Point-of-care INR testing using CoaguChek S and XS showed good correlation with hospital laboratory monitoring (r = 0.91), with 87% of paired measurements within 0.5 INR units of each other.
RCT (n=151)
Crossover
No
Does point-of-care INR testing accurately reflect hospital laboratory INR measurements in patients on oral anticoagulation?
Point-of-care INR testing is a reliable alternative to hospital laboratory monitoring, particularly for INR values between 2.0 and 3.5, though external quality control remains important.
Effect estimate: r = 0.91
The development of point-of-care (POC) testing devices enables patients to test their own international normalized ratio (INR) at home. However, previous studies have shown that when compared with clinical laboratory values, statistically significant differences may occur between the two methods of INR measurement. The aim of this study was to evaluate the accuracy of the CoaguChek S and XS POC meters relative to clinical laboratory measurements. As part of a randomized, crossover patient self-testing (PST) study at Cork University Hospital, patients were randomized to 6 months PST or 6 months routine care by the anticoagulation management service. During the PST arm of the study, patients measured their INR at home using the CoaguChek S or XS POC meter. External quality control was performed at enrollment, 2 months and 4 months by comparing the POC measured INR with the laboratory determined value. One hundred and fifty-one patients provided 673 paired samples. Good correlation was shown between the two methods of determination (r = 0.91), however, statistically significant differences did occur. A Bland-Altman plot illustrated good agreement of INR values between 2.0 and 3.5 INR units but there was increasing disagreement as the INR rose above 3.5. Eighty-seven per cent of all dual measurements were within the recommended 0.5 INR units of each other. This study adds to the growing evidence that POC testing is a reliable and safe alternative to hospital laboratory monitoring but highlights the importance of external quality control when these devices are used for monitoring oral anticoagulation.
Ryan et al. (Fri,) conducted a rct in Oral anticoagulation monitoring (n=151). Point-of-care INR testing (CoaguChek S and XS) vs. Hospital laboratory monitoring was evaluated on Correlation of POC measured INR with laboratory determined value (r = 0.91). Point-of-care INR testing using CoaguChek S and XS showed good correlation with hospital laboratory monitoring (r = 0.91), with 87% of paired measurements within 0.5 INR units of each other.
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