The reliability of point-of-care prothrombin time testing. A comparison of CoaguChek S and XS INR measurements with hospital laboratory monitoring.

Hdl Handle:
http://hdl.handle.net/10147/200336
Title:
The reliability of point-of-care prothrombin time testing. A comparison of CoaguChek S and XS INR measurements with hospital laboratory monitoring.
Authors:
Ryan, F; O'Shea, S; Byrne, S
Affiliation:
Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland.
Citation:
The reliability of point-of-care prothrombin time testing. A comparison of CoaguChek S and XS INR measurements with hospital laboratory monitoring. 2010, 32 (1 Pt 1):e26-33 Int J Lab Hematol
Journal:
International journal of laboratory hematology
Issue Date:
Feb-2010
URI:
http://hdl.handle.net/10147/200336
DOI:
10.1111/j.1751-553X.2008.01120.x
PubMed ID:
19032373
Abstract:
The development of point-of-care (POC) testing devices enables patients to test their own international normalized ratio (INR) at home. However, previous studies have shown that when compared with clinical laboratory values, statistically significant differences may occur between the two methods of INR measurement. The aim of this study was to evaluate the accuracy of the CoaguChek S and XS POC meters relative to clinical laboratory measurements. As part of a randomized, crossover patient self-testing (PST) study at Cork University Hospital, patients were randomized to 6 months PST or 6 months routine care by the anticoagulation management service. During the PST arm of the study, patients measured their INR at home using the CoaguChek S or XS POC meter. External quality control was performed at enrollment, 2 months and 4 months by comparing the POC measured INR with the laboratory determined value. One hundred and fifty-one patients provided 673 paired samples. Good correlation was shown between the two methods of determination (r = 0.91), however, statistically significant differences did occur. A Bland-Altman plot illustrated good agreement of INR values between 2.0 and 3.5 INR units but there was increasing disagreement as the INR rose above 3.5. Eighty-seven per cent of all dual measurements were within the recommended 0.5 INR units of each other. This study adds to the growing evidence that POC testing is a reliable and safe alternative to hospital laboratory monitoring but highlights the importance of external quality control when these devices are used for monitoring oral anticoagulation.
Item Type:
Article
Language:
en
Description:
The development of point-of-care (POC) testing devices enables patients to test their own international normalized ratio (INR) at home. However, previous studies have shown that when compared with clinical laboratory values, statistically significant differences may occur between the two methods of INR measurement. The aim of this study was to evaluate the accuracy of the CoaguChek S and XS POC meters relative to clinical laboratory measurements. As part of a randomized, crossover patient self-testing (PST) study at Cork University Hospital, patients were randomized to 6 months PST or 6 months routine care by the anticoagulation management service. During the PST arm of the study, patients measured their INR at home using the CoaguChek S or XS POC meter. External quality control was performed at enrollment, 2 months and 4 months by comparing the POC measured INR with the laboratory determined value. One hundred and fifty-one patients provided 673 paired samples. Good correlation was shown between the two methods of determination (r = 0.91), however, statistically significant differences did occur. A Bland-Altman plot illustrated good agreement of INR values between 2.0 and 3.5 INR units but there was increasing disagreement as the INR rose above 3.5. Eighty-seven per cent of all dual measurements were within the recommended 0.5 INR units of each other. This study adds to the growing evidence that POC testing is a reliable and safe alternative to hospital laboratory monitoring but highlights the importance of external quality control when these devices are used for monitoring oral anticoagulation.
MeSH:
Adult; Aged; Aged, 80 and over; Cross-Over Studies; Female; Home Care Services; Humans; International Normalized Ratio; Laboratories, Hospital; Male; Middle Aged; Point-of-Care Systems; Prothrombin Time; Quality Control; Reproducibility of Results; Self Care
ISSN:
1751-553X

