Development and validation of an app-based cell counter for use in the clinical laboratory setting

Abstract

Introduction:For decades cellular differentials have been generated exclusively on analog tabletop cell counters. With the advent of tablet computers, digital cell counters – in the form of mobile applications (“apps”) – now represent an alternative to analog devices. However, app-based counters have not been widely adopted by clinical laboratories, perhaps owing to a presumed decrease in count accuracy related to the lack of tactile feedback inherent in a touchscreen interface. We herein provide the first systematic evidence that digital cell counters function similarly to standard tabletop units.Methods:We developed an app-based cell counter optimized for use in the clinical laboratory setting. Paired counts of 188 peripheral blood smears and 62 bone marrow aspirate smears were performed using our app-based counter and a standard analog device. Differences between paired data sets were analyzed using the correlation coefficient, Student's t-test for paired samples and Bland–Altman plots.Results:All counts showed excellent agreement across all users and touch screen devices. With the exception of peripheral blood basophils (r = 0.684), differentials generated for the measured cell categories within the paired data sets were highly correlated (all r ≥ 0.899). Results of paired t-tests did not reach statistical significance for any cell type (all P > 0.05), and Bland–Altman plots showed a narrow spread of the difference about the mean without evidence of significant outliers.Conclusions:Our analysis suggests that no systematic differences exist between cellular differentials obtained via app-based or tabletop counters and that agreement between these two methods is excellent.

N-thiocarboxyanhydrides, amino acid-derived enzyme-activated H2S donors, enhance sperm mitochondrial activity in presence and absence of oxidative stress

“…An aliquot of each ejaculate was collected and fixed in 0.3% formaldehyde in phosphate-buffered saline (PBS) solution for the evaluation of sperm abnormalities: only the ejaculates showing < 25% abnormal spermatozoa were used for the experiments. Evaluation (cell counting) of sperm morphology, mitochondrial activity, plasma membrane integrity, and acrosomal status were performed using the app-based cell counter designed by Thurman et al [ 54 ].…”

Morphogo: An Automatic Bone Marrow Cell Classification System on Digital Images Analyzed by Artificial Intelligence

“…In the study, we analyzed the cells in the bone marrow smears using digital slides and automated cell analysis techniques. Morphological analysis of blood smears [10] and bone marrow smears [1] is still an essential element of hematological diagnostics. In peripheral blood, automated blood cell analysis techniques are well established and widely used.…”

“…The successful detection and classification of mature peripheral blood cells demonstrate high sensitivity scores [6, 14, 15]. Although some progress has been made in the study of automated analysis of bone marrow cells [8, 10, 11], it is still dependent on the traditional method of manual microscope evaluation, which has limitations [2]. The Morphogo system, which enables digital image acquisition and the automatic cell image analysis of bone marrow smears and isolated display of immature cells, dysplastic cells, and blasts, will help improve these problems.…”

“…In recent years, there has been an increasing interest in developing computational methods to assist pathologists in histological analysis via digital images [4-6] and artificial intelligence (AI) systems [7]. Automated image processing systems have been developed to address the difficulties of cell classification in blood smear [4-6, 8, 9] and bone marrow aspirate smears [8, 10, 11]. Studies have shown that the CellaVision® DM96 [4, 6, 9] and DI-60 [12] digital systems are an efficient tool to perform leukocyte count and differential in clinical laboratories.…”

Development and Pilot Testing of a Comprehensive Mobile Application to Assist Cell Count Determination During Peripheral Smear and Bone Marrow Examination

“…Manual tally counters with five or eight keys are widely used to assist in the manual enumeration of cells. However, these manual tally counters lack editing capacity, must be procured sufficiently for each laboratory setting, and are relatively expensive [8]. Mobile applications (apps) are widely used in the field of medicine to assist healthcare providers as well as patients with manual work [9][10][11].…”