Comparison of Thrombelastography with Common Coagulation Tests

1981 ◽  
Vol 46 (04) ◽  
pp. 752-756 ◽  
Author(s):  
L Zuckerman ◽  
E Cohen ◽  
J P Vagher ◽  
E Woodward ◽  
J A Caprini
Keyword(s):  
Laboratory Tests ◽  
Clinical Utility ◽  
Blood Clotting ◽  
Strong Relationship ◽  
Relative Strength ◽  
Additional Information ◽  
Patients With Cancer ◽  
Two Samples ◽  
Coagulation Tests ◽  
Common Laboratory

SummaryThrombelastography, although proven as a useful research tool has not been evaluated for its clinical utility against common coagulation laboratory tests. In this study we compare the thrombelastographic measurements with six common tests (the hematocrit, platelet count, fibrinogen, prothrombin time, activated thromboplastin time and fibrin split products). For such comparisons, two samples of subjects were selected, 141 normal volunteers and 121 patients with cancer. The data was subjected to various statistical techniques such as correlation, ANOVA, canonical and discriminant analysis to measure the extent of the correlations between the two sets of variables and their relative strength to detect blood clotting abnormalities. The results indicate that, although there is a strong relationship between the thrombelastographic variables and these common laboratory tests, the thrombelastographic variables contain additional information on the hemostatic process.

scholarly journals New insights into the blood clotting

2018 ◽  
Vol 5 (3) ◽  
pp. 13-22
Author(s):  
F. I. Ataullakhanov ◽  
A. G. Rumyantsev
Keyword(s):  
Critical Review ◽  
Laboratory Tests ◽  
Blood Clotting ◽  
Coagulation Testing ◽  
Coagulation Tests ◽  
The Status ◽  
Standard Set ◽  
Modern Standard ◽  
Testing Set

In recent years, an active revision of ideas about the mechanisms of blood clotting has been performed. Traditional views were largely inaccurate, which is the main reason for the inconsistency of the modern standard set of coagulation tests. This set was found to be insensitive, especially to hypercoagulable disorders. In this paper, we consider modern concepts of how blood clotting occurs. From this consideration follows the need for a critical review of existing methods for assessing the status of hemostasis and a standard set of laboratory tests. The lecture ends with a brief examination of which methods are the most informative today and could form the basis of a new informative coagulation testing set.

Evaluation and cost estimation of laboratory tests overuse through a CCDSS in a university hospital

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Vallone ◽  
A Tamburrano ◽  
C Carrozza ◽  
A Urbani ◽  
A Cambieri ◽  
...  
Keyword(s):  
Cost Estimation ◽  
Laboratory Tests ◽  
Quality Care ◽  
Clinical Decision Support Systems ◽  
Patient Characteristics ◽  
Clinical Decision ◽  
University Hospital ◽  
Specific Patient ◽  
Global Rate ◽  
Common Laboratory

Abstract Computerized Clinical Decision Support Systems (CCDSS) are information technology-based systems that use specific patient characteristics and combine them with rule-based algorithms. The aim of this study is to conduct a survey to measure and assess the over-utilization rates of laboratory requests and to estimate the monthly cost of inappropriate requests in inpatients of the “Fondazione Policlinico Universitario A. Gemelli IRCCS” Care Units. This observational study is based on the count of rules violations for 43 different types of laboratory tests requested by the Hospital physicians, for a total of 5,716,370 requests, over a continuous period of 20 months (from 1 July 2016 to 28 February 2018). Requests from all the hospital internal departments (except for Emergency, Intensive Care Units and Urgent requests) were monitored. The software intercepted and counted, in silent mode for the operator, all requests and violations for each laboratory test among those identified. During the observation period a mean of 285,819 requests per month were analyzed and 40,462 violations were counted. The global rate of overuse was 15.2% ± 3.0%. The overall difference among sub-groups was significant (p < 0.001). The most inappropriate exams were Alpha Fetoprotein (85.8% ± 30.5%), Chlamydia trachomatis PCR (48.7% ± 8.8%) and Alkaline Phosphatase (20.3% ± 6.5%). All the exams, globally considered, generated an estimated avoidable cost of 1,719,337€ (85,967€ per month) for the hospital. This study reports rates (15.2%) similar to other works. The real impact of inappropriateness is difficult to assess, but the generated costs for patients, hospitals and health systems are certainly high and not negligible. Key messages It would be desirable for international medical communities to produce a complete panel of prescriptive rules for all the most common laboratory exam. That is useful not only to reduce costs, but also to ensure standardization and high-quality care.

