External quality assessment of prothrombin time: The split‐sample model compared with external quality assessment with commercial control material

Sølvik, Una Ørvim; Stavelin, Anne; Christensen, Nina Gade; Sandberg, Sverre

doi:10.1080/00365510600684580

Cited by 16 publications

(14 citation statements)

References 30 publications

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“…This type of quality control has been evaluated and found useful as an alternative to the traditional EQAS (17), although it has been opposed by others (25,26). A different approach is developed in Austria and the Czech Republic where the INRatio users are asked to report results from the on-board QC system.…”

Section: Discussionmentioning

confidence: 99%

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External quality assessment of point-of-care International Normalized Ratio (INR) testing in Europe

Stavelin

Meijer²,

Kitchen³

et al. 2012

Clinical Chemistry and Laboratory Medicine

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Background: Point-of-care testing (POCT) of prothrombin time, expressed as International Normalized Ratio (INR), is widely used to monitor patients in oral anticoagulation treatment. Guidelines recommend that POCT users should participate in an external quality assessment (EQA) scheme whenever available. The aim of this study was to investigate which European countries provide EQA for POCT INR and to compare how these schemes are organized. Methods: Thirty European countries were invited to participate in this study. Those who reported that they provide EQA for POCT INR filled in a questionnaire dealing with different aspects of their schemes. Results: Nineteen countries reported that they do not provide EQA for POCT INR, while 12 organizations from nine countries reported that they provide this service. Most of these countries circulate lyophilized samples with for the participants unknown target values. Samples with certified INR values and procedures using split samples with fresh patient samples are also used. The acceptability limits vary from 15% to 30%, and the total number of samples circulated per year varies from 1 to 12. Most of the countries organize educational activities together with their schemes. Conclusions: This study demonstrates that there is a wide variation in the way EQA for POCT INR is performed in Europe and that there are many European countries that do not provide this service. Even though our findings indicate that EQA for POCT INR draws some challenges, especially in providing suitable control materials, participation in such schemes is considered useful.

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Section: Discussionmentioning

confidence: 99%

“…Publications show that an EQAS for POCT INR is available in the Czech Republic (15), the Netherlands (16), Norway (17) and the UK (14). To our knowledge, however, no studies have investigated the coverage of POCT INR schemes in Europe.…”

Section: Introductionmentioning

confidence: 99%

External quality assessment of point-of-care International Normalized Ratio (INR) testing in Europe

Stavelin

Meijer²,

Kitchen³

et al. 2012

Clinical Chemistry and Laboratory Medicine

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“…INR results from stably anticoagulated patients should be within 0AE5 of each other. This approach has been used for INR testing (Tripodi et al, 2004;Solvik et al, 2006). There are difficulties with this approach because the quality of hospital laboratory INR results may vary (Kitchen et al, 1994).…”

Section: External Quality Assessment (Eqa)mentioning

confidence: 99%

Point‐of‐care testing in haemostasis

Perry

Fitzmaurice

Kitchen³

et al. 2010

Br J Haematol

124

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SummaryPoint-of-care testing (POCT) in haematology has seen a significant increase in both the spectrum of tests available and the number of tests performed annually. POCT is frequently undertaken with the belief that this will reduce the turnaround time for results and so improve patient care. The most obvious example of POCT in haemostasis is the out-ofhospital monitoring of the International Normalized Ratio in patients receiving a vitamin K antagonist, such as warfarin. Other areas include the use of the Activated Clotting Time to monitor anticoagulation for patients on cardio-pulmonary bypass, platelet function testing to identify patients with apparent aspirin or clopidogrel resistance and thrombelastography to guide blood product replacement during cardiac and hepatic surgery. In contrast to laboratory testing, POCT is frequently undertaken by untrained or semi-trained individuals and in many cases is not subject to the same strict quality control programmes that exist in the central laboratory. Although external quality assessment programmes do exist for some POCT assays these are still relatively few. The use of POCT in haematology, particularly in the field of haemostasis, is likely to expand and it is important that systems are in place to ensure that the generated results are accurate and precise.Keywords: point-of-care testing, haemostasis, quality assurance, near patient testing.Point-of-care testing (POCT) is defined as a diagnostic test at or near the site of the patient with the rationale that such testing will result in the rapid generation of results and improve patient care. POCT is frequently undertaken by nonlaboratory personnel both within and outwith the hospital setting and the last 10 years has seen a significant increase in its use, particularly in the field of haemostasis. The importance of POCT is highlighted by a recent publication from the This review summarizes POCT in relation to haemostasis, and complements a previously published guideline by the British Committee for Standards in Haematology on POCT in Haematology (Briggs et al, 2008).

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“…An alternative approach to EQA for POC INR monitoring13 is referred to as the split sample method. Here the patient is tested using the POC device by the normal finger stick method but also has a venous sample taken which is anticoagulated and sent to a hospital laboratory for an INR test.…”

Section: Discussionmentioning

confidence: 99%

Point of Care INR testing devices: performance of the Roche CoaguChek XS and XS Plus in the UK NEQAS BC external quality assessment programme for healthcare professionals: four years’ experience

Kitchen¹,

Kitchen

Jennings³

et al. 2012

J Clin Pathol

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External quality assessment of prothrombin time: The split‐sample model compared with external quality assessment with commercial control material

Cited by 16 publications

References 30 publications

External quality assessment of point-of-care International Normalized Ratio (INR) testing in Europe

External quality assessment of point-of-care International Normalized Ratio (INR) testing in Europe

Point‐of‐care testing in haemostasis

Point of Care INR testing devices: performance of the Roche CoaguChek XS and XS Plus in the UK NEQAS BC external quality assessment programme for healthcare professionals: four years’ experience

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