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Medical Forum / General / Laboratory / January 2007RBC Morphologic grading
I have not found a standardized reference. Perhaps this because it is considered relatively unimportant. (? :-) ) I have just read a Candian study on the subject that concludes that the physicians should setup the grading system....dumb, stupid, ...god would that be wonderiful! The tables I see are not practical for routine use. The grading listed in these tables are not consistent between different shapes and sizes. I know there is an old reference (help!) out there, but am unsure if it is practical for todays environment. I have based our "+" (plus) system (1-4) on rough number of occurances over four field of veiw at 100 x. E.g. +1 in 25% of the fields, +2 in 50% of the fields, +3 at least once in every field, and +4 occuring multiply times in one field of view. Simple! I don't want the techs to have to be refering to a table every time. Of course, what seems practical and wise to one in isolation may be exposed as a whim. Input welcome. ----------------------- Be suspicious of these who spell Hematolgy with an "a"! > ----------------------- > Be suspicious of these who spell Hematolgy with an "a"! Because they are spelling it correctly ;o) Hahahahah, thanks need that >> ----------------------- >> Be suspicious of these who spell Hematolgy with an "a"! > > Because they are spelling it correctly ;o) >I have not found a standardized reference. Perhaps this because it is >considered relatively unimportant. (? :-) ) I have just read a Candian [quoted text clipped - 10 lines] >course, what seems practical and wise to one in isolation may be exposed as >a whim. Input welcome. I'm sorry, but what exactly are you talking about here? RBC morph, hematology, it's not micro (bacti), manky so you might not be familar with >>I have not found a standardized reference. Perhaps this because it is >>considered relatively unimportant. (? :-) ) I have just read a Candian [quoted text clipped - 12 lines] > > I'm sorry, but what exactly are you talking about here? > RBC morph, hematology, it's not micro (bacti), manky so you might not be > familar with Haematology is what I do, but I'm not at all sure what the OP is getting at. Take for example a + system for microcytosis. Does "+++ micro" mean the cells are all very small, or that there is a large percentage of cells that are quite small? >>>I have not found a standardized reference. Perhaps this because it is >>>considered relatively unimportant. (? :-) ) I have just read a Candian [quoted text clipped - 12 lines] >> >> I'm sorry, but what exactly are you talking about here? But what is very small is relative and how large a percentage. I think +1, +2 or +3 (or in some cases +4) are kind of meaningless when one wish to establish consistent amoung technicians or teaching morphology. Now I expect techs to relie on the indices as guide, but outside the RDW (suggesting 15-17 +1, 17-19 +2 etc) its not to predictive or semi-qunatitative. >> RBC morph, hematology, it's not micro (bacti), manky so you might not be >> familar with [quoted text clipped - 22 lines] >>> >>> I'm sorry, but what exactly are you talking about here? Everywhere I've worked the grading system refers to the amount of the morphology, averaged over 10 fields 1+equal to 25%, 2+ equivalent to 50%, etc. similar to how you number cellular contents in urine microscopsy. Hope this helps, Marsha > Everywhere I've worked the grading system refers to the amount of the > morphology, averaged over 10 fields 1+equal to 25%, 2+ equivalent to 50%, > etc. similar to how you number cellular contents in urine microscopsy. > > Hope this helps, Not really. What does 25% anisocytosis mean? Thanks, this is along the lines I came up with independently (always suspect) Difference here is I am using 4 fields of view at 100 x. I do about 25 to 30 (about 14%) manual diffs on the am shift and have to balance the time spent. Problem is even though it seems practical, I find it strange that I have found not specific references. I will be getting some new reference manuals specific to hematology. I have also noted variances between institutions in the number of pluses (+). I.e. some go to +3 others to +4. To whatever number, I feel the same top grade should be used for all rbc morphology. I.e., I have seen some grade one parameter (i.e., acanthocytres) to +3 while grading another to +4 (i.e.schizocytes...yes there are two spellings). > Everywhere I've worked the grading system refers to the amount of the > morphology, averaged over 10 fields 1+equal to 25%, 2+ equivalent to 50%, [quoted text clipped - 3 lines] > > Marsha I assume it refers to the number of fields examined. I.e. cell type noted in 25% of the fields examined. But that is only my intepertation. > Thanks, this is along the lines I came up with independently (always > suspect) Difference here is I am using 4 fields of view at 100 x. I do [quoted text clipped - 19 lines] >> >> Marsha Sorry, some of my posts are going to individuals rather than group. I am trying to correct problem. > Thanks, this is along the lines I came up with independently (always > suspect) Difference here is I am using 4 fields of view at 100 x. I do [quoted text clipped - 19 lines] >> >> Marsha Sorry the grading was for types of cells noted. For Aniso and POik its either there or not. Didn't matter as to quantity Marsha > Sorry the grading was for types of cells noted. For Aniso and POik its > either there or not. Didn't matter as to quantity Aniso & poik are present in EVERY single blood film - the degree is everything. Yes! >> Sorry the grading was for types of cells noted. For Aniso and POik its >> either there or not. Didn't matter as to quantity > > Aniso & poik are present in EVERY single blood film - the degree is > everything. I just HAD to respond to the "Be suspicious of these who spell Hematolgy with an "a"! " quote ..... You are an idiot!! There are 2 o's in the word HEMATOLOGY not HEMATOLGY ... DUH!! And, yes, it is spelled with an "a". It can also be spelled Haematology. According to Moe, Larry and Curly it is "hematoology" two "o"s right. ------------------- There are three kinds of people, those that can add and those that cannot. >I just HAD to respond to the "Be suspicious of these who spell > Hematolgy with an "a"! " quote ..... You are an idiot!! There are 2 > o's in the word HEMATOLOGY not HEMATOLGY ... DUH!! And, yes, it is > spelled with an "a". It can also be spelled Haematology. >I just HAD to respond to the "Be suspicious of these who spell > Hematolgy with an "a"! " quote ..... You are an idiot!! There are 2 > o's in the word HEMATOLOGY not HEMATOLGY ... DUH!! And, yes, it is > spelled with an "a". It can also be spelled Haematology. As the one who spells "hematolgy with an "a"!", I don't think I can comment whether or not the original poster is an idiot, but I'm sure that if he is, then he is an idiot who can reply to the correct post, and doesn't need two months to spot his error. >I have not found a standardized reference. Perhaps this because it is >considered relatively unimportant. (? :-) ) I have just read a Candian [quoted text clipped - 10 lines] >course, what seems practical and wise to one in isolation may be exposed as >a whim. Input welcome. Did anyone come up with a reference or an answer to this - I've been charged with sorting out something along these lines for our network (4 NHS trusts with eight seperate haematology labs) |
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