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PubMed1999

A randomized double-blind controlled trial of automated term dissection.

OBJECTIVE: To compare the accuracy of an automated mechanism for term dissection to represent the semantic dependencies within a compositional expression, with the accuracy of a practicing Internist to perform this same task. We also compare the results of four evaluators to determine the inter-observer variability and the variance between term sets, with respect to the accuracy of the mappings and the consistency of the failure analysis. METHODS: 500 terms, which required a compositional expression to effect an exact match, were randomly distributed into two sets of 250 terms (Set A and Set B). Set A was dissected using the Automated Term Dissection (ATD) Algorithm. A physician specializing in Internal Medicine dissected set B. He had no prior knowledge of the dissection algorithm or how it functioned. In this manuscript, the authors use Human Term Dissection (HTD) to refer to this method. Set A was randomized to two sets of 125 terms (Set A1 and Set A2). Set B was randomized to two sets of 125 terms (Set B1 and Set B2). A new set of 250 terms Set C was created from Set A1 and Set B2. A second new set of 250 terms Set D was created from Set A2 and Set B1. Two expert Indexers reviewed Set C and another two expert Indexers reviewed Set D. They were blinded to which terms were dissected by the clinician and which terms were dissected by the automated term dissection algorithm. The person providing the files for review to the Indexers was also unaware of which terms were dissected by ATD vs. the HTD method. The Indexers recorded whether or not the dissection was the best possible representation of the input concept. If not, a failure analysis was conducted. They recorded whether or not the dissection was in error and if so was a modifier not subsumed or was a Kernel concept subsumed when it should not have been. If a concept was missing, the Indexers recorded whether it was a Kernel concept, a modifier, a qualifier or a negative qualifier. RESULTS: The ATD method was judged to be accurate and readable in 265 out of the 424 terms with adequate content (62.7%). The HTD method was judged to be accurate in 272 out of 414 terms with adequate content (65.7%). There was no statistically significant difference between the rates of acceptability of the ATD and HTD methods (p = 0.33). There was a non-significant trend toward greater acceptability of the ATD method in the subgroup of terms with three or more compositional elements. ATD was acceptable in 53.6% of the terms where the HTD was only acceptable in 43.6% (p = 0.11). The failure analysis showed that both methods misrepresented kernel concepts and modifiers much more commonly than qualifiers (p < 0.001). CONCLUSIONS: There is no statistically significant difference in the accuracy and readability of terms dissected using the automated term dissection method when compared with human term dissection, as judged by four expert medical indexers. There is a non-significant trend toward improved performance of the ATD method in the subset of more complex terms. The authors submit that this may be due to a tendency for users to be less compulsive when the time to complete the task is long. Automated term dissection is a useful and perhaps preferable method for representing readable and accurate compound terminological expressions.

Abstracting and Indexing↗

PubMed2000

[Macular diseases--application of automated static perimetry and optical coherence tomography].

The usefulness of automated static perimetry and optical coherence tomography in the management of macular diseases has been described. Scotomata in eyes with central serous chorioretinopathy could be evaluated with central 10-degree automated static perimetry. The degree of visual field defects in eyes with the disease varied greatly with mean deviation of -10 dB or less in as many as 10% of the subjects. Although retinitis pigmentosa is a diffuse retinal dystrophy, eyes with a moderately advanced stage of retinitis pigmentosa should be managed as a macular disease, because the functioning retina is confined within the vascular arcade. The progressive nature in this stage of the disease could be demonstrated with a central 10-degree automated static perimetry measured once or twice a year and the use of univariate linear regression of mean deviation, in half of the patients with a mean follow-up period of 5 years. Functional recovery in eyes with exudative age-related macular degeneration after laser surgery or submacular surgery could be evaluated with central 10-degree automated static perimetry. Eyes with increased mean deviation in spite of reduced visual acuity after therapeutic intervention should also be evaluated. Macular function could also be evaluated using a color test. A newly developed color saturation discrimination test was applied to patients with age-related macular degeneration, retinitis pigmentosa, and cone dystrophy. The degree of dyschromatopsia was less in eyes with age-related macular degeneration than in those with retinitis pigmentosa or cone dystrophy with the same level of acuity loss. The highly protrusive nature of the orange-red nodule in eyes with idiopathic polypoidal choroidal vasculopathy was demonstrated with dimensional measurement with OCT. The degree of protrusion was greater than in eyes with serous pigment epithelial detachment, which suggests that the polypoidal lesion is covered with rigid tissues including Bruch's membrane. Parafoveal retinal sensitivity obtained with automated static perimetry was studied in correlation with retinal thickness measured using OCT in eyes with branch retinal vein occlusion showing macular edema without macular non-perfusion or massive retinal hemorrhages. The increased retinal thickness due to macular edema is closely correlated with retinal sensitivity both at the fovea and in the parafoveal area. Eighty-nine phakic eyes of 46 patients with retinitis pigmentosa patients were studied to detect cystoid macular edema using OCT. Cystoid lesions were observed in the macula in 12 eyes in 6 (13%) of 46 patients. Some eyes with OCT-proven cystoid macular edema did not show dye pooling in the fluorescein angiogram. The width of the total area of cystoid lesions was positively correlated with best-corrected visual acuity but the thickness of the neurosensory retina at the center of the fovea was not. OCT findings of successfully repaired macular holes were categorized into 3 groups. Eyes with U-type showed a normal foveal contour and a dark layer corresponding to the outer segment of photoreceptors. Eyes with V-type showed a notch in the surface of repaired neurosensory retina without a dark layer on the retinal pigment epithelium. Those with W-type showed a defect of the neurosensory retina, where the retinal pigment epithelium was exposed. The visual results were excellent in eyes with U-type, but poor in those with W-type.

