Automated screening for tuberculosis by multiparametric analysis of data obtained during routine complete blood count

Int J Lab Hematol. 2014 Apr;36(2):156-64. doi: 10.1111/ijlh.12148. Epub 2013 Sep 6.

Abstract

Introduction: The main goal of this study was to develop a multiparametric cell population data (CPD) model that combines information from several morphologic parameters generated by DxH800, in addition to the traditional parameters regularly reported in the CBC-diff, and to test the performance of this model in screening the general population for primary tuberculosis (TB).

Methods: A total of 3741 study cases were divided into two groups, test and validation set at cut-off value of 6000 WBCs/μL. We developed multiparametric model for primary TB screening (TB hemeprint), selected CPD, and calculated parameters which could discriminate primary TB from other non-TB diseases and normal control in test set. We applied it to the validation set, which was a set of completely different samples, to test its reproducibility if applied to a routine laboratory test.

Results: After screening primary TB using TB hemeprint, sensitivity, specificity, PPV, and NPV were 85.4%, 89.6%, 31.1%, and 99.1%, respectively, in primary TB with lower than 6000 WBCs/μL of test set (test set-L). In primary TB with higher than 6000 WBCs/μL of test set (test set-H), those values were 83.1%, 85.6%, 29.7%, and 98.6%, respectively. There were only 0.4% (2/461) and 0.6% (2/326) of normal control samples included in test set-L and -H, respectively. Diagnostic efficiencies except sensitivity in each validation set were very comparable with those in each test set.

Conclusion: Tuberculosis hemeprint may allow us to screen primary TB with acceptable sensitivity and specificity using combination of TB-specific CPD and calculated parameters.

Keywords: Automatic blood cell analyzer; calculated parameters; cell population data; mycobacterium tuberculosis.

MeSH terms

  • Blood Cell Count* / methods
  • Blood Cell Count* / standards
  • Erythrocyte Indices
  • Humans
  • Mass Screening
  • Reference Values
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Tuberculosis / blood*
  • Tuberculosis / diagnosis*