title: Optimization of laboratory workflow in clinical hematology laboratory with reduced manual slide review: comparison between Sysmex XE-2100 and ABX Pentra DX120.
abstract: BACKGROUND
  The validation of automated hematology analyzer results by manual slide review (MSR) is currently an inevitable work process in clinical hematology laboratories. The laboratory workload would be optimized if the requirement for MSR could be reduced without compromising patient care. We investigated whether slide-making rates would be different between two hematology analyzers, which were paired with their own automated slide makers/stainers: Sysmex XE-2100 with SP-1000i (Sysmex, Kobe, Japan) and ABX Pentra DX120 with SPS evolution (ABX-Horiba, Montpellier, France).
  
  
  METHODS
  A total of 943 samples were run in parallel on the Sysmex XE-2100 and ABX Pentra DX120. Reflex slides were automatically made in each analyzer according to its own criteria, which reflected the criteria of MSR in our laboratory. The slide-making rates were compared, and the results were further confirmed using the criteria of MSR.
  
  
  RESULTS
  The slide-making rates in Sysmex XE-2100, ABX Pentra DX120, and manual review were 22.5% (212/943), 15.91% (150/943), and 11.5% (108/943), respectively. In 774 (82.1%) samples, the three methods showed concordant results, and all made slides in 82 samples. Using the manual method as a standard, the sensitivity and specificity were 86.1% and 85.8% in Sysmex XE-2100 and 89.8% and 93.7% in ABX Pentra DX120.
  
  
  CONCLUSIONS
  Our data show that the slide-making rates are variable in different hematology analyzers. It also implies that although MSR cannot be fully substituted by modern hematology analyzers, it can be effectively reduced to optimize laboratory workload.
authors.affiliation: Department of Laboratory Medicine, Konkuk University School of Medicine, Kwangjin-gu, Seoul, Korea. dearmina@hanmail.net
authors.forename: M
authors.initials: M
authors.lastname: Hur
authors.forename: J-H
authors.initials: JH
authors.lastname: Cho
authors.forename: H
authors.initials: H
authors.lastname: Kim
authors.forename: M-H
authors.initials: MH
authors.lastname: Hong
authors.forename: H-W
authors.initials: HW
authors.lastname: Moon
authors.forename: Y-M
authors.initials: YM
authors.lastname: Yun
authors.forename: J Q
authors.initials: JQ
authors.lastname: Kim
mesh_terms: D019411:Clinical Laboratory Techniques / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D005069:Evaluation Studies as Topic; D006403:Hematologic Tests / Q000295:instrumentation* / Q000592:standards; D006405:Hematology / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D057188:Workflow