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June 1, 1993American Journal of Clinical Pathology

Failure of the International Normalized Ratio to Generate Consistent Results Within a Local Medical Community

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Why the study?

Does a local normalized ratio (LNR) provide more consistent prothrombin time standardization than the International Normalized Ratio (INR) across different hospitals?

Population

64 plasmas obtained from patients chronically receiving oral anticoagulants

Comparison

Local normalized ratio based on a calculated… vs International Normalized Ratio (INR)

Design

Other

Authors

VNValerie NgImperial College Healthcare NHS TrustJLJack LevinUnited States Army Medical CommandLCLaurence CorashUniversity of California, San Francisco

Discussion

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Implication

INR mismatches across hospitals may affect anticoagulation consistency; leaves open whether LNR improves standardization in practice.

Structured PICO

Does a local normalized ratio (LNR) provide more consistent prothrombin time standardization than the International Normalized Ratio (INR) across different hospitals?

P
Population
64 plasmas obtained from patients chronically receiving oral anticoagulants
I
Intervention
Local normalized ratio (LNR) based on a calculated local sensitivity index (LSI)
C
Comparator
International Normalized Ratio (INR)
O
Outcome
Consistency and classification agreement of prothrombin time results across three hospitalssurrogate

The study demonstrates significant inconsistency in INR values across local hospitals, challenging the reliability of the INR concept for standardizing oral anticoagulant therapy.

Cite This Study

Ng et al. (1993) studied this question.

synapsesocial.com/papers/6a7013fbb27f158178272f1fhttps://doi.org/10.1093/ajcp/99.6.689
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Oral Anticoagulant Therapy Control: Evidence that INR Expression Improves the Inter-Laboratory Comparability of Results - The Bologna Oral Anticoagulant Control Exercise1987 · 20 citations
  2. 2Questions and Answers on Prothrombin Time Standardisation in Oral Anticoagulant Control1985 · 86 citations
  3. 3Automation and prothrombin time: a United Kingdom field study of two widely used coagulometers.1990 · 43 citations
  4. 4Comparison of Two Automated Coagulometers and the Manual Tilt-Tube Method for the Determination of Prothrombin Time1989 · 60 citations
  5. 5Proficiency Testing and Standardization of Prothrombin Time: Effect of Thromboplastin, Instrumentation, and Plasma1984 · 37 citations