We Get Biased on Things That Make Sense

Extract

When I was teaching third year medical students, and bench-lecturing clinical laboratory science students, I emphasized the importance of clinical details and the history of patients in laboratory test processing, especially in the evaluation of peripheral blood films. During those times, one of my students stated, “but including details of patients might somehow affect the decision of the reviewer, and may lead to a bias.” I responded that we are biased on things that make sense. This means that we decide based on the evidence we see from a microscopy evaluation in the light of the clinical detail and history. How do clinical details and history help us reach decisions?

If specimens are the “in vitro ambassadors” of patients to the laboratory, then properly completed request forms are their “credentials”. The content of the request form is thus a bridge that connects patients and clinicians with the laboratory. The more informative the request form is, the better and more accurate the outcome.

Peripheral blood film evaluation and characterization of blood cells based solely on morphology is inherently complex and prone to error. The complex nature of blood cell morphology becomes apparent when we deal with undifferentiated or immature cells, or in conditions that are characterized by overlapping cellular features, and/or the coexistence of some diseases. These and other factors listed below are some of the reasons why we need to have clinical details and the history of patients included in a request form to maximally contribute to the accuracy of…