Verification And Comparison Of Sysmex Kx-21n Cell-dyn 1800 And Horiba Abx Micros Es 60 Automated Hematology Analyzers At Tikur Anbessa Specialized Hospital Addis Ababa Ethiopia
Background: Laboratory testing plays a crucial role in the detection, diagnosis and treatment ofrndisease in patients. Analytical evaluation of a new analyzer or method should be done in order tornconfirm the declared specifications before its introduction into the routine use. Agreement of allrnautomated hematology analyzers must be carried out in all laboratories. But, the practice of usingrnautomated analyzers interchangeably without evaluation is common in our country includingrnTikur Anbessa specialized hospital (TASH).rnObjective: To verify performance and compare agreement of Cell-Dyn 1800, Sysmex KX-21Nrnand Horiba ABX micros ES 60 hematology analyzers found in TASH.rnMethods: A cross sectional study was conducted to verify performance and assess agreementrnbetween Cell-Dyn 1800, Sysmex KX-21N and Horiba ABX micros ESrn60rnhematology analyzersrnat Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia. The study period was fromrnFebruary to May 2017. According to the CLSI guideline a total of 267 samples were analyzed inrnduplicates on the three analyzers to verify and compare them. Data cleaning and analysis werernperformed by Microsoft excel 2007 and SPSS version 20.rnResult: We found that minimal carryover (< 0.5%) and excellent linearity for white blood cell,rnhemoglobin, red blood cell and platelet (r > 0.999). Precision was good for all major CBCrnparameters with % CV< 2.0. Agreement between most of the parameters of the analyzers lies inrnthe limits of agreement for more than 95% of cases according to the Bland-Altman plot analysis.rnPearson correlation and linear regression graph showed that the three analyzers were wellrncorrelated (r > 0.900) for major CBC parameters. The correlation of WBC differential-rnneutrophil and lymphocyte were excellent (r > 0.920). Poor correlation was observed in mixedrncells (r=0.005) especially in the high levels between Horiba and Sysmex. There was alsornmoderate correlation in mean platelet volume (MPV) between analyzers of Horiba and Sysmexrn(r= 0.593 and r=0.572) at normal and high levels respectively.rnConclusion: The overall performance of the three analyzers is excellent. They agree well withrneach other and can be used interchangeably with care in mixed cells and MPV.rnKey words: Method comparison, performance evaluation, verification of hematology analyzersrnSysmex KX-21, Horiba ABX micros ES 60, Cell-Dyn 1800, hematology