Ann Lab Med.  2018 Nov;38(6):512-517. 10.3343/alm.2018.38.6.512.

An Automated Draft Report Generator for Peripheral Blood Smear Examinations Based on Complete Blood Count Parameters

• Kim YG
• Kwon JA
• Moon Y
• Park SJ
• Kim S
• Lee HA
• Ko SY
• Chang EA
• Nam MH
• Lim CS
• Yoon SY

• KMID: 2429115
• DOI: http://doi.org/10.3343/alm.2018.38.6.512

Abstract

BACKGROUND
Complete blood count (CBC) results play an important role in peripheral blood smear (PBS) examinations. Many descriptions in PBS reports may simply be translated from CBC parameters. We developed a computer program that automatically generates a PBS draft report based on CBC parameters and age- and sex-matched reference ranges.
METHODS
The Java programming language was used to develop a computer program that supports a graphical user interface. Four hematology analyzers from three different laboratories were tested: Sysmex XE-5000 (Sysmex, Kobe, Japan), Sysmex XN-9000 (Sysmex), DxH800 (Beckman Coulter, Brea, CA, USA), and ADVIA 2120i (Siemens Healthcare Diagnostics, Eschborn, Germany). Input data files containing 862 CBC results were generated from hematology analyzers, middlewares, or laboratory information systems. The draft reports were compared with the content of input data files.
RESULTS
We developed a computer program that reads CBC results from a data file and automatically writes a draft PBS report. Age- and sex-matched reference ranges can be automatically applied. After examining PBS, users can modify the draft report based on microscopic findings. Recommendations such as suggestions for further evaluations are also provided based on morphological findings, and they can be modified by users. The program was compatible with all four hematology analyzers tested.
CONCLUSIONS
Our program is expected to reduce the time required to manually incorporate CBC results into PBS reports. Systematic inclusion of CBC results could help improve the reliability and sensitivity of PBS examinations.

Keyword

Complete blood count; Peripheral blood smear; Draft report generator

MeSH Terms

Blood Cell Count*
Clinical Laboratory Information Systems
Delivery of Health Care
Hematology
Indonesia
Information Storage and Retrieval
Programming Languages
Reference Values

Figure

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  Fig. 1 Draft report: one sample is selected from the Sample List (left, shaded), and instantly, the Instrument Data panel is auto populated with complete blood count parameters. A draft report is prepared in the Draft Report panel. The Microscopic Findings panel remains in its initial state at this point. Age- and sex-matched reference ranges can be applied, if age and sex are manually selected (at the top of the screen). In this example, the Excel data file was generated from Sysmex XE-5000 (Sysmex, Kobe, Japan).

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  Fig. 2 Final report: A manual differential count was performed, and the results are typed into the Microscopic Findings panel (red box). All changes made in the Microscopic Findings (in this case, differential counts and poikilocytosis) are automatically reflected in the Draft Report. Work-up (w/u) for Epstein-Barr virus (EBV) and cytomegalovirus (CMV) markers is recommended, owing to the increased reactive lymphocyte count (arrow). The grading scale for poikilocytosis follows the International Council for Standardization in Haematology guidelines (red circle, −, ++, and +++ for elliptocytes) [3]. In this example, the Excel data file was generated from Sysmex XE-5000 (Sysmex, Kobe, Japan).

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  Fig. 3 In this example, the input data file contains patient information, such as sex and age, enabling automatic adjustment of sex and age options of the program (red box). In this case, the patient is one year old. The hemoglobin, mean corpuscular volume (MCV), and white blood cell (WBC) differential counts would have indicated microcytic anemia and relative lymphocytosis had adult reference ranges been applied. However, they are interpreted as normal, following the age-specific reference ranges. In this example, the Excel data file was generated from HemLink, a middleware for Beckman Coulter hematology analyzers.

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