 2005 TLHD CBC review criteria generate a large number of false – negative and false – positive CBC results, while the 2002 CBC review criteria are more suitable for VUH SK's General and ICU departments. Meanwhile there was no difference in application of 2002 and 2005 CBC review criteria for the hematology – oncology outpatient department. It was found that the least false – positive and false – negative results were obtained using both, quantitative and qualitative CBC review criteria. The cytomorphological smear testing results were most accurately reflected by CBC quantitative review criteria such as: the number of WBC and neutrophil counts, and the least accurate – platelet count. All laboratories should carry out an analysis of the suitability of automated CBC review criteria for its patient population and develop their own CBC review rules. |
