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Whither the WBC Differential?—Some Alternatives

  • Ralph A. Korpman
  • Brian Bull
Conference paper

Abstract

Most efforts to automate the WBC differential have involved the use of devices to identify and enumerate WBC types, the underlying assumption being that the cell type percentages constitute the important end result.

A different assumption exists. It is that the clinical usefulness of this procedure derives primarily from the fact that a trained morphologist has conducted a detailed examination of the slide. Based on this second assumption, a different approach to automation was investigated. This involved the use of a computer system to augment the morphologist in the slide examination process. This augmentation was accomplished by:
  1. 1.

    Determination of linked abnormalities on 117,000 WBC counts and presentation of linkages to the morphologist when a particular abnormality was identified on the hemogram or the slide.

     
  2. 2.

    Information feedback which compared each technologist with others in the laboratory performing similar tasks.

     
  3. 3.

    Varying the number of cells examined per slide, based on the apparent abnormality of the slide.

     

The linkage patterns found, their clinical usefulness, and the impact on technologist performance and test quality are discussed.

Key Words

Leukocytes White cells Differential Automation Linked abnormalities 

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References

  1. 1.
    BULL, B., KORPMAN, R. A.: The logistics of the leukocyte differential count (implications for automation). IN: KOEPKE, J., et al., eds., Aspen Conference on WBC Differential Counts, 1979, pp. 217–224Google Scholar
  2. 2.
    STATLAND, B. E., WINKEL, P., HARRIS, S. C., BURDSALL, M., SAUNDERS, A. M.: A study of variation of concentratrion values of leukocyte types: 1. Biological components of variation in healthy subjects, Advances in Automated Analyses, Technicon International Congress, Mediad Incorporated, Tarrytown, N.Y. 1977, pp. 28–32Google Scholar
  3. 3.
    WINKEL, P., STATLAND, B. E., BURDSALL, M. J., HARRIS, S. C., LINTRUP, J., SAUNDERS, A. M.: A study of variation of concentration values of leukocyte types: 2. Analytical considerations — manual versus automated cell counting. Advances in Automated Analysis, Technicon International Congress, Mediad Incorporated, Tarrytown, N.Y. 1977, pp. 33–40Google Scholar
  4. 4.
    BULL, B., KORPMAN, R. A.: Characteristics of the WBC differential. Blood Cells 6, 411–419, 1980 PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1981

Authors and Affiliations

  • Ralph A. Korpman
    • 1
  • Brian Bull
    • 1
  1. 1.Department of Pathology and Laboratory MedicineLoma Linda University School of MedicineLoma LindaUSA

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