title: Evaluation and optimization of the extended information process unit (E-IPU) validation module integrating the sysmex flag systems and the recommendations of the French-speaking cellular hematology group (GFHC).
abstract: The French-Speaking Cellular Haematology Group (GFHC) recently published criteria for microscopic analysis of a blood smears when a hemogram is requested. In order to evaluate and improve these recommendations using an XN (Sysmex) analyzer, we assessed 31,836 samples categorized into two sub-groups of patients either receiving or not receiving care in the clinical hematology/oncology departments of two university hospitals. By combining the manufacturer's recommendations and the GFHC recommendations, 21.3% of samples had a positive review flag in phase 1 of our study (17,991 samples). In phase 2 (13,845 samples), increasing the immature granulocytes (IG) percentage from 5-10% as a review trigger threshold, and ignoring slides with isolated flags 'PLT HIGH' (thrombocytosis) or 'MCV LOW' (microcytosis) or 'Blast/Abn Lymph and Atypical Lymph' (blast cells/abnormal lymphocytes and atypical lymphocytes) (in the absence of abnormal cells on a previous blood smear within 72 h), enabled us to significantly reduce the number of slides reviewed from 21.3-15.0% (p < 0.0001), without loss of clinical value. This decrease occurred in both sub-groups (hematology 48.7-38.0%, non-hematology 18.3-11.7%, p < 0.0001). In conclusion, the application of the GFHC criteria adapted to XN analyzers has enabled us to optimize the hematology laboratory processes, and thus reduce the production costs and the turnaround time of hemogram results.
authors.affiliation: a CHU CAEN - Laboratory of Haematology , Caen , France ;
authors.forename: Edouard
authors.initials: E
authors.lastname: Cornet
authors.affiliation: b Haematology Laboratory , Namur Thrombosis and Haemostasis Center (NTHC) , Namur Research Institute for Life Sciences (NARILIS), CHU UCL Namur, Université Catholique de Louvain , Belgium ;
authors.forename: François
authors.initials: F
authors.lastname: Mullier
authors.affiliation: b Haematology Laboratory , Namur Thrombosis and Haemostasis Center (NTHC) , Namur Research Institute for Life Sciences (NARILIS), CHU UCL Namur, Université Catholique de Louvain , Belgium ;
authors.forename: Noemie
authors.initials: N
authors.lastname: Despas
authors.affiliation: b Haematology Laboratory , Namur Thrombosis and Haemostasis Center (NTHC) , Namur Research Institute for Life Sciences (NARILIS), CHU UCL Namur, Université Catholique de Louvain , Belgium ;
authors.forename: Hugues
authors.initials: H
authors.lastname: Jacqmin
authors.affiliation: a CHU CAEN - Laboratory of Haematology , Caen , France ;
authors.forename: Carole
authors.initials: C
authors.lastname: Geara
authors.affiliation: c Avicenne Hospital, Clinical Research Unit , Bobigny , France.
authors.forename: Marouane
authors.initials: M
authors.lastname: Boubaya
authors.affiliation: b Haematology Laboratory , Namur Thrombosis and Haemostasis Center (NTHC) , Namur Research Institute for Life Sciences (NARILIS), CHU UCL Namur, Université Catholique de Louvain , Belgium ;
authors.forename: Bernard
authors.initials: B
authors.lastname: Chatelain
authors.affiliation: a CHU CAEN - Laboratory of Haematology , Caen , France ;
authors.forename: Xavier
authors.initials: X
authors.lastname: Troussard
mesh_terms: D059788:Dried Blood Spot Testing / Q000379:methods* / Q000592:standards; D006402:Hematologic Diseases / Q000175:diagnosis*; D006801:Humans; D058996:Quality Improvement; D015203:Reproducibility of Results
keywords: Analytical techniques; automated blood counts; decision support systems; evidence-based laboratory medicine; hematologic diseases; hematology; laboratory management; laboratory routines and automation; laboratory standardization; management; medical biochemistry; microscopy