Mayo Clinic's Finding about CoaguChek and ProTime Meters

[Guest]

Mayo Clin Proc. 2005 Feb;80(2):181-6.

Importance of device evaluation for point-of-care prothrombin time international normalized ratio testing programs.

McBane RD 2nd, Felty CL, Hartgers ML, Chaudhry R, Beyer LK, Santrach PJ.

Department of Internal Medicine and Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Minn 55905, USA. [email protected]

OBJECTIVE: To determine the accuracy of 2 commercially available point-of-care devices relative to plasma international normalized ratio (INR) values. PATIENTS AND METHODS: Point-of-care INR testing was performed with the CoaguChek and ProTime 3 devices in consecutive patients attending an anticoagulation clinic between June 18, 2003, and August 6, 2003. Results were compared with plasma INRs using a sensitive thromboplastin (International Sensitivity Index, 1.0). RESULTS: Ninety-four patients agreed to participate in the study. Relative to the plasma INR, values were in agreement +/-0.4 INR unit 82% and 39% of the time for the CoaguChek and ProTime 3 devices, respectively. The mean +/- SD CoaguChek INRs were 0.2+/-0.31 unit lower, whereas ProTime 3 INRs were 0.8+/-0.68 unit higher than plasma INR values. Treatment decisions based on these data would have resulted in inappropriate dose adjustments 10% and 22% of the time for these 2 respective devices. Correlation with plasma was greater for the CoaguChek (r2=0.90) compared with the ProTime 3 device (r2=0.73). CONCLUSIONS: Optimal warfarin treatment requires accurate measurement of the INR. The choice of a point-of-care device for INR management depends on the reliability of INR data generated by the device.

 

[Ross]

So minus the technobable, bottom line is would they or would they not consider them accurate? Personally, I'd like to see them test between labs and see what results they come up with.

 

[RCB]

I'm I missing something?

I'm I missing something?

Mayo Clin Proc. 2005 Feb;80(2):181-6.

Treatment decisions based on these data would have resulted in inappropriate dose adjustments 10% and 22% of the time for these 2 respective devices. Correlation with plasma was greater for the CoaguChek (r2=0.90) compared with the ProTime 3 device (r2=0.73).


CONCLUSIONS: Optimal warfarin treatment requires accurate measurement of the INR. The choice of a point-of-care device for INR management depends on the reliability of INR data generated by the device.

Shouldn't the "conclusion" be the top section and the "conclusions:" be a statement fact in the protocol section?

 

[Guest]

I don't take any credit or blame for the way it is written, i just copied it verbatim from the National Library of Medicine's website.

I've done about 30,000 patient visits with CoaguChek (our clinic has done over 300 so far in Feb). I think what it proves is the way that I handle things works. Don't get more than 0.2 units below your range without doing something to increase the dose and try to keep the INR under 5.0. If you play by those rules you don't need to worry too much about which one is off which way and by how much. You also don't get obsessed with numbers. I try to treat the person, not the lab value.