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Ordóñez-Robles M, Pons-Belda OD, Moína MJ, Bernardo-Gutiérrez Á, Prieto-García B. Assessment of coagulation assays on Roche Cobas t711 analyzer: performance and clinical implications. Blood Coagul Fibrinolysis 2023; 34:523-529. [PMID: 37823437 DOI: 10.1097/mbc.0000000000001261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
OBJECTIVES We performed an analytical assessment of five coagulation tests [i.e. prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, thrombin time (TT) and D-dimer] on the Roche Cobas t711 analyzer and a comparison study with the methodology in use at our laboratory (i.e. Werfen ACL Top 750 analyzer), expanding the analysis to the clinical implications of Cobas t711 implementation. METHODS Imprecision studies were performed following the Clinical and Laboratory Standards Institute (CLSI) H57 A:2008 guideline. Linearity of D-dimer and fibrinogen tests was analysed according to the CLSI EP06-A: 2003 recommendations. For method comparison, the results were analyzed using the Bland-Altman plot and Passing-Bablok regression. RESULTS Imprecision met manufacturer claims for PT, aPTT and TT. D-dimer and fibrinogen tests showed a coefficient of variation (CV)% over manufacturer claims at certain concentration levels. Linearity ranges could not be verified. Comparison study revealed that results are not interchangeable for any test, a lower correlation for aPTT test and lower D-dimer results from Roche Cobas t711. CONCLUSION The strength of this study relies on the analysis of the clinical implications of reporting Cobas t711 results compared to those obtained with the methodology in use at our laboratory. Different sensibility to factor deficiency, anticoagulant therapy and interferences might explain lower correlation rates obtained for the aPTT test. Different monoclonal antibodies used for D-dimer determination might explain the lower results obtained with the Cobas t711 analyzer. This aspect needs further studies given the relevance of D-dimer test to exclude thrombotic events and reinforces the need of harmonization in the haemostasis laboratory.
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Affiliation(s)
| | | | | | - Ángel Bernardo-Gutiérrez
- Laboratorio de Medicina
- Servicio de Hematología, Hospital Universitario Central de Asturias (HUCA), Spain
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Guven B, Can M, Tekin A. Comparison of Fibrinogen Concentrations Determined by the Clauss Method with Prothrombin-Derived Measurements on an Automated Coagulometer. J Appl Lab Med 2022; 7:1337-1345. [PMID: 35993826 PMCID: PMC9452101 DOI: 10.1093/jalm/jfac066] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 06/17/2022] [Indexed: 11/28/2022]
Abstract
Background This research aims to compare fibrinogen results, obtained from the Clauss and PT-derived method on the Cobas t511 analyzer, in patients with specific categories of disease. A second aim was to determine the reference range for these 2 methods. Methods We retrospectively compared fibrinogen concentrations of 914 patients obtained by the Clauss and PT-derived methods on the Cobas t511 coagulation analyzer from the laboratory information system. Fibrinogen data was segregated into a healthy outpatient population and those populations with possible fibrinogen abnormalities including pregnancy, chronic illness, liver disease, heart and vascular diseases, and clinical suspicion of COVID-19. All data were analyzed using Passing–Bablok regression and Bland–Altman analysis. Reference ranges were determined from fibrinogen results of the healthy outpatient population who presented for a clinic check-up. Results All fibrinogen results were grouped and compared according to fibrinogen values (low, normal, and high), international normalized ratio (INR) values (<1.2, 1.2–2.0, and >2.0), and diagnosis. There were statistically significant positive correlations in all groups (P < 0.05), except for low fibrinogen values (P = 0.96). Results with INR value <1.2 had the highest correlation between 2 methods. Conclusion The PT-derived method can be used alone in the Cobas t511 analyzer, especially in patients with an INR <1.2. Reported new reference ranges of the PT-derived method could help to determine and compare the clinical significance of fibrinogen methods. Further studies must be focused on the conditions in which PT-derived fibrinogen results should be directed to the Clauss test.
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Affiliation(s)
- Berrak Guven
- Department of Biochemistry, Faculty of Medicine, Zonguldak Bulent Ecevit University , Zonguldak , Turkey
| | - Murat Can
- Department of Biochemistry, Faculty of Medicine, Zonguldak Bulent Ecevit University , Zonguldak , Turkey
| | - Abdulkadir Tekin
- Department of Biochemistry, Faculty of Medicine, Zonguldak Bulent Ecevit University , Zonguldak , Turkey
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Dalton H, Martin M, Garcia-Filion P, Shavelle D, Huang PH, Clark J, Beinart S, Israel A, Korpi-Steiner N. Activated clotting time in inpatient diagnostic and interventional settings. J Thromb Thrombolysis 2022; 54:660-668. [PMID: 35731496 DOI: 10.1007/s11239-022-02672-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/26/2022] [Indexed: 10/17/2022]
Abstract
Monitoring for the anticoagulant effect of unfractionated (UFH) at the point of care using activated clotting time in real time is vital where risk of thrombosis is high. Although monitoring UFH effect is a routine and important task, changing from one ACT instrument type or technology to another must be preceded by a clinical and statistical evaluation to determine the suitability and repeatability and establish normal and treatable ranges of this newer instrument. In this multi-center prospective evaluation we tested 1236 paired ACT+ samples, and 463 paired ACT-LR samples (1699 total) from enrolled study subjects. Clinical settings included CVOR cardiopulmonary bypass, at the beside in extracorporeal life support (ELS), the Cardiac Catheterization Lab (CCL) during diagnostic studies and percutaneous coronary interventions (PCI), interventional radiology procedures and EP interventions. This study found more consistent clinical performance from the GEM Hemochron 100 as compared to the current clinical model, the Hemochron Signature Elite. The bias of GEM Hemochron 100 for ACT+ and ACT-LR was greatest in the setting of the CVOR where ACT levels were high. ACT-LR measurements by the GEM Hemochron 100 were comparable to the SE when performed in settings of CCL, ECM, EP and ICU. Results obtained for both ACT-LR and ACT+ in all clinical settings in this study using the GEM Hemochron 100 are as accurate and more repeatable as those with the current clinically available Signature Elite.
