An Assessment of the Coulter Gen•S Automated Flagging System

Assessment of the Reliability of the Sysmex XE-5000 Analyzer to Detect Platelet Clumps

“…VPA, vortexed prior to analysis; PCIC, platelet count inaccurate due to clumps; NPLT, platelet count not obtainable due to clumps; NWC, normal with clumps; IWC, increased with clumps; DWC, decreased with clumps; RBT, if clinically indicated, a reliable platelet count may be obtained from a specimen collected in a blue-top (citrated) tube; CBC, complete blood count PPV of more than 95.0% each for the CLP flag. 5 Our findings on the XE-5000 reveal better sensitivity and similar or slightly lower NPV, PPV, and specificity compared with that of the GenS.…”

Optimization of Criteria for Verification of Automated Platelet Counts Generated by the Sysmex XE-2100 Hematology Analyzer

“…Based on the findings of (a) the lowest percent positive yield of 1.9 and (b) the reliability of over 99% of results (459 out of 463), achieved for the group of specimens with platelet count <100 × 10 3 /µL, one could also understandably exclude platelet count <100 × 10 3 /µL as a criteria for a reflex order of a platelet scan. However, considering (a) the likelihood physicians making quick patient management decisions based on unverified low platelet counts (eg, ordering an additional work-up including a hematology consult, postponing a surgery, or administering platelet transfusions), which in our experience is higher than desirable and (b) less than ideal sensitivity of the automated flagging system for CLP, [16][17] we decided to keep the platelet count <100 × 10 3 /µL as a criterion, but limit it to only the initial result. According to our revised policy, platelet scans will not be performed on follow-up platelet counts that are <100 × 10 3 /µL unless accompanied by either a delta check failure or flagged for CLP by the analyzer, and/or platelet clumping noted on previous smear examination.…”

“…These findings associated with the Sysmex XE-2100 analyzer, for the CLP flag in particular, are in agreement with the only available reports of efficiency of flagging systems for older models of Coulter analyzer (STKS and GenS) published by our group almost a decade ago. [16][17] To the best of our knowledge, there are no other similar studies published in the recent literature assessing the efficiency of individual flags generated by various analyzers currently in use in laboratories around the world.…”

Utility of Peripheral Blood Smear Examination in the Presence of Automated Haematology Analyser with Reference to Anaemia

“…The benefit of manual scan is the ability to identify clinically significant cell types (pencil cells, tear drop cells, burr cells, schistocytes, target cells, sickle cells, blast cells) that are not quantifiable by instruments, but that produce flags on the automated results. 19,20,21 The automated haematology analyser readings are as reliable as the standard manual method, even though the manual scan of peripheral smear provides additional diagnostic information. Hence, PBS examination even today cannot be totally replaced by automated haematology analysers as they provide so much additional information which cannot be summarized completely by the mere numerical calculations of an automated analyser but the present generation of automated haematology analysers are well on par and provide accurate morphological typing of anaemia in cases of Microcytic Hypochromic Anaemia, Macrocytic Anaemia and Normocytic Normochromic Anaemia with normal RDW thus reducing the workload and thereby increasing the efficiency of a laboratory.…”