Red blood cell morphology reporting: how much is a waste of time?

Red blood cell morphology (RBC-M) reporting is a routine requirement for hospital laboratories when reporting complete blood counts. However, there is little evidence that RBC-M reporting is useful to pediatric clinicians. We surveyed pediatric hematology specialists and nonspecialists at the BC Children's Hospital (Vancouver, Canada), to evaluate the perceived clinical utility of this reporting. Although a large majority of pediatric clinicians refer to RBC-M reports in their clinical practice, less than half consider these reports to be clinically useful. Hematology specialists were more likely than nonspecialists to identify individual RBC-M descriptions as clinically useful. Some RBC-M descriptions, such as anisocytosis, were considered not useful by specialists and by nonspecialists. A large proportion of nonspecialist respondents noted that they did not know the clinical significance of some of the RBC-M terms. Educational initiatives to inform nonspecialists about the clinical significance of some RBC-M descriptions should be considered. A few RBC-M descriptions are not clinically useful to either specialists or nonspecialists, and these could be omitted from RBC-M reports as a step toward improved hematology laboratory reporting.