Article Text

Historical data decrease complete blood count reflex blood smear review rates without missing patients with acute leukaemia
  1. Esther Rabizadeh1,2,
  2. Itay Pickholtz1,
  3. Mira Barak3,
  4. Paul Froom3
  1. 1Hematology Laboratory, Clalit Health Services, Rabin Medical Center, Petah Tikva, Israel
  2. 2Hemato-Oncology Laboratory, Felsenstein Medical Research Center, Tel Aviv University, Petah Tikva, Israel
  3. 3Central Laboratory, Clalit Health Services, Haifa and the Western Galilee, Nesher, Israel
  1. Correspondence to Professor Paul Froom, Central Laboratory, Clalit Health Services, Haifa and the Western Galilee, Hatassia 4, Nesher 20300, Israel; paulfr{at}


Introduction The availability of historical data decreases the rate of blood smear review rates in outpatients, but we are unaware of studies done at referral centres. In the following study, we determined the effect of historical data on the rates of peripheral blood smears over a 3-month period and then the detection rate of patients with acute leukaemia.

Methods All results of complete blood counts (CBCs) tested on three ADVIA 120 analyzers at the regional Rabin Medical Centre, Beilinson Campus over a 3-month period were accessed on a computerised laboratory information system. Over a 3-month period, we determined the proportion of total CBC and patients with criteria for a manual differential count and the actual number of peripheral blood smears done. Finally, we determined the proportion of 100 consecutive patients with acute leukaemia detected using our criteria that included limiting reflex testing according to historical data.

Results Over the 3-month period, there were 34 827 tests done in 12 785 patients. Without historical data, our smear rate would have been 24.5%, but with the availability of historical data, the blood smear review rate was 5.6%. The detection rate for cases of acute leukaemia was 100%.

Conclusions We conclude that the availability of previous test results significantly reduces the need for blood smear review without missing any patients with acute leukaemia.


Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.