Effect of Factors within Routine CBC Management System to the Repeatability of CBC Testing and their Variability of Repeating Results from Hematology Automation

Nanthaporn Thianto, Khaimuk Changsri


On a routine CBC inspection with automated hematology analyzer, the number of repetitions and the deviations from the repetition are the important indicators of the CBC service’s effectiveness. Factors that can affect CBC services are not only good management and properly technology used but also patient samples. Examining the impact of these factors will make it possible to make informed decisions about how to improve the CBC system. We have examined the impact of the factors including technician workload, pairing of automated hematology analyzers for repeated measurement and patient samples by using the 894 repeated CBC data of hematology laboratory. Hematology Laboratory of Faculty of Medicine Vajira Hospital from 2013 to 2015. Among these data, CBC repeated rates were measured and then error indices were calculated. The proportion of non-substitution of repeated value range from high to low are MCV, HCT, PLT, WBC, RBC and Hb respectively. There is a negative significant linear relationship between the workload and the proportion of repetitions (p = 0.042, r = - 0.958)

while the number of repetitions and workloads were not significantly correlated (p <0.05).

The non-substitution of repeated results among 4 different time intervals were also not different.

In the study of age-group, the non-substitution of repeated results of HCT and MCV in the children younger than 2 years of age were significantly larger than those of the 2-year age group. (p = 0.001). In addition, trend of the deviation of the repetition data in the low, normal and high values for all groups were similar showing significantly high in the red blood cell parameters only. Conclusion is that the automatic pairing and workload did not divert the non-substitution results. The most deviated of repeated results were found in MCV and HCT. This audit can be applied to other laboratories to measure the impact of system factors on the CBC's performance and also optimizing it in that organization.

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