183 - Variability of coagulation testing between two separate laboratories: implications for diagnosis and therapeutic monitoring
Rivista: RIMeL - IJLaM, Vol. 1, N. 3, 2005 (MAF Servizi srl ed.)
G. Lippi, D. Giavarina, M.R. Carta, G. Poli, M. Montagnana, G.L. Salvagno, G. Soffiati, G.C. Guidi
Despite introduction of some measures to achieve a more
effective standardization in routine coagulation testing, there
are evidences that harmonization among different clinical
laboratories has not been fully achieved as yet. To evaluate
whether differences in instruments and reagents between
two separate laboratories might influence the clinical management
of patients with hemostatic disturbances, we
analyzed prothrombin time (PT), activated partial thromboplastin
time (APTT), fibrinogen and d-dimer in 84 consecutive
outpatients on oral or heparin anticoagulant therapy.
Despite statistically significant differences could be
observed for all the parameters tested, Passing & Bablok
analysis yielded acceptable results. The extent of measurement
deviation always exceeded the current analytical quality
specifications for desirable bias, when available. The
percentage of patients in the therapeutic range or outside
the respective reference range was significantly different
between laboratories for APTT and fibrinogen, but not
for PT and d-dimer. In conclusion, results of our investigation
testify that some further efforts are needed to achieve
harmonization of routine coagulation testing among laboratories.