NECESIDAD DE LA EVALUACION MORFOLOGICA DEL HEMOGRAMA EN UN HOSPITAL COMPLEJO TIPO 1: CONTROL DE CALIDAD Y GESTION.

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Bibliographic Details
Title:	NECESIDAD DE LA EVALUACION MORFOLOGICA DEL HEMOGRAMA EN UN HOSPITAL COMPLEJO TIPO 1: CONTROL DE CALIDAD Y GESTION.
Alternate Title:	NECESSITY OF THE MORPHOLOGICAL EVALUATION OF THE HAEMOGRAM IN A COMPLEX HOSPITAL TYPE 1: MANAGEMENT AND QUALITY CONTROL.
Source:	Revista Chilena de Tecnología Médica. 2010, Vol. 30 Issue 1, p1558-1564. 7p.
Subjects:	BLOOD cell count, HEMATOLOGY, MORPHOLOGY, PUBLIC hospitals
Geographic Terms:	CHILE
Abstract (English):	Objectives: To determine selection criteria for the morphological evaluation of full blood count samples, based on clinical criterias and the results of an automatic hematological analyzer. To analyze the cost-benefits and gestión of such a selection procedure in samples obtained from a public general hospital. Patients, Materials and Methods: All patients with a full blood count taken at the Hospital de Carabineros de Chile during August 2009 were included. All samples were analyzed using a Beckman-Coulter HmX® automatic analyzer and analyzed morfologically by the Medical Science Officer. Patient details including age, sex, hematological parameters Hemoglobin, white cell and platelet count and place of reference were noted. The results were analyzed using clinical and instrument alerts, including all clinical hematological parameters considered important. Results: 2,222 patients were included in the study. There were an agreement in analysis between the HmX and Medical Science Officer in 93.9% of cases, with a sensitivity of 93.9%, specificity of 88.9%, a positive and negative predictive value of 95.9% and 92.7% respectively to detect and abnormal blood count. Owing to the selection criteria used it was possible to eliminate the need for morphological evaluation in 79.5% of cases, the possibility of a serious error of omission being minimal, only 1,6% of cases were false negative, on morphological and not clinical grounds. Discussion: The study showed that it is possible to decrease the number of morphological evaluations in 80% of cases, which is similar to the figures internationally reported for a general hospital. The clinical alert puts emphasis on the treating physician to complete clinical details on the order form. In total, there were 1.6% of false negative cases on morphological grounds y it is important to note that some morphological abnormalities will not be detected. The concordance between the analyzer and Medical Science Officer was 93.9%. The was a 30% decrease in costs and more importantly the liberation of Medical Science officer time, 37 hours/month to be used in work of greater complexity. [ABSTRACT FROM AUTHOR]
Abstract (Spanish):	Objetivo: Determinar criterios de selección de muestras para la evaluación morfológica del hemograma, basados en parámetros clínicos y resultados del contador hematológico y en términos de gestión, costos y clínica, los resultados de un programa de selección de muestras para la evaluación morfológica del examen en un hospital tipo 1. Pacientes, Materiales y Método: Pacientes con una muestra tomada en el Hospital de Carabineros de Chile durante el mes de Agosto de 2009, las que fueron analizadas en un equipo Beckman- Coulter HmX® y evaluadas morfológicamente por el Tecnólogo Médico. Se registraron los parámetros clínicos tales como hemoglobina, leucocitos y plaquetas, además del lugar de derivación, especialidad y edad del paciente. Los resultados fueron analizados, tanto por alerta clínica como instrumental, incluyendo todos los parámetros considerados clínicamente importantes. Resultados: Participaron 2.222 pacientes, hubo concordancia entre el Tecnólogo Médico y el analizador en 93,9% de los casos, con una sensibilidad de 97,3% y una especificidad de 88,9% con valores predictivos positivo y negativo de 95,9% y 92,7% respectivamente, para detectar una muestra anormal. Por criterios de selección se eliminó la evaluación morfológica en 79,5% de los casos. Hubo 1,6% de casos falso-negativos en los criterios de morfología. Discusión: El estudio demostró que es posible disminuir el número de evaluaciones morfológicas hechas al hemograma en un 80% de los casos, lo cual es semejante a los estudios internacionales efectuados en un hospital tipo 1. El sistema de alerta clínica pone énfasis en la importancia de que el médico tratante ingrese la información clínica en la solicitud de hemograma. Hay una liberación importante de tiempo de Tecnólogo Médico para utilizar su capacidad en funciones de mayor complejidad. [ABSTRACT FROM AUTHOR]
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Database:	MedicLatina

Description
Abstract:	Objectives: To determine selection criteria for the morphological evaluation of full blood count samples, based on clinical criterias and the results of an automatic hematological analyzer. To analyze the cost-benefits and gestión of such a selection procedure in samples obtained from a public general hospital. Patients, Materials and Methods: All patients with a full blood count taken at the Hospital de Carabineros de Chile during August 2009 were included. All samples were analyzed using a Beckman-Coulter HmX® automatic analyzer and analyzed morfologically by the Medical Science Officer. Patient details including age, sex, hematological parameters Hemoglobin, white cell and platelet count and place of reference were noted. The results were analyzed using clinical and instrument alerts, including all clinical hematological parameters considered important. Results: 2,222 patients were included in the study. There were an agreement in analysis between the HmX and Medical Science Officer in 93.9% of cases, with a sensitivity of 93.9%, specificity of 88.9%, a positive and negative predictive value of 95.9% and 92.7% respectively to detect and abnormal blood count. Owing to the selection criteria used it was possible to eliminate the need for morphological evaluation in 79.5% of cases, the possibility of a serious error of omission being minimal, only 1,6% of cases were false negative, on morphological and not clinical grounds. Discussion: The study showed that it is possible to decrease the number of morphological evaluations in 80% of cases, which is similar to the figures internationally reported for a general hospital. The clinical alert puts emphasis on the treating physician to complete clinical details on the order form. In total, there were 1.6% of false negative cases on morphological grounds y it is important to note that some morphological abnormalities will not be detected. The concordance between the analyzer and Medical Science Officer was 93.9%. The was a 30% decrease in costs and more importantly the liberation of Medical Science officer time, 37 hours/month to be used in work of greater complexity. [ABSTRACT FROM AUTHOR]
ISSN:	07160135