Determining the Correlation Between Automated vs. Manual Method for Reticulocyte Estimation

Abstract

Objective: To determine the correlation between automated and manual methods for the determination of reticulocyte (Retic) count in symptomatic patients.

Methodology: This cross-sectional study was conducted at Rehman Medical Institute, Peshawar, from November 2021 to April 2022. A total of 384 patients of both genders and all ages were enrolled. Anemic patients with high Retic counts who were referred to RMI for reticulocyte (RC) examination were included. Samples that were improperly proportioned with anticoagulants, lipemic, hyperbilirubinemic, or hemolyzed were excluded. The reticulocyte counts of all samples were analyzed using both manual methods and an automated analyzer (Sysmex XN analyzer), with evaluations performed by two different hematologists to eliminate observer bias.

Results: No significant deviation was observed between manual and automated reticulocyte counts in male or female specimens (P > 0.05). Similarly, there was no significant difference in average reticulocyte counts among adults, children, and infants (P > 0.05). However, a noticeable difference in mean manual and automated RC was observed across different types of anemia, including microcytic, normocytic, and macrocytic anemia. Additionally, the mean reticulocyte hemoglobin cellular content, reticulocyte volume, and immature reticulocyte fraction showed significant differences across all specimens (P < 0.001).

Conclusion: There were no significant deviations in reticulocyte counts between the manual and automated methods. The manual method is preferred for its cost-effectiveness, while the automated approach is recommended for its efficiency and accuracy.