MULTIPARAMETER INTERPRETATIVE REPORTING IN DIAGNOSTIC LABORATORY HEMATOLOGY

Accurate diagnosis and classification of hematologic malignancies (acu te leukemias and chronic lymphoproliferative disorders) requires a mul tiparameter approach including peripheral blood analysis, bone marrow examination, and immunophenotyping. We have designed knowledge-based c omputer systems for interpretation of the hemogram and peripheral bloo d smears, analysis of flow cytometric immunophenotyping panels, and mo rphologic assessment of bone marrow specimens. The 3 modules share a r elational database which includes pertinent clinical history in additi on to the laboratory results. The bone marrow module automatically wri tes a complete interpretative report with a final diagnosis by searchi ng all of the databases for appropriate clinical, peripheral blood, an d immunophenotyping information. The ability of the 3 modules to inter act, and the quality of the interpretative reports were tested on 100 consecutive patients with leukemia. The final diagnosis made by the bo ne marrow system agreed with the hospital diagnosis in 94 cases and th e authors' interpretation in 99 of 100 cases.