Physician review of the peripheral blood smear: When and Why An opinion

Objectives: To determine when a physician should review a peripheral blood smear and to propose criteria for such review. Participants: The members of the Hematology and Clinical Microscopy Resource Committee of the College of American Pathologists (CAP) reached consensus on this topic with the assistance of 12 other CAP members with expertise in outcomes research. In addition, the Committee obtained expert opinions of representatives of the American Academy of Family Practitioners, the American Academy of Pediatrics, the American College of Physicians, the American Society of Clinical Pathologists, and the American Society of Hematology. The Committee sponsored the study. Evidence: The 17 members of the Committee reviewed relevant articles from Medline literature searches covering 1970-1999 and from manual searches of bibliographies. The consensus statement was written by one of the authors (PP) and was reviewed by the entire Committee, other CAP members, and representatives of other medical societies. Conclusions: In many instances physician review of the peripheral blood smear is an essential component of proper patient care. In both clinical and laboratory settings the practice can result in more timely diagnosis, better-quality laboratory data, and improved patient management.