Adult↗

PubMed2001

Evaluation of a fully automated serum assay for C-terminal cross-linking telopeptide of type I collagen in osteoporosis.

BACKGROUND: Biochemical markers of bone turnover can provide prognostic information about the risk of osteoporotic fracture and are useful tools for monitoring efficacy of antiresorptive therapy. A serum-based automated assay may be of better clinical value than urinary markers because of lower imprecision and day-to-day within-person variability. Our aim was to evaluate the technical and clinical performances of a new, fully automated assay for serum C-terminal cross-linking telopeptide of type I collagen (CTX), a marker of bone resorption. METHODS: Serum CTX was measured on the Elecsys 2010 automated analyzer (Roche). Results were compared with those of the manual ELISA. We measured serum CTX concentrations in 728 healthy women, ages 31-89 years. We investigated the ability of this assay to predict the rate of postmenopausal forearm bone loss evaluated by four repeated bone mineral density measurements using dual-x-ray absorptiometry in 305 women followed prospectively for 4 years. Finally, in a cohort of healthy, untreated, postmenopausal women, we compared baseline serum CTX in 55 women who subsequently had a fracture (20 vertebral and 35 peripheral fractures) with values in the 380 women who did not fracture during a mean 5 years of follow-up. RESULTS: The within- (n = 21) and between-run (n = 21) CVs were <4.1% and 5.7%, respectively. In 728 healthy women, serum CTX concentrations (automated) correlated with those of the manual ELISA (r = 0.82; P<0.0001). The median long-term within-person variability assessed by four repeated measurements over 3 months in 18 postmenopausal women was 9.4%. Compared with 254 premenopausal women, serum CTX was 39% (P<0.0001) higher in 45 perimenopausal women and 86% (P<0.0001) higher in 429 postmenopausal women (mean age, 64 years). Baseline serum CTX correlated negatively with changes of bone mass measured at the mid (r = -0.23; P<0.0001) and distal (r = -0.27; P<0001) radius. Postmenopausal women with serum CTX greater than the mean + 2 SD values in premenopausal women accounted for 42% of the population, lost bone at the mid radius on average eightfold more rapidly than the other women (-0.27% +/- 2.92% vs. -2.25% +/- 3.95%; P<0.0001), and had increased risk of fracture with a relative risk (95% confidence interval) of 1.8 (1.01-3.1) after adjustment for physical activity. CONCLUSIONS: The automated assay for serum CTX is precise and predicts rate of bone loss and fracture risk in postmenopausal women. Because it is convenient to use and has high throughput, this serum bone resorption marker may be useful for the investigation of patients with osteoporosis.

Adult↗

PubMed2001

Automated immunohistochemical staining of formalin-fixed and paraffin-embedded tissues using a catalyzed signal amplification method.

