Went to the NEQAS Haematology meeting in Birmingham. It was a really good meeting. On Tuesday 19th, I went to a session about new NEQAS schemes. It was a discussion session and we talked about n-RBC's, ESR's, MPV, RDW and iron deficiency indicators. NEQAS are piloting an n-RBC scheme at the moment and are trying to create their own in-house material. Our Sysmex XE analysers are capable of n-RBC counts. At the moment, we only perform counts on neonatal samples. If any adult specimens contain n-RBC's, the analysers produce a NRBC flag and a film is looked at. We informed NEQAS that it was more important that the n-RBC material was able to generate an NRBC flag, which we cold then go on and quantitate.
The value of the ESR was discussed, a couple of laboratories no longer perform an ESR but conduct plasma viscosity testing instead. It was felt that despite the ESR being a non-specific test, GPs and A&E staff find it a good indicator of disease status and as a monitoring tool. Despite the vast number of years over which the ESR test has been performed, there is still no external quality assurance scheme available. NEQAS are trying to produce an ESR scheme. Most laboratories did use internal QC material for automated ESR's.
The Mean Platelet Volume was introduced as a new parameter. Very few laboratories reported the MPV. The science is that MPV can be an indicator of risk of thrombosis. The larger the MPV, the greater the risk. The room ws asked why the MPV was not being reported. One answer was that there was no room on the printed report. One answer to this was to stop reporting the MCHC as this, although a useful parameter in the laboratory for assessing sample integrity, was of no clinical value. It' space on the report could be taken by the MPV. Most laboratories stated that they were not reporting the MPV as clinicians were not requesting it. This led to a debate on who's responsibility it was to educate the clinicians about new parameters available from the laboratory. Some felt it was the responsibility of biomedical scientists to educate their consultants and to try an get the word to the hospital doctors via the grand rounds. My feeling is that until a guideline is written, we are unlikely to begin reporting this parameter. Many laboratories said that they do report the RDW. Currently, the laboratory I work in does not report this parameter. The use of the percentage hypochromia, and some others, were also mentioned as a new parameters for iron deficiency.. Again, many laboratories had analysers that can measure this parameter but very few reported it.
On Wednesday 20th, we had a talk about harmonisation in haematology. This talk was about Carter; moving services closer to the patient, exploring new ways of working, consolidation/networks, innovation in workforce and technology etc. We were then given a talk about trying to harmonise reference ranges across the UK, Wales have achieved this to a certain extent. As ideal as this would be, different analysers using different reagents require different reference ranges. All laboratories were urged to at least report their parameters in harmonised units ie Hb in g/dL not g/L. NEQAS schemes are helping to achieve this by requesting results back to them in specified units. The use of comments was also approached. Comments should be standardised, meaningful, consistent, add value and be evidenced based.
A talk was then given about the Haematinic's NEQAS scheme and the problems experienced with specific analysers. The measurement of Holotranscolabumin (active B12) was mentioned.
A funny talk was given about the naming of cells. Check out the website www.photobucket.com/morphological similes.
An overview of the Tuesday afternoon session was given and also for the other session about Digital Morpohology. NEQAS run a digital morphology scheme that biomedical scientists can sign up to for CPD.
Overall, it was a really good meeting.
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