Simel D L, DeLong E R, Feussner J R, Weinberg J B, Crawford J
Health Services Research Field Program, Durham Veterans Administration Medical Center, NC 27705.
Arch Intern Med. 1988 Apr;148(4):822-4. doi: 10.1001/archinte.148.4.822.
An improved anemia classification may be available by combining measures of red blood cell size variability with mean corpuscular volume. Visual inspection of the peripheral blood film allows semiquantitative description of anisocytosis while quantitative measures are determined from electronic cell counter analyzers' red blood cell distribution width. We evaluated correlations between semiquantitative and quantitative measures of anisocytosis for different groups of observers. Hematologists', medical students', and medical residents' semiquantitative assessment of anisocytosis correlated with the quantitative red blood cell distribution width. The interobserver variability demonstrated that all observers correlated with each other, while the intraobserver variability of semiquantitative anisocytosis demonstrated that observers were more precise than could be predicted by chance. However, the extreme precision of the red blood cell distribution width strongly suggests that it should be the "gold standard" for measuring red blood cell size variability.
通过将红细胞大小变异性测量值与平均红细胞体积相结合，可能会得到一种改进的贫血分类方法。对外周血涂片进行目视检查可对红细胞大小不均进行半定量描述，而定量测量则由电子细胞计数分析仪的红细胞分布宽度来确定。我们评估了不同观察组中红细胞大小不均的半定量和定量测量之间的相关性。血液学家、医学生和住院医师对红细胞大小不均的半定量评估与定量红细胞分布宽度相关。观察者间的变异性表明所有观察者之间都具有相关性，而半定量红细胞大小不均的观察者内变异性表明观察者的精确程度高于随机预测。然而，红细胞分布宽度的极高精确性强烈表明它应是测量红细胞大小变异性的“金标准”。
