Software for the Pathologist: The Blood and Bone Marrow Counter
Stephanie, Diane, Schniederjan MD; Emory University; Karen, Patricia, Mann MD, PhD; Emory University; Alexis, Byrne, Carter MD; Emory University; Benjamin, Lee, Wagenman MD; Emory University;
Content:
Examination of bone marrow aspirates and peripheral blood with abnormal automated cell counts require manual differential counts of nucleated cells. Many laboratories still use push-button manual counters, the largest of which accommodates only eight cell types and has widely spaced buttons which are not conducive to one-hand counting. Electronic counters are often expensive, have display screens of limited size, poor ergonomic design and relatively few counting buttons.
Technology:
A simple bone marrow and peripheral blood counting program was developed that could be executed on any computer running Microsoft Windows XP (Microsoft Corporation, Redmond, WA, USA). The program was constructed using Microsoft Visual Studio 2005 in Visual Basic.
Design:
The program design allows the reader to manipulate the glass slide on the microscope using one hand while counting with the other hand on a nearby computer keyboard. Up to twenty different cell types may be counted, five of which are customizable. Cell counts are performed in 100-cell increments, and up to 10 sets of 100 cells may be stored in memory. Patient information can be entered, and printouts contain the raw data, calculated averages and calculated ratios. For training purposes, the program includes help information, images and descriptions of cell types.
Results:
The software was compared to both manual and electronic counters in the laboratory at Emory University. The software was faster and more user-friendly than counting with manual punch counters.
Conclusion:
We have developed a peripheral blood and bone marrow cell counting program which is easy to use and has more capabilities than currently available manual and electronic counters. We have additionally demonstrated that simple software development can improve and facilitate routine laboratory procedures. Potential disadvantages of this software include an inability to interface with some laboratory information systems and lack of database functionality to maintain storage of differential counts after the program is closed. However, as laboratory information systems become more sophisticated and database functionality improves, the data could potentially be imported and stored. Advantages include those already described as well as distribution of the software as freeware.
