Journal Information
Journal ID (publisher-id): BM
Journal ID (nlm-ta): Biochem Med (Zagreb)
Title: Biochemia Medica
Abbreviated Title: Biochem. Med. (Zagreb)
ISSN (print): 1330-0962
ISSN (electronic): 1846-7482
Publisher: Croatian Society of Medical Biochemistry and Laboratory Medicine
Article Information
Copyright statement: Copyright Croatian Society of Medical Biochemistry and Laboratory Medicine
Copyright: 2024, Copyright Croatian Society of Medical Biochemistry and Laboratory Medicine
License (https://creativecommons.org/licenses/by/4.0/):
This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY) 4.0 License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Date received: 15 December 2023
Date accepted: 01 April 2024
Publication date: 15 June 2024
Publication date: 15 June 2024
Volume: 34
Issue: 2
Electronic Location Identifier: 020803
Publisher ID: bm-34-2-020803
DOI: 10.11613/BM.2024.020803
The band count imprecision – a Croatian multicentric pilot study
[1] Department of Medical Laboratory Diagnostics, University Hospital Sveti Duh, Zagreb, Croatia
[2] Department of Sport and Exercise Medicine, University of Zagreb, Faculty of Kinesiology, Zagreb, Croatia
[3] Working Group for Laboratory Hematology of the Croatian Society of Medical Biochemistry and Laboratory Medicine
[4] Department of Medical Biochemistry, General County Hospital Vinkovci, Vinkovci, Croatia
[5] Department of Oncology and Nuclear Medicine, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
[6] Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
[7] Department of Laboratory Diagnostics, General Hospital Dr. Josip Benčević, Slavonski Brod, Croatia
[8] Department of Medical Laboratory Diagnostics, University Hospital of Split, Split, Croatia
[9] Clinical Department of Laboratory Diagnostics, University Hospital Dubrava, Zagreb, Croatia
[10] Department of Laboratory Diagnostics, University Hospital Centre Zagreb, Zagreb, Croatia
[11] University of Zagreb, Faculty of Pharmacy and Biochemistry, Zagreb, Croatia
Author notes:
[*] Corresponding author: vanja.radisic@gmail.com
Author contributions
V Radišić Biljak: conceptualization, formal analysis, investigation, methodology, supervision, visualization, writing - original draft, writing - review & editing. V Jureša: investigation, writing - original draft. V Vidranski: investigation, writing - original draft. I Vuga: investigation, writing - original draft. F Tomić: investigation, writing - original draft. F Smaić: investigation, writing - original draft. M Horvat: investigation, writing - original draft. B Krešić: investigation, writing - original draft. B Šimac: investigation, writing - original draft. I Lapić: visualization, writing - original draft, writing - review & editing.
• Band counting is unreliable practice due to the high inter-observer variability
• 2015 International Council for Standardization in Haematology guidelines recommend to count band neutrophils as segmented neutrophils
• The inclusion of bands within the white blood cell differential is still used in Croatia
• There is a very high variability in enumerating bands among Croatian laboratories
• There is a need for national recommendations that will endorse ICSH guidelines
Introduction
Due to high inter-observer variability the 2015 International Council for Standardization in Haematology (ICSH) recommendations state to count band neutrophils as segmented neutrophils in the white blood cell (WBC) differential. However, the inclusion of bands as a separate cell entity within the WBC differential is still widely used in hematology laboratories in Croatia. The aim of this multicentric study was to assess the degree of inter-observer variability in enumerating band neutrophils within the WBC differential among Croatian laboratories.
Materials and methods
Seven large Croatian hospital laboratories from different parts of the country participated in the study. In each of 7 participating laboratories, one blood smear, that was flagged by the analyzer as possibly having bands, was evaluated by all personnel participating in the analysis of hematology samples. Between-observer manual smear reproducibility was expressed as coefficient of variation (CV) and calculated using the following formula: CV (%) = (standard deviation (SD)/mean value) x 100%.
Results
The CVs (%) and relative band neutrophil counts in participating laboratories were as follows: 15.4% (16-24), 19.2% (16-32), 19.5% (17-40), 21.1% (17-44), 35.0% (8-26), 51.9% (3-29), and remarkably high 62.4% (12-59). For segmented neutrophils CVs were lower, ranging from 7.4% to 32.2%. The CVs did not correlate with the number of staff members in each hospital (P = 0.293).
Keywords: neutrophils; observer variation; hematology
