Suspect flags and regional flags on the Coulter-STKS: An assessment

Gene L. Gulati, William Kocher, Roland Schwarting, Ali Issa, Manmohan Dhanjal

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

The reliability of the flagging system of the Coulter-STKS (Beckman Coulter, Miami), an automated analyzer used worldwide to perform CBCs and differential leukocyte counts, was assessed by determining the sensitivity, specificity, efficiency, predictive value of normal (PVN), and predictive value of abnormal (PVA) for individual suspect-flags and regional-flags generated by the analyzer. Automated differentials were compared with manual differentials, initially from the data collected prospectively in a random population of 647 blood specimens. Low prevalence of several flags in this specimen population led us to retrospectively review hundreds of additional flagged automated differentials along with the corresponding manual differentials to gather 100 data points per qualitative abnormality or flag, to better determine sensitivity and PVA. Each automated differential was assessed to be either true normal or false normal or either true abnormal or false abnormal, based on predefined microscopic criteria. Of the evaluated flags, immature granulocyte/band 1 (IGB1) and immature granulocyte/band 2 (IGB2), the two most prevalent flags (31,6% and 10.8%, respectively), had the lowest efficiency (59%-68%). Specificity and PVN for all flags other than IGB1 and IGB2 were within the desirable range, although sensitivity and PVA were at less than desirable levels. Enhancement of sensitivity and PVA of many if not all, flags, and specificity and PVN of IGB1 and IGB2 flags will increase the reliability and consequently the cost-effectiveness of the STKS automated flagging system.

Original languageEnglish (US)
Pages (from-to)675-680
Number of pages6
JournalLaboratory Medicine
Volume30
Issue number10
DOIs
StatePublished - 1999
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Clinical Biochemistry
  • Biochemistry, medical

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