An immunohistochemical assay using catalyzed signal amplification (CSA), which is based on the peroxidase catalyzed deposition of biotinylated tyramide, is a highly sensitive method to visualize weak immunohistochemical signals originating from rare antigens or masked antigens in formalin-fixed, paraffin-embedded (FFPE) tissues. However, CSA methods are hampered by poor reproducibility and the complexity of their staining procedures. In this study, we aimed to apply the CSA procedure to a capillary gap-based, automated immunostainer, TechMate Horizon, to perform immunohistochemical signal amplification effectively and reproducibly. A variety of cellular antigens previously considered to be undetectable in FFPE human specimens were selected and examined with the automated immunostainer. Compared with the manual CSA staining method that takes more than 2 hours, the automated CSA method took less than 2 hours to complete. The staining results from the automated CSA method presented higher reproducibility, as well as lower background owing to well-regulated, punctual staining and washing at every step of the procedure. Conclusively, the automation of the CSA method enabled us to perform the time-consuming and complicated CSA amplification technique with minimal effort in an accurate, consistent, and reproducible manner.

Antigens↗

PubMedDate not supplied

Virtual automation.

Total laboratory automation (TLA) can be substituted in mid-size laboratories by a computer sample workflow control (virtual automation). Such a solution has been implemented in our laboratory using PSM, software developed in cooperation with Roche Diagnostics (Barcelona, Spain), to this purpose. This software is connected to the online analyzers and to the laboratory information system and is able to control and direct the samples working as an intermediate station. The only difference with TLA is the replacement of transport belts by personnel of the laboratory. The implementation of this virtual automation system has allowed us the achievement of the main advantages of TLA: workload increase (64%) with reduction in the cost per test (43%), significant reduction in the number of biochemistry primary tubes (from 8 to 2), less aliquoting (from 600 to 100 samples/day), automation of functional testing, drastic reduction of preanalytical errors (from 11.7 to 0.4% of the tubes) and better total response time for both inpatients (from up to 48 hours to up to 4 hours) and outpatients (from up to 10 days to up to 48 hours). As an additional advantage, virtual automation could be implemented without hardware investment and significant headcount reduction (15% in our lab).

Autoanalysis↗

PubMed2002

Evaluation of an automated preanalytical robotic workstation at two academic health centers.

BACKGROUND: Purchase of automated systems in today's clinical laboratory needs justification based on demonstrable improvements in efficiency and a sound payback model. Few studies provide information on laboratory automation that focuses on the preanalytical portion of specimen processing. METHODS: We recently evaluated an automated preanalytical processing unit (GENESIS FE500) at two academic health centers. This preanalytical unit processes blood specimens through automated specimen sorting, centrifugation, decapping, labeling, aliquoting, and placement of the processed specimen in the analytical rack. We quantified the output of the FE500 by processing >3000 barcode-labeled specimens according to a protocol designed to test all of the features of this automated specimen-processing unit. RESULTS: Depending on the batch size, aliquot number requested, and percentage of tubes that required centrifugation, the mean system output performance varied between 93 and 502 total tubes/h. Throughput increased when the batch size expanded from 40 or 100 samples (mean = 211 total tubes processed/h) to batch sizes of 200 and 300 tubes (mean = 474 total tube processed/h). The GENESIS FE500 processed specimen tubes differing in size from 13 x 65 mm (width x height) to 16 x 100. At one site, the FE500 was operated by one person, compared with the three individuals required to perform the same tasks manually. Finally, the specimen-processing error rate determined at one of the institutions was significantly reduced. CONCLUSIONS: We conclude that the GENESIS FE500 effectively reduces the labor associated with specimen processing; decreases the number of laboratory errors that occur with specimen sorting, labeling, and aliquoting; and improves the integrity of specimen handling throughout the steps of specimen processing.

Autoanalysis↗

PubMed1986

How increased automation will improve the 1990 census of population and housing of the United States.

"The U.S. Bureau of the Census will increase significantly the automation of operations for the 1990 Census of Population and Housing, thus eliminating or reducing many of the labor-intensive clerical operations of past censuses and contributing to the speedier release of data products. An automated address control file will permit the computer to monitor the enumeration status of an address. The automated address file will also make it possible to begin electronic data processing concurrently with data collection, and, thus, 5-7 months earlier than for the 1980 Census. An automated geographic support system will assure consistency between various census geographic products, and computer-generated maps will be possible. Other areas where automation will be introduced or increased are questionnaire editing, coding of written entries on questionnaires, and reporting of progress and cost by field offices."

Americas↗

PubMed1992

[Automated assay method for protein C anticoagulant activity].

