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Auto-validation of Routine Coagulation/Hemostasis Assays with Reflex Testing of Abnormal Test Results. | LitMetric

Auto-validation of Routine Coagulation/Hemostasis Assays with Reflex Testing of Abnormal Test Results.

Methods Mol Biol

Department of Haematology, Institute of Clinical Pathology and Medical Research (ICPMR), NSW Health Pathology, Westmead Hospital, Westmead, NSW, Australia.

Published: May 2023

AI Article Synopsis

  • Hemostasis laboratories are essential for diagnosing and treating bleeding or clotting disorders, using routine tests like prothrombin time (PT/INR) and activated partial thromboplastin time (APTT) for screening and monitoring treatment.
  • There’s a push for laboratories to enhance service quality by speeding up response times and minimizing errors, leading to the development of automated processes for testing and validating coagulation results within a large network of 27 laboratories.
  • The implementation of these automated rules, which standardize processes and allow quick referrals to specialists, has resulted in improved turnaround times and reduced operating costs, benefiting most labs in the network.

Article Abstract

Hemostasis laboratories play a crucial role in the diagnosis and treatment of individuals with bleeding or thrombotic disorders. Routine coagulation assays, including the prothrombin time (PT)/international normalized ratio (INR), and activated partial thromboplastin time (APTT), are used for various purposes. These include as a screen of hemostasis function/dysfunction (e.g., possible factor deficiency) and for monitoring of anticoagulant therapy, such as vitamin K antagonists (PT/INR) and unfractionated heparin (APTT). Clinical laboratories are also under increasing pressure to improve services, especially response (test turnaround) times. There is also a need for laboratories to try to reduce error rates and for laboratory networks to standardize/harmonize processes and policies. Accordingly, we describe our experience with the development and implementation of automated processes for reflex testing and validation of routine coagulation test results. This has been implemented in a large pathology network compromising 27 laboratories and is under consideration for expansion to our larger network (of 60 laboratories). These rules have been custom-built within our laboratory information system (LIS), perform reflex testing of abnormal results, and fully automate the process of routine test validation for appropriate results. These rules also permit adherence to standardized pre-analytical (sample integrity) checks, automate reflex decisions, automate verification, and provide an overall alignment of network practices in a large network of 27 laboratories. In addition, the rules enable clinically significant results to be quickly referred to hematopathologists for review. We also documented an improvement in test turnaround times, with savings in operator time and thus operating costs. Finally, the process was generally well received and determined to be beneficial for most laboratories in our network, in part identified by improved test turnaround times.

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Source
http://dx.doi.org/10.1007/978-1-0716-3175-1_6DOI Listing

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