Analysis of sampling frequency in groundwater quality monitoring systems: a case study

1994 ◽  
Vol 30 (10) ◽  
pp. 73-78 ◽  
Author(s):  
Andrea Szucs ◽  
Gyözö Jordan
Keyword(s):  
Time Series ◽  
Groundwater Quality ◽  
Sampling Frequency ◽  
Quality Monitoring ◽  
Monitoring Systems ◽  
Additional Information ◽  
Alarm Systems ◽  
Cross Correlation Analysis ◽  
Two Samples ◽  
Groundwater Quality Monitoring

Sampling frequency is one of the most crucial factors in the design of groundwater quality monitoring systems. Monitoring systems in general have two major objectives: (1) to describe natural processes and long-term changes and (2) to serve as alarm-systems and detect single pollution events. A comparison between two data sequences of different sampling frequency - weekly and monthly - is made through an example of the groundwater quality monitoring system in the karstic region of the Transdanubian Mountains in Hungary. Hydrogeochemical time series were first decomposed into their components: trend, periodicity, autocorrelation, and rough in succession. In order to identify outliers within the rough, Exploratory Data Analysis (EDA) was applied. Optimal sampling frequency was determined based on the analysis of the above components. Results have shown that: (1) seasons shorter than two months do exist in the studied time series which cannot be captured by monthly sampling; (2) for monitoring seasonal processes samples should be collected at the Nyquist frequency (at least two samples per period); for pollution detection autocorrelation lag-time (or semi-variogram range in time) should determine the sampling distance; in the lack of autocorrelation property the analysis of outliers should guide the sampling design; (3) cross-correlation analysis between precipitation and the observed parameters indicative of pollutant travel time yields valuable additional information on the pollution sensitivity of the hydrogeological system.

scholarly journals Derivation of standard distribution ranges for common laboratory tests specific for hemodialysis patients by the latent abnormal value exclusion method

2007 ◽  
Vol 40 (3) ◽  
pp. 261-269
Author(s):  
Sumiko Igarashi ◽  
Kiyoshi Ichihara ◽  
Masatoshi Takiya ◽  
Mitsuru Kurata ◽  
Takayasu Taira ◽  
...  
Keyword(s):  
Laboratory Tests ◽  
Hemodialysis Patients ◽  
Distribution Ranges ◽  
Standard Distribution ◽  
Exclusion Method ◽  
Common Laboratory

Common laboratory tests, values, and interpretations

1985 ◽  
Vol 5 (6) ◽  
pp. 264-269 ◽  
Author(s):  
ALFREDO J. FERNANDEZ ◽  
NORMAN A. FLAXMAN
Keyword(s):  
Laboratory Tests ◽  
Common Laboratory

scholarly journals Bedside Coagulation Tests in Diagnosing Venom-Induced Consumption Coagulopathy in Snakebite

Toxins ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 583 ◽  
Author(s):  
Supun Wedasingha ◽  
Geoffrey Isbister ◽  
Anjana Silva
Keyword(s):  
Low Income ◽  
Whole Blood ◽  
Blood Clotting ◽  
Specific Treatment ◽  
Small Sample ◽  
Consumption Coagulopathy ◽  
Clotting Time ◽  
Wide Range ◽  
Coagulation Tests ◽  
Blood Clotting Time

Venom-induced consumption coagulopathy is the most important systemic effect of snake envenoming. Coagulation tests are helpful to accurately and promptly diagnose venom-induced consumption coagulopathy and administer antivenom, which is the only specific treatment available. However, bedside clotting tests play a major role in diagnosing coagulopathy in low-income settings, where the majority of snakebites occur. We conducted a literature search in MEDLINE® from 1946 to 30 November 2019, looking for research articles describing clinical studies on bedside coagulation tests in snakebite patients. Out of 442 articles identified, 147 articles describing bedside clotting assays were included in the review. Three main bedside clotting tests were identified, namely the Lee–White clotting test, 20-min whole blood clotting time and venous clotting time. Although the original Lee–White clotting test has never been validated for snake envenoming, a recently validated version has been used in some South American countries. The 20-min whole blood clotting time test is the most commonly used test in a wide range of settings and for taxonomically diverse snake species. Venous clotting time is almost exclusively used in Thailand. Many validation studies have methodological limitations, including small sample size, lack of case-authentication, the inclusion of a heterogeneous mix of snakebites and inappropriate uses of gold standard tests. The observation times for bedside clotting tests were arbitrary, without proper scientific justification. Future research needs to focus on improving the existing 20-min whole blood clotting test, and also on looking for alternative bedside coagulation tests which are cheap, reliable and quicker.

scholarly journals Reference Intervals for Common Laboratory Tests in Melanesian Children

2011 ◽  
Vol 85 (1) ◽  
pp. 50-54 ◽  
Author(s):  
Laurens Manning ◽  
Stephen P. Chubb ◽  
Peter M. Siba ◽  
Ivo Mueller ◽  
Timothy M. E. Davis ◽  
...  
Keyword(s):  
Laboratory Tests ◽  
Reference Intervals ◽  
Common Laboratory
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