We developed an automated assay method for protein C anticoagulant activity to prolong the APTT measured with automated coagulation apparatus. The automated assay method required following three reagents. One was 0.025 mol/l calcium chloride solution. The other two were a protein C deficient plasma and a phospholipid plus protein C activator both of which constituted a recomposed protein C assay kit (BMY). 0-50% activities of protein C and clotting times were regressed on normal linear curve, while 25-150% activities and clotting times were regressed on logarithmic curve. The coefficients of variation were 2.9-3.4% (intra-assay) and 3.6-3.9% (inter-assay). A correlation of protein C activities between measured by automated assay method and by ordinary manual method was good (r = 0.954). Our data suggest that this automated assay is a useful method for measuring the protein C anticoagulant activities utilizing a coagulation apparatus.

Blood Coagulation Tests↗

PubMed1992

Variability of indirect methods used to determine blood pressure. Office vs mean 24-hour automated blood pressures.

Blood pressure is a cardiovascular measurement with dynamic characteristics that can be influenced by a number of internal and external factors. The preferred blood pressure determination method would be one that reduces variability between measurements and that reflects the true blood pressure level. In this article, we present the variability of, and agreement between, the blood pressures collected by two indirect methods on the same patients during a hypertensive research project. Data obtained on patients in a typical clinical setting are also provided. Twenty-four-hour diastolic pressures obtained by the automated method demonstrated no regression to a lower mean, while blood pressures obtained casually in the office exhibited such regression. The 95% confidence interval of repeated measures for casual office blood pressure on a patient in a research setting (35/17 mm Hg) or in typical clinic practice (26/19 mm Hg) were similar, while the range of the mean 24-hour automated blood pressure monitoring (21/11 mm Hg) was smaller and demonstrated less variability. The magnitudes of the differences in blood pressures obtained on separate occasions in the same subjects were significantly lower with automated vs casual blood pressure determination methods (7.9/4.6 vs 13.7/7.4 mm Hg for both systolic and diastolic pressures). The agreement (95% confidence interval) between blood pressures obtained by the two methods (19/12 mm Hg) was found to be similar to the repeatability of automated blood pressure monitoring alone, and superior to that for data recorded casually in the office (35/17 mm Hg). Thus, the variability in mean 24-hour automated blood pressures is less than that for casual office blood pressures. The clinician should understand that the variability of blood pressures measured on an individual may be much greater than that reported for populations of hypertensive patients, and must be considered when applying epidemiologic group data to a specific patient. Moreover, any methodology of indirect blood pressure measurement that may reduce the variability and improve repeatability of casual office blood pressures deserves further consideration.

Ambulatory Care↗

PubMed1991

Adding automated perimetry to glaucoma evaluation and treatment.

Tangent-screen visual fields were compared with the fields determined by a newly acquired automated perimeter in 100 eyes of consecutive patients with glaucoma or suspected glaucoma. The tangent screen found defects in 12 eyes, and the automated perimeter found defects in 34 eyes. Because the automated perimeter found new defects or defects much worse than were found by the tangent-screen examinations, three patients received timolol, and a laser iridotomy, two laser trabeculoplasties, and three filtering operations were done on other patients. The major benefit in switching from tangent screen to automated perimetry was increased confidence in the visual fields tested as an indicator for treating patients with glaucoma. A minor problem in using the automated perimeter was that the testing was slightly longer and more tiring. This problem was reduced by using a translucent occluder, rather than the universally used opaque one.

Glaucoma↗

PubMed1986

Office automation.

By now, the term "office automation" should have more meaning for those readers who are not intimately familiar with the subject. Not all of the preceding material pertains to every department or practice, but certainly, word processing and simple telephone management are key items. The size and complexity of the organization will dictate the usefulness of electronic mail and calendar management, and the individual radiologist's personal needs and habits will determine the usefulness of the home computer. Perhaps the most important ingredient for success in the office automation arena relates to the ability to integrate information from various systems in a simple and flexible manner. Unfortunately, this is perhaps the one area that most office automation systems have ignored or handled poorly. In the personal computer world, there has been much emphasis recently on integration of packages such as spreadsheet, database management, word processing, graphics, time management, and communications. This same philosophy of integration has been applied to a few office automation systems, but these are generally vendor-specific and do not allow for a mixture of foreign subsystems. During the next few years, it is likely that a few vendors will emerge as dominant in this integrated office automation field and will stress simplicity and flexibility as major components.

