Therapeutic concordance of two portable monitors and two routine automatic oral anticoagulant monitoring systems using as reference the manual prothrombin time technique

Vacas, Marta; Lafuente, P.J.; Unanue, Iciar; Santos, Mônica de Oliveira; Iriarte, J.A.

doi:10.1038/sj.thj.6200249

Cited by 4 publications

(2 citation statements)

References 14 publications

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“…Such monitors need to be accurate over the full therapeutic range of the INR, between 2·0–4·5, and require an acceptable independent evaluation (Fitzmaurice & Machin, 2001). A number of studies have proved comparability between POC testing and conventional laboratory techniques based on POC testing by healthcare professionals (Bachour et al , 2001; Vacas et al , 2001; Havrda et al , 2002; Shiach et al , 2002; Loebstein et al , 2003; Jackson et al , 2004), whereas others have questioned the reliability of POC test INR results (Poller et al , 2003; Vacas et al , 2003). Of note, INR results obtained by technically skilled healthcare professionals using POC testing devices have been reported to be more reliable than those achieved by non‐technical trained individuals (Delaney et al , 1999).…”

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confidence: 99%

Patient self‐testing is a reliable and acceptable alternative to laboratory INR monitoring

et al. 2004

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SummaryAn ageing population and the continuing expansion of clinical indications for coumadin therapy have increased pressure on hospital anticoagulant clinics. One solution is patient self-testing (PST) of the international normalized ratio (INR) using capillary blood samples on point-of-care coagulation monitors at home. We conducted a prospective study to determine whether patients can achieve accurate INR values through PST, using the CoaguChek S (Roche Diagnostics, Lewes, UK). The main outcome measurements were: comparability of INR values obtained by PST and the hospital laboratory, patient acceptability as assessed by a questionnaire and anticoagulant control. Eighty-four patients [53 men, 31 women; median age 59 years (range 26-83)], receiving long-term oral anticoagulation (warfarin), were recruited from our Anticoagulation Clinic. Patients were randomized to weekly self-testing or continuing 4-weekly hospital laboratory monitoring of INR. Comparison of INRs (n ¼ 234) showed no significant differences between the CoaguChek (median INR 3AE02) and laboratory testing (median INR 3AE07). There was excellent correlation between the two methods (r ¼ 0AE95), with 85% of CoaguChek results within 0AE5 INR units of the laboratory method. On four occasions, differences of >1 unit INR were obtained, but in each case the patient's anticoagulation was unstable (INR >4AE5 by both methods) and the differences in INR would not have altered patient management. 87% of patients found self-testing straightforward, 87% were confident in the result they obtained and 77% preferred self-testing. We conclude that PST is a reliable alternative to hospital clinic attendance and is acceptable to the majority of suitably trained patients.

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Patient self‐testing is a reliable and acceptable alternative to laboratory INR monitoring

et al. 2004

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“…Several studies indicated an excellent correlation between photo‐optical and electromechanical coagulation analysers, while the comparison between POC and laboratory or manual INRs showed a certain variability in the results, with potential clinical disagreement and differences in VKA dosing . However, it is not known which test actually correlates better with the overall blood coagulation potential, because these three INR methods have never been compared simultaneously with global coagulation assays.…”

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A comparative study using thrombin generation and three different INR methods in patients on Vitamin K antagonist treatment

Riva

Vella

Meli

et al. 2017

Int J Lab Hematology

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Summary Introduction Vitamin K antagonist (VKA) treatment requires routine monitoring using the international normalized ratio (INR). However, different INR assays may vary in their results. The aim of this study was to assess the agreement of three different INR methods, compared with thrombin generation, in patients on VKA treatment. Methods Sixty patients attending the Anticoagulation Clinic at Mater Dei Hospital (Msida, Malta) for VKA monitoring between August and September 2015 were enrolled. The INR was tested using a point‐of‐care (POC) device (CoaguChek XS Plus, Roche Diagnostics) for both capillary and venous blood samples, a photo‐optical (Sysmex CS‐2100i/CA‐1500, Siemens) and a mechanical clot detection system (Thrombolyzer XRC, Behnk Elektronik). All assays used human recombinant thromboplastin as reagent. Thrombin generation was performed using the calibrated automated thrombogram. Results There was a negative curvilinear correlation between the endogenous thrombin potential and different INR assays (r≤−.75) and a strong positive linear correlation between the CoaguChek XS Plus on capillary samples and the other INR methodologies (r≥.96). Conclusion All different INR assays showed good correlation with the thrombin generation potential. The POC INR showed one of the highest correlation coefficients with thrombin generation, confirming the POC devices as an accurate, valid alternative to laboratory INR in VKA patients.

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Self Management of Oral Anticoagulation with the INRatio System: Accuracy and Reliability Following a Two-Day Structured Training Program

Taborski¹,

Völler²,

Körtke³

et al. 2004

Laboratory Medicine

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Therapeutic concordance of two portable monitors and two routine automatic oral anticoagulant monitoring systems using as reference the manual prothrombin time technique

Cited by 4 publications

References 14 publications

Patient self‐testing is a reliable and acceptable alternative to laboratory INR monitoring

Patient self‐testing is a reliable and acceptable alternative to laboratory INR monitoring

A comparative study using thrombin generation and three different INR methods in patients on Vitamin K antagonist treatment

Self Management of Oral Anticoagulation with the INRatio System: Accuracy and Reliability Following a Two-Day Structured Training Program

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