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Table 1 Indication for and added clinical value of clinician-initiated blood smear reviews

From: Clinician-ordered peripheral blood smears have low reimbursement and variable clinical value: a three-institution study, with suggestions for operational efficiency

Indication Smears for this indication, among all smears performed (%) Smears with added clinical value, among smears performed for this indication (%)
Any 515 (100%) 118 (23%)
Any RBC abnormality 259 (50%) 48 (19%)a
Any WBC cell abnormality 126 (24%) 32 (25%)a
Any PLT abnormality 150 (29%) 20 (13%)a
Any cytosis 53 (10%) 18 (34%)
 Erythrocytosis 2 (0%) 0 (0%)
 Leukocytosis 42 (8%) 18 (43%)
 Thrombocytosis 12 (2%) 1 (8%)
Any cytopenia 267 (52%) 45 (17%)
 Anemia 179 (35%) 32 (18%)
 Leukopenia 79 (15%) 11 (14%)
 Thrombocytopenia 135 (26%) 18 (13%)
Any abnormal cell morphology 39 (8%) 9 (23%)
 RBC morphology 22 (4%) 4 (18%)
 WBC morphology 6 (1%) 3 (50%)
 PLT morphology 5 (1%) 1 (20%)
Hematolymphoid neoplasm 65 (13%) 30 (46%)
Blasts 5 (1%) 2 (40%)
Hemolysis 100 (19%) 24 (24%)
Parasites 4 (1%) 1 (25%)
Other 55 (11%) 15 (27%)
Not specified 33 (6%) 6 (18%)
  1. aThe proportion of smears with potential clinical value differed significantly across these three categories of indications (p = 0.0375)
  2. RBC Red blood cell, WBC White blood cell, PLT Platelet