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Analysis of manual reticulocyte counts in the clinical laboratories of Ponta-Grossa and Campos Gerais, PR, Brazil
Simionatto, Mackelly; Paula, Josiane P; Nascimento, Aguinaldo J; Leonart, Maria Suely S; Cicchetti, Domenic.
  • Simionatto, Mackelly; s.af
  • Paula, Josiane P; s.af
  • Nascimento, Aguinaldo J; Universidade Federal do Paraná. Curitiba. BR
  • Leonart, Maria Suely S; Universidade Federal do Paraná. Curitiba. BR
  • Cicchetti, Domenic; Yale University School of Medicine. Department of Biometry. New Haven. US
Rev. bras. hematol. hemoter ; 31(5): 315-320, 2009. ilus, tab
Article in English | LILACS | ID: lil-533604
ABSTRACT
Reticulocyte counts are widely used in laboratories to evaluate bone marrow erythropoietic activity and have great diagnostic and prognostic importance in the treatment of anemias. Reticulocytes are supravitally stained with new methylene blue or brilliant cresyl blue, which highlight the characteristic aspect of the reticulum visible by light microscopy. Known criteria were observed for good manual reticulocyte counting with special attention being paid to the preparation of reticulocyte slides, to counting fields without overlapping cells, and to the number of evaluated cells. The aim of this study was to evaluate the inter-observer variation and also to analyze the statistical error of manual reticulocyte counting. The Intraclass correlation coefficient (ICC) according to Bartko was used to evaluate the level of agreement among 12 laboratory technicians who evaluated the same 25 blood smears. The results of statistical analyses showed that the amount of random error, defined as (1-r2), varied from 4 percent to 60 percent among the technicians. Although imprecision occurred, the overall profiles were quite similar, and intraclass correlation coefficients indicated that the results obtained have clinical significance.
RESUMO
A contagem do reticulócitos é usada extensamente na rotina laboratorial para avaliar a atividade eritropoiética da medula óssea, e é de grande importância no diagnóstico e no prognóstico na terapia de anemias hemolíticas. São coradas com o azul de metileno novo e o azul cresil brilhante, o que conferem o aspecto característico de retículo quando observado ao microscópioótico. Critérios conhecidos foram observados para um bom desempenho da contagem manual de reticulócitos, principalmente, atenção especial nas películas do sangue durante a montagem das lâminas; contagem nos campos que não contém sobreposição celular; e também no número de células avaliadas. O objetivo deste estudo foi avaliar a variação interobservadores, analisar o erro estatístico da contagem manual dos reticulócitos, e demonstrar as limitações deste método. A análise de correlação intraclasses segundo Bartko [Psychol Rep 193,1966; 34418,1974] foi usada para avaliar a concordância entre 12 observadores em um total de 25 lâminas do sangue, com contagens variadas de reticulócitos. Os resultados das análises estatísticas indicam que o erro casual, calculado como (1-r2) variou de 4 a 60 por cento entre os observadores. Embora ocorra imprecisão entre os observadores, o perfil geral entre eles é similar, e o coeficiente de correlação intraclasse indicou que os resultados obtidos são clinicamente úteis.
Subject(s)

Full text: Available Index: LILACS (Americas) Main subject: Bone Marrow / Reticulocyte Count / Clinical Laboratory Techniques Type of study: Diagnostic study / Practice guideline / Prognostic study Limits: Humans Country/Region as subject: South America / Brazil Language: English Journal: Rev. bras. hematol. hemoter Journal subject: Hematology Year: 2009 Type: Article Affiliation country: Brazil / United States Institution/Affiliation country: Universidade Federal do Paraná/BR / Yale University School of Medicine/US

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Full text: Available Index: LILACS (Americas) Main subject: Bone Marrow / Reticulocyte Count / Clinical Laboratory Techniques Type of study: Diagnostic study / Practice guideline / Prognostic study Limits: Humans Country/Region as subject: South America / Brazil Language: English Journal: Rev. bras. hematol. hemoter Journal subject: Hematology Year: 2009 Type: Article Affiliation country: Brazil / United States Institution/Affiliation country: Universidade Federal do Paraná/BR / Yale University School of Medicine/US