Computers↗

PubMed1979

Automated fluorometric determination of thiamine and riboflavin in infant formulas.

Commercial infant formulas were analyzed simultaneously for thiamine and riboflavin by an automated fluorometric method and by the AOAC manual fluorometric methods. For 10 products, the mean thiamine and riboflavin results determined using the automated method ranged from 104 to 113% and 90 to 112%, respectively, of those by the AOAC manual methods. The coefficients of variation for thiamine and riboflavin ranged from 1.05 to 3.90% and 0.60 to 2.48%, respectively, for the automated methods, and 1.48 to 3.86% and 0.69 to 10.9%, respectively, for the manual methods. Using the automated method, mean recoveries of thiamine and riboflavin added to samples were 103 and 104%, respectively. The automated method used a common sample preparation to determine both thiamine and riboflavin, and gave results equivalent to, or better than, those obtained by the manual methods.

Autoanalysis↗

PubMed1984

Analysis of caffeine: comparison of the manual enzyme multiplied immunoassay (EMIT), automated EMIT, and high-performance liquid chromatography procedures.

Caffeine has been recommended for the treatment of apnea in newborn children. Most of the current methods for measurement of caffeine in newborns have used high-performance liquid chromatography (HPLC) because analysis can be performed on as little as 50 microliter of serum, an important factor when obtaining multiple blood samples for routine drug monitoring in infants and children. We evaluated the manual Syva enzyme multiplied immunoassay technique (EMIT) caffeine procedure and compared the assay results with our HPLC caffeine method. The EMIT procedure was also automated, and these results were compared with those of the manual and HPLC procedures. The 7-micrograms/ml calibrator was analyzed 20 times to establish within-run precision for the manual procedure. The mean +/- SD was 6.97 +/- 0.33, and the coefficient of variation (CV) was 4.80%. Reproducibility was tested by multiple analysis of the 11-micrograms/ml control. The mean +/- SD (CV) for the manual system was 11.3 +/- 0.45 (4%), n = 17; for the HPLC system, 10.58 +/- 0.89 (8.4%), n = 10; and for the automated system, 10.4 +/- 0.78 (7.5%), n = 12. Samples from 32 patients were analyzed by each of the above procedures. There was a good correlation among all three procedures. The correlation coefficient (r) for HPLC vs. manual EMIT was 0.98; for HPLC vs. automated EMIT, 0.97; and for automated EMIT vs. manual EMIT, 0.96. We conclude that the new Syva EMIT caffeine method is reliable and reproducible and can be applied to automated analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Caffeine↗

PubMedDate not supplied

Evaluation of an automated radioimmunoassay for serum cortisol.

The performance characteristics are reported for a serum cortisol assay using the GAMMAFLO Automated Assay System, an automated continuous-flow system for radioimmunoassay (RIA). This automated system utilizes a combination of continuous-flow methodology and column chromatography techniques. The cortisol assay studied had a standard curve range of 10.0 to 500 microgram per L. The intra-assay and inter-assay precision were 5.1 percent and 7.2 percent (RSD), respectively, for a cortisol concentration of 160 microgram per L. The automated serum cortisol results correlated (r = 0.958 and 0.933) with two established manual radioimmunoassay procedures. No drift or carryover was detectable in 200 within-assay consecutive determinations performed at a rate of 42 determinations per hour (five hours continuous operation). The automated system studied appears to offer a viable alternative to cortisol manual RIA techniques in terms of overall precision simplicity of operation, and sample throughput.

Autoanalysis↗

PubMed1995

Clinical alternative for reducing the time needed to perform automated threshold perimetry.

BACKGROUND: Automated threshold perimetry is an important test used to diagnose and monitor open angle glaucoma. Unfortunately, the test can be tedious and demands that a patient concentrate for up to fifteen minutes or more per eye to achieve useful results. Many individuals are not capable of fixating for extended periods, and the reliability of the automated threshold test consequently suffers. This paper explores alternative methods to perform automated threshold perimetry so that the time required for testing is reduced while the clinical impact of performing abbreviated tests is minimized. METHODS: Several different versions of a central automated threshold perimetry test were run on a cooperative, normal individual utilizing a Humphrey Field Analyzer. One field was run on consecutive days in one eye only. The 24-2 and 30-2 test patterns were performed using the standard threshold format, FastPac, and certain modifications (involving the short-term fluctuation monitor and the fixation monitor) to measure the time required for the test to be performed and monitor any changes in the global indices as measured by the tests. RESULTS: The 30-2 automated threshold test requires about 13 minutes to perform while a similar central threshold test, the 24-2 test, run in a modified format (without the short-term fluctuation monitor and/or the fixation monitor) was performed in about five minutes. CONCLUSIONS: There are several methods that may be used to reduce perimetric testing time without compromising significantly the reliability of the diagnostic information. Reduced testing time may enable the clinician to obtain reliable fields in certain patients whose data are deemed unreliable when performing lengthier tests. The clinician must decide which data may be lost when testing time is reduced since clinical decision-making is inevitably affected whenever clinical data is not gathered.

