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Dr Bessman and Drs Karnad and Poskitt make valid points about the utility of the RDW in the evaluation of microcytic anemias. Although it is now available in our hospital, this was not utilized at the time that we initiated our study. However, it seems unlikely that clinicians who fail to recognize an abnormally low MCV will know how to utilize an abnormal RDW. This further emphasizes the most important point of our study—that the diagnostic approach and evaluation of microcytic anemias needs to be improved for physicians in general. Dr Feeley makes an important point about the greater effectiveness of a written note over computer flagging of aberrant results in laboratory data. However, in spite of the volume of information provided, it is still up to the clinician to determine the relative importance of all abnormal laboratory data and to decide which, if any, additional diagnostic tests are indicated.
Feeley EJ, Hansen RM, Anderson T, Hanson G. To the Editor.-Reply. Arch Intern Med. 1985;145(8):1535. doi:10.1001/archinte.1985.00360080217044