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Publication Date:
26 09 2011
ISSN:
1437-4331
DOI:
10.1515/cclm.2011.719

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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the International Federation of Clinical Chemistry and Laboratory Medicine and the European Federation of Clinical Chemistry and Laboratory Medicine

Editor-in-Chief: Plebani, Mario

null Lippi, Giuseppe / Gillery, Philippe / Kazmierczak, Steven / Lackner, Karl J. / Melichar, Bohuslav / Siest, Gérard / Whitfield, John B. / Abi Fadel, Marianne / Alvarez Menendez, Francisco V. / Azzazy, Hassan M.E. / Diamandis, Eleftherios P. / Eckardstein, Arnold / Favaloro, Emmanuel J. / Griesmacher, Andrea / Herrmann, Wolfgang / Hoffmann, Johannes J.M.L. / Hooijkaas, Herbert / Ichihara, Kiyoshi / Kaabachi, Naziha / Kim, Jeong-Ho / Korte, Wolfgang / Kroupis, Christos / Lai, Leslie Charles / Lam, Wai Kei Christopher / Marc, Janja / Miyoshi, Eiji / Özben, Tomris / Palicka, Vladimir / Panteghini, Mauro / Queralto, Jose M. / Scartezini, Marileia / Simundic, Ana-Maria / Tsongalis, Gregory J. / Wallemacq, Pierre E. / Yan, Shengkai / Young, Ian S. / Chiu, Rossa Wai Kwun / Ghosh, Debabrata / Kappelmayer, Janos / Lehmann, Sylvain / Sypniewska, Grazyna

12 Issues per year

Increased IMPACT FACTOR 2010: 2.069
Rank 9 out of 30 in category Medical Laboratory Technology in the 2010 Thomson Reuters Journal Citation Report/Science Edition

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Issues

External quality assessment of point-of-care International Normalized Ratio (INR) testing in Europe

1,4 / Meijer, Piet 2 / Kitchen, Dianne 3 / Sandberg, Sverre 4,5

1Norwegian Quality Improvement of Primary Care Laboratories (NOKLUS), Haraldsplass Diaconal Hospital, Bergen, Norway

2External quality Control of diagnostic Assays and Tests (ECAT Foundation), Leiden, The Netherlands

3United Kingdom National External Quality Assessment Scheme (UKNEQAS) for Blood Coagulation, Sheffield, UK

4NOKLUS, Department of Public Health and Primary Health Care, University of Bergen, Norway

5Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway

Corresponding author: Anne Stavelin, NOKLUS, Box 6165, N-5892 Bergen, Norway Phone: +47 55 97 95 00, Fax: +47 55 97 95 10

Citation Information: Clinical Chemistry and Laboratory Medicine. Volume 50, Issue 1, Pages 81–88, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/cclm.2011.719, September 2011

Publication History:

Received: 04/06/2011;
Accepted: 02/09/2011;
Published Online: 22/03/2012

Abstract

Background: Point-of-care testing (POCT) of prothrombin time, expressed as International Normalized Ratio (INR), is widely used to monitor patients in oral anticoagulation treatment. Guidelines recommend that POCT users should participate in an external quality assessment (EQA) scheme whenever available. The aim of this study was to investigate which European countries provide EQA for POCT INR and to compare how these schemes are organized.

Methods: Thirty European countries were invited to participate in this study. Those who reported that they provide EQA for POCT INR filled in a questionnaire dealing with different aspects of their schemes.

Results: Nineteen countries reported that they do not provide EQA for POCT INR, while 12 organizations from nine countries reported that they provide this service. Most of these countries circulate lyophilized samples with for the participants unknown target values. Samples with certified INR values and procedures using split samples with fresh patient samples are also used. The acceptability limits vary from 15% to 30%, and the total number of samples circulated per year varies from 1 to 12. Most of the countries organize educational activities together with their schemes.

Conclusions: This study demonstrates that there is a wide variation in the way EQA for POCT INR is performed in Europe and that there are many European countries that do not provide this service. Even though our findings indicate that EQA for POCT INR draws some challenges, especially in providing suitable control materials, participation in such schemes is considered useful.

Keywords: anticoagulation treatment; external quality assessment; international normalized ratio; point-of-care testing

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