ACCURACY AND COST EVALUATION OF A PORTABLE INR MONITOR
Abstract number: P-T-101
Paoletti1 O., Alatri1 A., Morstabilini1 G., Fugazza1 A., Testa1 S.
1Haemostasis and Thrombosis Centre, A.O. Istituti Ospitalieri di Cremona, Cremona, Italy
How-to-cite Paoletti O, Alatri A, Morstabilini G, Fugazza A, Testa S. ACCURACY AND COST EVALUATION OF A PORTABLE INR MONITOR. J Thromb Haemost 2007; 5 Supplement 2: P-T-101
Introduction: Portable coagulation systems are used to perform PT-INR test on capillary blood. These instruments can be used for monitoring oral anticoagulant therapy (OAT) in home patients or in patients followed in peripheral health units. This management has demonstrated to be useful to improve patient's quality of life. Aim of the study was to evaluate precision, accuracy and feasibility of two portable PT monitors and to compare costs between these systems.
Methods: Monitor A: Coadata 501 S (Alfa Wasserman Diagnostics, Bologna Italy) using a brain rabbit thromboplastin with an ISI of 1.1; Monitor B: CoaguChek S (Roche Diagnostics, Basel, Switzerland) using freeze-dried rabbit thromboplastin with an ISI of 1.84.
Dual capillary INR measurements were performed in 155 OAT patients with PT INR ranging from 1.0 to 6.0. Comparison of different systems was performed by linear regression and Bland and Altman statistical analysis.
Results: The coefficient correlation among the two different systems was 0.82. The linear regression equation was y=0.74x + 0.62 with p<0.0001. Bland-Altman analysis showed a good agreement with 95% of total values included between 2 DS. Furthermore we have calculated the proportion dual INR measurements within 0.5 INR units at 4 different INR ranges:
1.INR range 1.0-1.99: 90% of agreement
2.INR range 2.0-2.99: 93% of agreement
3.INR range 3.0-3.99: 67% of agreement
4.INR range 4.0-6.0: 50% of agreement
Global costs of the two portable monitors were evaluated. We found an advantage for Coadata system, resulting in 1[euro] less expensive for each PT determination, considering groups of at least 20 patients.
Conclusions: Results showed good correlation between the two different systems. Total agreement is better at INR level < 3. Coadata portable monitor is more economic in comparison with Coagucheck S; but less easy to use. Therefore it is a good system for PT/INR determinations in selected patients at peripheral health units, if used by professional trained staff.
To cite this abstract use the following format:
Journal of Thrombosis and Haemostasis 2007; Volume 5, Supplement 2: abstract number
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