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August 1985

To the Editor.—

Author Affiliations

Fremont, Calif

Arch Intern Med. 1985;145(8):1535. doi:10.1001/archinte.1985.00360080217043

In their article in the January Archives, Hansen et al showed that, in their hospital, half of the microcytic indexes reported as parts of complete blood cell counts were apparently unrecognized or ignored. It is not surprising that busy clinicians miss important data when they appear in a report filled with numbers generated by modern automated analyzers (the MCV is only one of 13 values presented in the printout of a standard hematology analyzer [Coulter Electronics Inc, Hialeah, Fla]). As the authors suggest, instrumentation that automatically flags abnormal data would be helpful, but more effective would be a short descriptive note, which good laboratory practice dictates should be part of the report in cases of abnormal morphologic findings. The Joint Commission on Accreditation of Hospitals1 requires that hospital laboratories have criteria for defining those specimens referred to a physician for review; this would include cases with microcytic indexes. The written