Fixation, Ocular↗

PubMed1996

[Diagnostic problems of hematological disorder using automated blood cell analyzer].

Although an automated blood cell counter provides the different test results to the clinician both precisely and rapidly, confusing data have also been reported which caused much confusion for the diagnosis of diseases. We investigated five different automated instruments using blood samples from different patients with hematological disorders to evaluate the flow of these automated counters in the interpretation of test results. Platelet aggregation, hemolysis and cryoglobulin can influence the evaluation with such automated instruments. The degree of the variance is different between false value and corrected value. Furthermore, cryoglobulin may give false data on coagulation and fibrinolysis tests. Automated white cell differentiation is based upon flow system or pattern recognition, but overlooking of the abnormal cells cannot be avoided by either method, such as a small number of blasts, atypical lymphocytes, adult T-cell leukemia cell, etc. Therefore, it is necessary of the bases is blood cell to the CD4/CD8 measurement and microscopic check along with considering biochemical parameters. We should make smears from such patients. For analysis of surface markers of hematological malignancy cell by flow cytometry proper selection of antibodies and setting of gate are required. To prevent mistakes due to morphological misinterpretation or other unsuitable conditions, we should thoroughly understand the morphologic aspects of leukemia cells.

Antigens, Surface↗

PubMed1996

Multiple use of disposable (tubing) set of HomeChoice automated peritoneal dialysis (APD) system in PD patients.

Our objective was to evaluate the multiple use of the tubing set of the HomeChoice automated peritoneal dialysis (PD) system in PD patients. The study was designed to reuse the tubing set of the HomeChoice automated PD system for two to seven treatments, each of 16-24 hours duration, in end-stage renal disease (ESRD) patients, and to continue to use the same set if the patient was disconnected for any reason. In a tertiary-referral university hospital, 17 ESRD patients on PD, admitted to a university hospital from January, 1995 to September, 1995, were studied. The patients were disconnected and connected in between or during PD treatments. Five-liter bags were used. All the fluid was either set initially or added as clinically indicated. One hundred and thirty-eight PD treatments were performed with the HomeChoice automated PD system, using 30 disposable (tubing) sets. Sixty-three disconnections were made for ambulation, transfer to other units, surgery, physical therapy, radiological investigations, and special procedures in between and during PD treatments. No episode of peritonitis occurred. The multiple use resulted in a 78% reduction in tubing sets and drain-line extension sets used, thereby reducing the disposable supplies and creating a substantial saving in nursing time. The multiple use of tubing sets of the HomeChoice automated PD system was safe and economical in patients undergoing automated PD in a hospital setting.

Catheters, Indwelling↗

PubMed1984

Detection of abnormal cells in white cell differentials: comparison of the HEMATRAK automated system with manual methods.

Automated differential systems can rapidly count larger numbers of cells compared with the standard manual procedure. When a fixed number of abnormal cells are interspersed randomly with a large number of normal cells, it can be shown mathematically that counting more cells increases the chances of detecting at least one abnormal cell. To test this hypothesis in a clinical setting, the authors compared 200-cell and 400-cell automated differentials obtained via the HEMATRAK Model 360 system with results of 100-cell differentials performed either manually or automatically for a group of 141 blood smears. Manual 100-cell differentials also were performed in a reference laboratory for comparison. In close agreement with theoretical expectation, both 200-cell and 400-cell differentials detected significantly more abnormal cells than did either the manual or automated 100-cell differential. Results of the latter two were not significantly different. Eighty-seven per cent of the slides that, according to the 100-cell manual differential, were without abnormal cells were found to have such cells on the 400-cell automated differential. Atypical lymphocytes and nucleated red blood cells were the abnormal cells most frequently identified.

Automation↗