International Journal of Research in Medical Sciences | October 2016 | Vol 4 | Issue 10 Page 4563 International Journal of Research in Medical Sciences Singhal S et al. Int J Res Med Sci. 2016 Oct;4(10):4563-4566 www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012 Research Article Can peripheral blood smear examination be totally replaced by automated hematology analyser - with special reference to anemia? Shivangi Singhal*, Nidhi Verma, Monika Rathi, Neha Singh, Preeti Singh, S. P. Sharma, Uma Tayal INTRODUCTION Peripheral blood smear (PBS) examination is a part of the routine work of every laboratory. The manual examination of these images is tedious, time consuming and suffers from interobserver variation. This has motivated researchers to develop different algorithms and methods to automate PBS image analysis. The automated hematology analyzers give more accurate and <1% coefficient of variation for the RBC indices and hence have replaced the manual methods. Thus we can definitely conclude that the hematology analyzers definitely have a potential to replace peripheral blood smear examination. 1 The expertise needed to see the PBS is definitely far more than that needed to run the analyzers. Moreover there is intra and inter observer variation in morphological typing of anemia based on PBS examination. The additional PBS review performed by hematologist hardly ever provided unique information and provided incremental helpful information in only 4% of the cases. 2 Cell counting with these instruments is rapid, objective, statistically significant (8000 or more cells are counted) and not subject to the distributional bias of the manual count. Hence automated instruments increase accuracy, speed of analysis, minimizes levels of human manipulation for test entry, sampling, sample dilution and ABSTRACT Background: The aims and objectives of present study was to correlate typing of anemia based on RBC indices obtained from an automated analyzer with peripheral blood smear (PBS) examination and also to find out whether the number of PBS examination can be reduced with the help of automated hematology analyzer. Methods: A total of 2500 blood samples showing anemia as per WHO reference range were collected in central pathology lab of SVBP Hospital attached to L.L.R.M. Medical College, Meerut, Uttar Pradesh, India over a period of one year. Samples were reported by auto-analyzer and PBS examination simultaneously. Results: Out of total 2500 cases, there were 1623 females (64.9%) and 877 males (35.1%) with male: female ratio 0.54:1. By auto-analyzer and PBS examination, MCHC anemia (49.8%) was the commonest anemia followed by NCNC anemia (36.5%) and Macrocytic anemia (4.2%). Discordant typing of anemia between two methods was found in 284 (11.4%) cases only. These cases were diagnosed as normocytic normochromic (NCNC) anemia with raised RDW by autoanalyzer while as Dimorphic Anemia (DA) on PBS examination. Also morphological changes such as RBC inclusions, spherocytes, RBC fragments, schistocytes, nucleated RBCs were seen only on PBS examination. Conclusions: The Study concluded that even today PBS examination is very important and cannot be totally replaced by automated analyzer and both methods are complementary to each other. Keywords: Automated hematology analyzer, Peripheral blood smear, Examination, Anemia Department of Pathology, L. L. R. M Medical College, Meerut, Uttar Pradesh, India Received: 11 August 2016 Accepted: 07 September 2016 *Correspondence: Dr. Shivangi Singhal, E-mail: shivangisinghal15@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20163330