Validation of the International Consensus Group Criteria for Slide Review Following Automated Complete Blood Count at Jimma Medical Center, Ethiopia

Abstract

Background

The international consensus group suggested criteria for action following automated complete blood count and white blood cell differential analysis. These criteria were set based on data from laboratories of developed countries. It is highly important to validate the criteria in developing countries where infectious diseases are still rampant that can affect blood cell count and morphology. Thus, this study aimed to validate the consensus group criteria for slide review at Jimma Medical Center, Ethiopia from November 1, 2020 to February 30, 2021.

Methods

The study comprised a total of 1685 patient samples from the daily laboratory workload of CBC analysis. The samples were collected in K2-EDTA tubes (Becton Dickinson) and analyzed using Coulter DxH 800 and Sysmex XT-1880 hematology analyzers. A slide review was done on two Wright-stained slides for each sample. All statistical analyses were performed using SPSS version 20 software.

Results

There were 39.8% positive findings, the majority of which were related to red blood cells. The false negative and false positive rates for Sysmex and Coulter analyzer were 2.4% vs 4.8%; and 4.6% vs 4.7%, respectively. The false negative rate was unacceptably higher when we used physicians’ triggered slide review, which was 17.3% and 17.9% for Sysmex and Coulter analyzers, respectively.

Conclusion

Generally, the consensus group rules are suitable to use in our setting. However, we might still need to modify the rules, particularly to reduce the review rates. It is also necessary to confirm the rules with case mixes proportionally derived from the source population.

Keywords:

• validation
• international consensus group criteria
• slide review
• complete blood count

Acknowledgments

The authors would like to thank Jimma University’s research and community service office for supporting this study. We sincerely thank the staff of Jimma University Medical Center laboratory unit for their unreserved support during the study.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This study was supported by the Jimma University research and community service office for data collection, analysis, and resources; no authors received special or specific funding for this study.