An international study of how laboratories handle and evaluate patient samples after detecting an unexpected APTT prolongation

On behalf of the joint Working Group on Postanalytical Phase (WG-POST) of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and European Organisation for External Quality Assurance Providers in Laboratory Medicine (EQALM)

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: An unexpectedly detected prolonged activated partial thromboplastin time (APTT) can be a harmless laboratory finding, but can also reflect a thrombotic tendency or a bleeding disorder. The assistance of laboratory professionals in the interpretation of an unexpectedly detected prolonged APTT (uAPTT) is often required. The way in which uAPTTs are evaluated in laboratories was assessed in this international study with the aim of determining whether laboratory professionals are able to fulfill this need. Methods: Postanalytical practices after uAPTT were investigated and the mixing study methodology (if used) was studied by circulating a case report with a questionnaire to staff in the invited laboratories. In addition, the interpretations of those staff regarding the presence or absence of inhibitors in three APTT mixing study scenarios were examined. Results: Large within- and between-country variations were detected in both postanalytical practices and mixing study methodologies among the 990 responding laboratories, 90% of which were in 13 countries. Shortcomings regarding the investigation of uAPTTs leading to potentially incorrect or delayed clinical diagnoses were found in 88% of the laboratories. Of the laboratories to which the interpretative questions were sent, 49% interpreted all mixing study scenarios correctly. uAPTTs were investigated appropriately and all mixing study scenarios interpreted correctly in parallel in only 9.6% of the participating laboratories. Conclusions: The clinical requirement for the assistance of laboratory professionals in the interpretation of uAPTTs cannot be met at most of the participating laboratories. Laboratory professionals should be trained in the evaluation of ordinary laboratory tests, such as that for uAPTTs.

Original languageEnglish
Pages (from-to)1593-1603
Number of pages11
JournalClinical Chemistry and Laboratory Medicine
Volume53
Issue number10
DOIs
Publication statusPublished - Sep 1 2015

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Partial Thromboplastin Time
Thromboplastin
Delayed Diagnosis

Keywords

  • activated partial thromboplastin time (APTT)
  • clinical interpretation
  • mixing studies
  • postanalytical phase

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

On behalf of the joint Working Group on Postanalytical Phase (WG-POST) of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and European Organisation for External Quality Assurance Providers in Laboratory Medicine (EQALM) (2015). An international study of how laboratories handle and evaluate patient samples after detecting an unexpected APTT prolongation. Clinical Chemistry and Laboratory Medicine, 53(10), 1593-1603. https://doi.org/10.1515/cclm-2014-1183

An international study of how laboratories handle and evaluate patient samples after detecting an unexpected APTT prolongation. / On behalf of the joint Working Group on Postanalytical Phase (WG-POST) of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and European Organisation for External Quality Assurance Providers in Laboratory Medicine (EQALM).

In: Clinical Chemistry and Laboratory Medicine, Vol. 53, No. 10, 01.09.2015, p. 1593-1603.

Research output: Contribution to journalArticle

On behalf of the joint Working Group on Postanalytical Phase (WG-POST) of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and European Organisation for External Quality Assurance Providers in Laboratory Medicine (EQALM) 2015, 'An international study of how laboratories handle and evaluate patient samples after detecting an unexpected APTT prolongation', Clinical Chemistry and Laboratory Medicine, vol. 53, no. 10, pp. 1593-1603. https://doi.org/10.1515/cclm-2014-1183
On behalf of the joint Working Group on Postanalytical Phase (WG-POST) of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and European Organisation for External Quality Assurance Providers in Laboratory Medicine (EQALM). An international study of how laboratories handle and evaluate patient samples after detecting an unexpected APTT prolongation. Clinical Chemistry and Laboratory Medicine. 2015 Sep 1;53(10):1593-1603. https://doi.org/10.1515/cclm-2014-1183
On behalf of the joint Working Group on Postanalytical Phase (WG-POST) of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and European Organisation for External Quality Assurance Providers in Laboratory Medicine (EQALM). / An international study of how laboratories handle and evaluate patient samples after detecting an unexpected APTT prolongation. In: Clinical Chemistry and Laboratory Medicine. 2015 ; Vol. 53, No. 10. pp. 1593-1603.
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abstract = "Background: An unexpectedly detected prolonged activated partial thromboplastin time (APTT) can be a harmless laboratory finding, but can also reflect a thrombotic tendency or a bleeding disorder. The assistance of laboratory professionals in the interpretation of an unexpectedly detected prolonged APTT (uAPTT) is often required. The way in which uAPTTs are evaluated in laboratories was assessed in this international study with the aim of determining whether laboratory professionals are able to fulfill this need. Methods: Postanalytical practices after uAPTT were investigated and the mixing study methodology (if used) was studied by circulating a case report with a questionnaire to staff in the invited laboratories. In addition, the interpretations of those staff regarding the presence or absence of inhibitors in three APTT mixing study scenarios were examined. Results: Large within- and between-country variations were detected in both postanalytical practices and mixing study methodologies among the 990 responding laboratories, 90{\%} of which were in 13 countries. Shortcomings regarding the investigation of uAPTTs leading to potentially incorrect or delayed clinical diagnoses were found in 88{\%} of the laboratories. Of the laboratories to which the interpretative questions were sent, 49{\%} interpreted all mixing study scenarios correctly. uAPTTs were investigated appropriately and all mixing study scenarios interpreted correctly in parallel in only 9.6{\%} of the participating laboratories. Conclusions: The clinical requirement for the assistance of laboratory professionals in the interpretation of uAPTTs cannot be met at most of the participating laboratories. Laboratory professionals should be trained in the evaluation of ordinary laboratory tests, such as that for uAPTTs.",
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AU - Meijer, Piet

AU - Kristoffersen, Ann Helen

AU - Carraro, Paolo

AU - Sozmen, Eser

AU - Faria, Ana Paula

AU - Sandberg, Sverre

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AB - Background: An unexpectedly detected prolonged activated partial thromboplastin time (APTT) can be a harmless laboratory finding, but can also reflect a thrombotic tendency or a bleeding disorder. The assistance of laboratory professionals in the interpretation of an unexpectedly detected prolonged APTT (uAPTT) is often required. The way in which uAPTTs are evaluated in laboratories was assessed in this international study with the aim of determining whether laboratory professionals are able to fulfill this need. Methods: Postanalytical practices after uAPTT were investigated and the mixing study methodology (if used) was studied by circulating a case report with a questionnaire to staff in the invited laboratories. In addition, the interpretations of those staff regarding the presence or absence of inhibitors in three APTT mixing study scenarios were examined. Results: Large within- and between-country variations were detected in both postanalytical practices and mixing study methodologies among the 990 responding laboratories, 90% of which were in 13 countries. Shortcomings regarding the investigation of uAPTTs leading to potentially incorrect or delayed clinical diagnoses were found in 88% of the laboratories. Of the laboratories to which the interpretative questions were sent, 49% interpreted all mixing study scenarios correctly. uAPTTs were investigated appropriately and all mixing study scenarios interpreted correctly in parallel in only 9.6% of the participating laboratories. Conclusions: The clinical requirement for the assistance of laboratory professionals in the interpretation of uAPTTs cannot be met at most of the participating laboratories. Laboratory professionals should be trained in the evaluation of ordinary laboratory tests, such as that for uAPTTs.

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