title: Historical data decrease complete blood count reflex blood smear review rates without missing patients with acute leukaemia.
abstract: BACKGROUND
  The availability of historical data decreases the rate of blood smear review rates in outpatients, but we are unaware of studies done at referral centres. In the following study, we determined the effect of historical data on the rates of peripheral blood smears over a 3-month period and then the detection rate of patients with acute leukaemia.
  
  
  METHODS
  All results of complete blood counts (CBCs) tested on three ADVIA 120 analyzers at the regional Rabin Medical Centre, Beilinson Campus over a 3-month period were accessed on a computerised laboratory information system. Over a 3-month period, we determined the proportion of total CBC and patients with criteria for a manual differential count and the actual number of peripheral blood smears done. Finally, we determined the proportion of 100 consecutive patients with acute leukaemia detected using our criteria that included limiting reflex testing according to historical data.
  
  
  RESULTS
  Over the 3-month period, there were 34,827 tests done in 12,785 patients. Without historical data, our smear rate would have been 24.5%, but with the availability of historical data, the blood smear review rate was 5.6%. The detection rate for cases of acute leukaemia was 100%.
  
  
  CONCLUSIONS
  We conclude that the availability of previous test results significantly reduces the need for blood smear review without missing any patients with acute leukaemia.
authors.affiliation: Hematology Laboratory, Clalit Health Services, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Esther
authors.initials: E
authors.lastname: Rabizadeh
authors.forename: Itay
authors.initials: I
authors.lastname: Pickholtz
authors.forename: Mira
authors.initials: M
authors.lastname: Barak
authors.forename: Paul
authors.initials: P
authors.lastname: Froom
mesh_terms: D000208:Acute Disease; D001772:Blood Cell Count; D006801:Humans; D007938:Leukemia / Q000097:blood* / Q000175:diagnosis; D010976:Platelet Count; D012017:Referral and Consultation; D012680:Sensitivity and Specificity
keywords: COMPUTER SYSTEMS; HAEMATOLOGY; LEUKAEMIA