A question was posed about INR measurements

[pellicle]

Hi

A question was posed in another thread, and I thought it would be interesting to see the answers, so I thought I'd make a poll...

After my AVR, I went to a coumadin clinic for about a year before switching to home testing. They always used a finger stick and portable device. That was 16 years ago. Since then, occasionally, I had my INR tested at several different clinics. They all used a Coaguchek device.

 

[RobThatsMe]

The Coumadin clinic and doctors always send me to the lab for INR testing. I would prefer finger stick because that is what I use at home, and I don't have to be concerned about the reagent they use in the labs when they test my blood for INR.
I have been home testing since 2001, and never looked back, except to check on occasion to see if my home tester is relatively close to the lab draw, I usually take my home test unit to the lab, and check it on that immediately after they draw my blood.
Cheers,
Rob

 

[pellicle]

I usually take my home test unit to the lab, and check it on that immediately after they draw my blood.
Cheers,

Hey, good to see ya, I do the same when I go yearly.

Thanks for the data

 

[Cactus52]

I take my Coagucheck with me to check it with my cardio Coagucheck every few months. and it’s usually within .2

 

[KLS39]

I test at home on my Coagsense. Occasionally I go to the lab for a comparison or if I am doing a blood draw for another reason I will add the INR to the blood draw.

 

[pellicle]

Hi

I test at home on my Coagsense. Occasionally I go to the lab for a comparison or if I am doing a blood draw for another reason I will add the INR to the blood draw.

so basically you don't get managed by the Clinic at the Clinic right?

 

[ATHENS1964]

When I got out of the hospital I had the ROCHE device, as soon as I got home I did the first test for the first week I did every day as my cardiologist suggested. On the tenth day and after the measurement was for 3 consecutive days about 2.5 in a lab and I did a measurement there, I was at 2.7. Since then I count home every week and go to the lab every 5-6 months for comparison.

 

[KLS39]

Hi



so basically you don't get managed by the Clinic at the Clinic right?

I have never gone to a clinic. I input my INR results into an app for the company that provides my machine. The company calls my cardiologists office who then calls me to discuss the results and whether I should make any adjustments to my dose.

 

[pellicle]

I input my INR results into an app for the company that provides my machine. The company calls my cardiologists office who then calls me to discuss the results and whether I should make any adjustments to my dose.

that's an excellent method. I have wonedered when Roche are going to take advantage of the inclusion of Bluetooth in the INRange device to close the loop on relying on the accuracy of the user ... it would be pretty easy to integrated into the systems.

 

[LondonAndy]

I test weekly with a CoaguChek XS, and every 6 weeks I send that week's result to my GP, who also provides my anticoagulation clinic service. Every 6 months I go there and do a test on my machine at the same time as they do a test on their multi-patient machine, to compare accuracy. It is usually the same or +/- 0.1

 

[Mister_James]

that's an excellent method. I have wonedered when Roche are going to take advantage of the inclusion of Bluetooth in the INRange device to close the loop on relying on the accuracy of the user ... it would be pretty easy to integrated into the systems.

This would be a terrible idea. Then I can't "doctor" my results. I need to manage my INR managers.

 

[LondonAndy]

This would be a terrible idea. Then I can't "doctor" my results. I need to manage my INR managers.

I agree! I self-manage my Warfarin dose, but I don't think I am supposed to!

 

[pellicle]

This would be a terrible idea. Then I can't "doctor" my results. I need to manage my INR managers.

Personally I don't want the INRange either, but if I was to allow the general public to use my dosing algorithm and be subject to legal claims I'd want proof there wasn't garbage in.
https://en.wikipedia.org/wiki/Garbage_in,_garbage_out

 

[pellicle]

I test weekly with a CoaguChek XS,

I guess I should have made this clearer in the question: I specifically am interested in "when people travel to a clinic" to get the test.

For instance, I voted venous draw, because when i I go to a clinic it's all they offer me.

However, so he I've been out on my own and self managing I use the coaguchek for all measurements.

 

[RAS]

that's an excellent method. I have wonedered when Roche are going to take advantage of the inclusion of Bluetooth in the INRange device to close the loop on relying on the accuracy of the user ... it would be pretty easy to integrated into the systems.

This would be a terrible idea. Then I can't "doctor" my results. I need to manage my INR managers.

I intentionally don't use the BT capability in my Roche Vantas device because I sometimes test more often than the minimum every 2 weeks required to stay in the service. Biotel/Cardionet bills per every 4 reported tests, so I keep my cost down by limiting reporting (I enter results in their website) to just the minimum. If I used the App/BT to report my INR, it would upload the current plus all INR history stored in the device not previously reported.

 

[pellicle]

I intentionally don't use the BT capability in my Roche Vantas device because I sometimes test more often than the minimum every 2 weeks required to stay in the service.

I'm not sure I see the reasons for not using BT (when just taking a mid point reading) based on what you've said (unless you mean "some of the times").

My point however was important and still stands from the perspective of the managers (software or human). If they don't have good data they can't do good management (which I assume most people sort of expect).

I do understand the billing bits, and that's rather fraught, however my intention would be a bit more like the open source project(s?) that exist for helping diabetics (who take a lot more measurements).

PS: why do you want to "stay in the service" ??

 

[pekster11]

I go to a medical centre for my "official" INR test (venous draw)
I'm only going there once every 3 months now, and may make it twice a year in the future.

I will use my home Coagucheck meter within an hour of the venous draw. Always been within .2 ratio of eachother

Last time I had a venous draw at the Medical Centre, it gave the exact same result as my Coaguecheck meter

 

[RAS]

I'm not sure I see the reasons for not using BT (when just taking a mid point reading) based on what you've said (unless you mean "some of the times").

Perhaps I wasn't clear. It's to keep my cost down by not allowing every test to be uploaded and billed.

If for example, I did 8 tests in 8 weeks and I used the BT feature, all 8 tests would be uploaded via BT.
It's a service. Billing is based on usage of the service. The service includes the device, supplies, and reporting to the provider. There is no separate charge for supplies, so I order enough so I can test more often than every 2 weeks if I feel the need to do so, but I only report my tests every two weeks even if I test more often. As it turns out, the past year, I seldom need to test more often than every 2 weeks to stay in range, but the option is there if needed.

By using their web page, I can control which tests I report. that is not the case with the App and Bluetooth. If for example I did a test last week, but did not transmit it, then I did a test this week and did the transmit, it will send both this week and last week's results. The only way to prevent that is to "Clear Memory" which deletes all history plus settings. It's not selective.

They bill every 4 tests. If I used BT in the above scenario, I would get 2 bills (unless I went through the clear memory hassle). By only reporting every 2 weeks, I get only 1 bill.

I'm only in the service to get a reliable source of test strips. I prefer not to use eBay for my test strips.
Even though a nurse from my Cardio office calls to discuss my test result, I do my own dosing. They are required to make the call per the terms of the service.

PS: why do you want to "stay in the service" ??

If I don't test and report at least every 2 weeks, they will discontinue my participation in the service. At least that is what they told me at the beginning. I've never missed reporting on the schedule.

 

[pellicle]

If I don't test and report at least every 2 weeks, they will discontinue my participation in the service.

understood, but why do you want to stay in the service (given you seem to be largely self managing)

I'm only in the service to get a reliable source of test strips. I prefer not to use eBay for my test strips.

ahh I see ... personally I have no such reservations