Full metadata record

DC FieldValue Language
dc.contributor.authorRyan, Fen
dc.contributor.authorO'Shea, Sen
dc.contributor.authorByrne, Sen
dc.date.accessioned2012-01-05T15:37:49Z-
dc.date.available2012-01-05T15:37:49Z-
dc.date.issued2010-02-
dc.identifier.citationThe reliability of point-of-care prothrombin time testing. A comparison of CoaguChek S and XS INR measurements with hospital laboratory monitoring. 2010, 32 (1 Pt 1):e26-33 Int J Lab Hematolen
dc.identifier.issn1751-553X-
dc.identifier.pmid19032373-
dc.identifier.doi10.1111/j.1751-553X.2008.01120.x-
dc.identifier.urihttp://hdl.handle.net/10147/200336-
dc.descriptionThe development of point-of-care (POC) testing devices enables patients to test their own international normalized ratio (INR) at home. However, previous studies have shown that when compared with clinical laboratory values, statistically significant differences may occur between the two methods of INR measurement. The aim of this study was to evaluate the accuracy of the CoaguChek S and XS POC meters relative to clinical laboratory measurements. As part of a randomized, crossover patient self-testing (PST) study at Cork University Hospital, patients were randomized to 6 months PST or 6 months routine care by the anticoagulation management service. During the PST arm of the study, patients measured their INR at home using the CoaguChek S or XS POC meter. External quality control was performed at enrollment, 2 months and 4 months by comparing the POC measured INR with the laboratory determined value. One hundred and fifty-one patients provided 673 paired samples. Good correlation was shown between the two methods of determination (r = 0.91), however, statistically significant differences did occur. A Bland-Altman plot illustrated good agreement of INR values between 2.0 and 3.5 INR units but there was increasing disagreement as the INR rose above 3.5. Eighty-seven per cent of all dual measurements were within the recommended 0.5 INR units of each other. This study adds to the growing evidence that POC testing is a reliable and safe alternative to hospital laboratory monitoring but highlights the importance of external quality control when these devices are used for monitoring oral anticoagulation.en
dc.description.abstractThe development of point-of-care (POC) testing devices enables patients to test their own international normalized ratio (INR) at home. However, previous studies have shown that when compared with clinical laboratory values, statistically significant differences may occur between the two methods of INR measurement. The aim of this study was to evaluate the accuracy of the CoaguChek S and XS POC meters relative to clinical laboratory measurements. As part of a randomized, crossover patient self-testing (PST) study at Cork University Hospital, patients were randomized to 6 months PST or 6 months routine care by the anticoagulation management service. During the PST arm of the study, patients measured their INR at home using the CoaguChek S or XS POC meter. External quality control was performed at enrollment, 2 months and 4 months by comparing the POC measured INR with the laboratory determined value. One hundred and fifty-one patients provided 673 paired samples. Good correlation was shown between the two methods of determination (r = 0.91), however, statistically significant differences did occur. A Bland-Altman plot illustrated good agreement of INR values between 2.0 and 3.5 INR units but there was increasing disagreement as the INR rose above 3.5. Eighty-seven per cent of all dual measurements were within the recommended 0.5 INR units of each other. This study adds to the growing evidence that POC testing is a reliable and safe alternative to hospital laboratory monitoring but highlights the importance of external quality control when these devices are used for monitoring oral anticoagulation.-
dc.language.isoenen
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshCross-Over Studies-
dc.subject.meshFemale-
dc.subject.meshHome Care Services-
dc.subject.meshHumans-
dc.subject.meshInternational Normalized Ratio-
dc.subject.meshLaboratories, Hospital-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshPoint-of-Care Systems-
dc.subject.meshProthrombin Time-
dc.subject.meshQuality Control-
dc.subject.meshReproducibility of Results-
dc.subject.meshSelf Care-
dc.titleThe reliability of point-of-care prothrombin time testing. A comparison of CoaguChek S and XS INR measurements with hospital laboratory monitoring.en
dc.typeArticleen
dc.contributor.departmentPharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland.en
dc.identifier.journalInternational journal of laboratory hematologyen
dc.description.provinceMunster-

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