Clinical Chemistry
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Clinical Chemistry 47: 801-802, 2001;
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Web of Science (2)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Laposata, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Laposata, M.
Related Collections
Right arrow General Clinical Chemistry
Right arrow Evidence Based Laboratory Medicine and Test Utilization
Right arrow Hemostasis and Thrombosis
Right arrow Drug Monitoring and Toxicology
Right arrow Hematology
(Clinical Chemistry. 2001;47:801-802.)
© 2001 American Association for Clinical Chemistry, Inc.

Editorial

Point-of-Care Coagulation Testing: Stepping Gently Forward

Michael Laposataa1

1 Division of Laboratory Medicine, Department of Pathology, Massachusetts General Hospital/Harvard Medical School, Boston, MA 02114

aAddress for correspondence: Gray Bldg, Rm 235, Massachusetts General Hospital, Boston, MA 02114. Fax 617-726-3256; e-mail Mlaposata@Partners.org.

As a specialist in diagnostic coagulation, I am frequently faced with a patient who does not want to drive into Boston to be monitored for warfarin (coumadin) therapy at our anticoagulation clinic. This fact has not been lost on instrument manufacturers, who have produced multiple point-of-care devices for home monitoring of the prothrombin time/international normalized ratio (PT/INR). The number of individuals taking coumadin for atrial fibrillation, recurrent venous or arterial thrombosis, and other conditions is tremendous. The total number of prescriptions for warfarin in 1999 exceeded 20 million. The report by Ambrose et al. (1) in this issue of Clinical Chemistry investigates the performance of a point-of-care testing (POCT) analyzer for activated clotting time (ACT) measurement in a population of children undergoing extracorporeal membrane oxygenation. The performance of the POCT analyzer was equivalent to that of other commercially available POCT instruments for ACT measurement, but the results showed no relationship to the gold standard test of plasma heparin concentration. This study highlights several issues relevant to point-of-care coagulation assays. One of the most important is whether the tests are performed at a clinical site or at home.

A recent survey of coagulation analyzers identified 17 devices (2). Of these, 15 had been cleared for use by the Food and Drug Administration as of October 1, 2000. Of these, 12 can be used to perform a PT/INR, 11 can perform an ACT or related test to manage heparin therapy, and 8 are available for partial thromboplastin time (PTT) measurements. Four of the instruments have had a patient self-testing program for home monitoring of PT/INR to optimize coumadin therapy.

POCT for coagulation at a clinical site by certified health professionals has some unique aspects, as noted below, but the major practice change for point-of-care coagulation studies is home . . . [Full Text of this Article]


References






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2001 by the American Association for Clinical Chemistry.