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Vol 53, No 2 (2022)
Review article
Submitted: 2021-12-02
Accepted: 2022-02-11
Published online: 2022-04-11
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The diagnostic pitfalls and challenges associated with basic hematological tests

Aleksandra Kubiak1, Ewelina Ziółkowska1, Anna Korycka-Wołowiec1
DOI: 10.5603/AHP.a2022.0014
·
Acta Haematol Pol 2022;53(2):104-111.
Affiliations
  1. Department of Hematology Medical University, Ciolkowskiego 2, 93-510 Lodz, Poland

open access

Vol 53, No 2 (2022)
REVIEW ARTICLE
Submitted: 2021-12-02
Accepted: 2022-02-11
Published online: 2022-04-11

Abstract

Several generations of automated hematology analyzers are currently being used to determine a wide range of hematological parameters. As their results form the basis of many medical interventions, it is required that they undergo analytical validation. Samples flagged as being pathological or non-diagnostic require re-testing in a different mode, revision, or additional diagnostic workup (e.g. microscopic smear). In order to avoid mistakes, close cooperation and continuous communication are needed between laboratory and medical staff. To address this, in this review we discuss the most frequent errors and pitfalls associated with the preanalytical and analytical phases of basic hematological tests. While not all diagnostic pitfalls are avoidable, this guidance regarding potentially problematic diagnostic situations will allow for their quick verification at the laboratory stage. An awareness of the causes of errors and of the existence of pitfalls can lower the costs of analytical procedures by minimizing the need to repeat analyses of potentially pathological samples, and have a positive impact on patient safety. In addition, reducing the potential for laboratory errors can improve the accuracy of medical diagnoses and avoid unnecessary treatment.

Abstract

Several generations of automated hematology analyzers are currently being used to determine a wide range of hematological parameters. As their results form the basis of many medical interventions, it is required that they undergo analytical validation. Samples flagged as being pathological or non-diagnostic require re-testing in a different mode, revision, or additional diagnostic workup (e.g. microscopic smear). In order to avoid mistakes, close cooperation and continuous communication are needed between laboratory and medical staff. To address this, in this review we discuss the most frequent errors and pitfalls associated with the preanalytical and analytical phases of basic hematological tests. While not all diagnostic pitfalls are avoidable, this guidance regarding potentially problematic diagnostic situations will allow for their quick verification at the laboratory stage. An awareness of the causes of errors and of the existence of pitfalls can lower the costs of analytical procedures by minimizing the need to repeat analyses of potentially pathological samples, and have a positive impact on patient safety. In addition, reducing the potential for laboratory errors can improve the accuracy of medical diagnoses and avoid unnecessary treatment.

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Keywords

complete blood count, diagnostic pitfalls, hematological parameters, laboratory errors

About this article
Title

The diagnostic pitfalls and challenges associated with basic hematological tests

Journal

Acta Haematologica Polonica

Issue

Vol 53, No 2 (2022)

Article type

Review article

Pages

104-111

Published online

2022-04-11

Page views

3351

Article views/downloads

496

DOI

10.5603/AHP.a2022.0014

Bibliographic record

Acta Haematol Pol 2022;53(2):104-111.

Keywords

complete blood count
diagnostic pitfalls
hematological parameters
laboratory errors

Authors

Aleksandra Kubiak
Ewelina Ziółkowska
Anna Korycka-Wołowiec

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