Quantitative Terminology in Red Blood Cell Morphology

The Use and Interpretation of Quantitative Terminology in Reporting of Red Blood Cell Morphology

Lawrence Hookey, David Dexter, David H. Lee

Laboratory Hematology 7:85-88
©2001 Carden Jennings Publishing Co., Ltd.

Despite advances in diagnostic technology in the hematology laboratory, the evaluation of peripheral blood films for abnormal red blood cell (RBC) morphology remains a manual task. The terminology used by laboratory technologists to describe the frequency of morphologically abnormal RBCs in peripheral blood films has rarely been studied. We conducted a study to determine the variability in the use of these quantitative descriptors and to determine how physicians interpret these terms. Thirty-one hematology laboratory technologists from 6 hospitals were asked to quantitate abnormal RBCs in a series of peripheral blood films using their usual terminology. Interpretation of these quantitative terms by the attending physicians and residents from an Internal Medicine teaching program was also assessed. We found a wide variation in the use of quantitative descriptors between technologists and between centers. Physicians' interpretations of these terms varied, with some terms having a narrow, consistent interpretation and others having a broader range of interpretations. We suggest that the precision of communication between the hematology laboratory staff and clinicians can be improved by tailoring the use of quantitative terminology to avoid terms that have a broad range of interpretations by physicians.

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