Finding Reference Criteria of Autoverification for Complete Blood Count (CBC) Analysis

Abstract

The complete blood count (CBC) is a basic diagnostic test routinely ordered in the laboratory. The CBC analysis involves several steps and requires a significant amount of work, leading to long wait times. The researchers aimed to establish appropriate reference criteria for automated result reporting (autoverification; AV) in CBC analysis to reduce waiting times and address service congestion. The study was conducted at The Hematology unit, Medical Technology and Clinical Pathology department, Udon Thani hospital. It was a cross-sectional descriptive study, collecting CBC test results from samples processed during regular working hours between May 27^th -31^st, 2024. The cases that underwent blood smear analysis (blood smear) and returned negative results for all parameters; including white blood cells (WBC),           red blood cells (RBC), and platelets, were included. Using Cochran's formula, a total of 400 cases were selected. High and low thresholds for each parameter were established and recorded as reference values in the Sysmex XN-3000 automated analyzer to define the criteria. Descriptive statistics were used to analyze false negative (FN) results, the rate of autoverification reporting, The Independent t-test will be used for analyzing the waiting time using PSPP 2.0.0. The significance level is set at 0.05 for statistical decision-making.

Results: The lower and upper reference values for the parameters of CBC, used as AV reference, WBC, RBC, HGB, HCT, MCV, MCH, MCHC, RDW-CV, PLT, NEUT, LYMP, MONO, EO, BASO, IG, Reticulocytes, and RET-He used set, and false negatives were found at rates of 0.75%, 2.00% and 1.00% for the parameters WBC, RBC and platelet, respectively. After 3 months of using the AV system, the average CBC result reporting rate by AV was 40.00% of the total CBC tests, with inpatient and outpatient rates of 31.00% and 44.81%, respectively. The waiting time for CBC test results for regular patients decreased from 109.80 minutes to 53.50 minutes and from 59.10 minutes to 43.10 minutes for emergency patients. The waiting times decreased significantly (p<0.001) for both inpatient and outpatient groups.