Performance of the Coumatrak System in a Large Anticoagulation Clinic

Foulis, Philip; Wallach, Paul M.; Adelman, Harold M.; Sanford, Barbara H.; McCain, Jeannette; Reed, D. N.; Schlede, Carolyn M.; Kokseng, Chester U.; Taylor, Charles Lewis

doi:10.1093/ajcp/103.1.98

Cited by 11 publications

(7 citation statements)

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“…14 25 Another study found only 40% of paired samples within 0.5 INR units of each other. 26 Thus, agreement between ProTime and laboratory INRs appears comparable with or better than that reported with other machines.…”

Section: Discussionsupporting

confidence: 68%

Outpatient Self‐Management of Warfarin Therapy: A Pilot Study

et al. 1999

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Self-testing and adjusting of warfarin dosages by patients is an evolving strategy for management of oral anticoagulation. We performed this open, prospective, 3-month pilot study to assess the feasibility of conducting a large, randomized trial comparing self-managed with physician-managed anticoagulation. Ten competent patients with planned anticoagulation for at least 3 months were provided education on warfarin therapy and trained to use an individualized warfarin nomogram. International normalized ratios (INRs) were determined weekly for 12 weeks and reported with warfarin dosages to the investigator for the first 8 weeks only. Eight patients elected to use a home monitor (ProTime) to measure INRs. Patients maintained 76.5% (range 50-91.7%) of INRs within the target range. In 119 dosage adjustment decisions, there were only 3 errors (2.5%). No bleeding or thrombotic complications occurred. To confirm concordance, initial and final INRs were measured concurrently by the ProTime monitor and laboratory. The mean absolute difference for 16 paired INR determinations was 0.33 (range 0.02-0.9). All patients expressed satisfaction and a desire to continue with self-management. This pilot study provides support for conducting a prospective, large-scale, randomized trial.

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Section: Discussionsupporting

confidence: 68%

Outpatient Self‐Management of Warfarin Therapy: A Pilot Study

et al. 1999

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“…This r valuewas actually superiorto r values reported in other portable monitor studies. 33,34,[37][38][39] Forall samples, 71.3% ofthe monitor INR measurements were within 0.1 INR unit ofthe laboratory reference; 83.2% were within 0.2INR unitofthelaboratory reference; 86.1qtij were within 0.3INR unit ofthe laboratory reference; 90.1 % were within 0.5INR unit of the laboratory reference; and 970/0 were within 1.0INR unit ofthe laboratory reference (Table I). These values were consistent with and in some casessuperior tovalues reported in otherstudies.…”

Section: Discussionmentioning

confidence: 99%

Comparison of a Portable Capillary Whole Blood Coagulation Monitor and Standard Laboratory Methods for Determining International Normalized Ratio

Koerner

Fuller

1998

Military Medicine

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The international normalized ratio (INR) is the current standard for monitoring anticoagulation therapy. Although simple to determine, it normally requires venipuncture and extensive laboratory resources for specimen handling and analysis. The portable capillary whole blood coagulation monitor is an alternative to laboratory venipuncture. Its promoted advantages are: it obtains a blood sample by finger-stick versus venipuncture; rapid turnaround time for results; resultant dosage adjustments (as appropriate) performed in minutes versus hours or days after testing; relative ease of use by nonlaboratory personnel; and potential for home monitoring. This project compared the results of INRs obtained through the venipuncturellaboratory process to INRsobtained by the portable monitoring process at the National Naval Medical Center. A correlation coefficient of 0.97 was determined. The difference in the mean INR results of the two testing methods was not clinically significant (p = 0.269). The portable monitor was determined to be a viable alternative to laboratory testing.

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“…Laboratory control of oral anticoagulant treatment without adequate reference to sensitivity of the laboratory technique and reagent may have an adverse effect on clinical management, 6 '" and the INR system has undoubtedly contributed to improvement in this respect.4 Use of conventional thromboplastins for determination of INR within laboratories has been supplemented by the availability of portable near-patient testing instruments.58 10 In the present study we evaluated one such analyser in respect of INR determinations of both citrated plasma and citrated venous whole blood and compared results to those obtained with conventional reagents and techniques.…”

Section: Discussionmentioning

confidence: 99%

Monitoring oral anticoagulant treatment with the TAS near-patient test system: comparison with conventional thromboplastins.

Kitchen

Preston²

1997

J Clin Pathol

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Background-A number of instruments have been developed for determination of prothrombin time (PT) and International Normalised Ratio (INR) at locations not limited to central laboratories. Aim-To evaluate one such portable instrument, the Thrombolytic Assessment System (TAS), which can be used in a near-patient setting. Methods-Samples from 20 normal subjects and 48 patients treated with warfarin for venous thromboembolic disease were studied. The warfarin group was divided into: initiation phase (n = 10), combined warfarin and heparin (n = 10), stabilised therapy (n = 20), and over anticoagulated patients (n = 8). PTs and INRs were determined in each group using three conventional thromboplastins (Diagen Activated, Manchester Reagent, and Instrumentation Laboratory) and two TAS techniques (whole blood or plasma). An independent International Sensitivity Index (ISI) calibration of the TAS system was performed. Results (7 Clin Pathol 1997;50:951-956)

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Performance of the Coumatrak System in a Large Anticoagulation Clinic

Cited by 11 publications

References 0 publications

Outpatient Self‐Management of Warfarin Therapy: A Pilot Study

Outpatient Self‐Management of Warfarin Therapy: A Pilot Study

Comparison of a Portable Capillary Whole Blood Coagulation Monitor and Standard Laboratory Methods for Determining International Normalized Ratio

Monitoring oral anticoagulant treatment with the TAS near-patient test system: comparison with conventional thromboplastins.

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