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Affiliation(s)
| | | | | | - David Shavelle
- University of Southern California Medical Center, Los Angeles, CA, USA
| | | | - Justin Clark
- Charleston Area Medical Center, Charleston, WV, USA
| | - Sean Beinart
- Washington Adventist Hospital, Takoma Park, MD, USA
| | - Andrew Israel
- Robert Wood Johnson Hospital, New Brunswick, NJ, USA
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Zhu C, Sun L, Li H, Dong Z, Yu S, Zhao X, Yang J, Wu W. Assessment and establishment of a reference interval for Roche Cobas t 711 coagulation analyzer for a hospital in China. Pract Lab Med 2022; 29:e00268. [PMID: 35242978 PMCID: PMC8866879 DOI: 10.1016/j.plabm.2022.e00268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/29/2022] [Accepted: 02/15/2022] [Indexed: 12/01/2022] Open
Abstract
Introduction Due to the use of different detection reagents and methods, coagulation analyzers can produce different results. Therefore, detection instruments, reagents and methods are important factors affecting the results of coagulation test. Therefore, this paper aims to establish reference intervals applicable to our laboratory for the Roche Cobas t 711 for routine coagulation assays. Methods:We completed a preliminary evaluation of the analytical performance of the cobas t 711 before any experiment. Healthy volunteer recruitment and ostensibly healthy patients via physical examination were performed to collect individual reference samples. Data were grouped and compared according to age, and the Z test was used to determine whether there was a statistically significant difference between the mean values after grouping. Results The self-established PT, APTT and TT reference intervals were 8.4–10.2s, 26.8–42.3s and 14.5–17.1s, respectively. The reference ranges of FIB, AT and DD for people aged 50 years or below were 1.85–3.78 (g/l), 83.9–113.2 (%) and 0–0.45 (mg/l), respectively, and those for people older than 50 years were 2.22–3.86 (g/l), 76.0–112.0 (%) and 0–0.52 (mg/l), respectively. Conclusion The self-built reference intervals for the Roche t 711 were basically consistent with those in the instructions, except the APTT ranges were slightly wider. Laboratories should establish applicable reference intervals according to their own conditions to provide guidance for the diagnosis, monitoring and prognosis of clinically related diseases.
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Affiliation(s)
| | | | | | | | | | | | - Ji Yang
- Corresponding author. Department of Laboratory Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200123, China.
| | - Wenjuan Wu
- Corresponding author. Department of Laboratory Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200123, China.
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Scherer-Burić RA, Lesser-Wetzold K, Nagel D, Weigand M, Spannagl M, Teupser D, Bruegel M. Performance testing of four automated coagulation analyzers in a university hospital setting with focus on global coagulation assays. Int J Lab Hematol 2022; 44:643-653. [PMID: 35179298 DOI: 10.1111/ijlh.13814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 01/27/2022] [Accepted: 02/07/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Several automated coagulation analyzers are available for laboratory use. In a university hospital central laboratory, we compared four different instruments. The results for global coagulation assays are presented here. METHODS ACL TOP 750 CTS (Instrumentation Laboratory), Atellica COAG 360 (COAG 360), BCS XP (both Siemens Healthineers), and cobas t 711 (Roche Diagnostics) were compared. For inter-instrument comparison, five basic coagulation parameters were analyzed in 476 patient plasma samples. Additional assessments included precision testing using commercial control samples and plasma pools, analysis time for a defined set of samples, sample capacity testing, minimum required sample volumes, and detection quality for hemolytic, icteric, or lipemic (HIL) interferences. RESULTS Good concordance between different instruments was evident from Bland-Altman plots and comparison of data from each instrument with the overall median (τ≥0.8). Shortest analysis times were found for BCS XP and COAG 360, COAG 360 revealed highest sample capacity. Observed required sample volumes were broadly in line with manufacturer specifications and varied according to instrument configurations. HIL detection differed between instruments and was best with ACL TOP 750 CTS. CONCLUSION The four analyzers showed similarly high levels of concordance, although some variations were apparent. The most significant differences between the instruments were found in analysis times and sample capacity. Analyzer capabilities must be considered when selecting laboratory equipment and defining algorithms for clinical practice.
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Affiliation(s)
| | | | - Dorothea Nagel
- Institute of Laboratory Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Michael Weigand
- Institute of Laboratory Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Michael Spannagl
- Department of Transfusion Medicine, Cellular Therapeutics and Hemostaseology, Clinic for Anesthesiology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Daniel Teupser
- Institute of Laboratory Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Mathias Bruegel
- Institute of Laboratory Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
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System performance evaluation of the cobas t 711 and cobas t 511 coagulation analyzers in routine laboratory settings. Blood Coagul Fibrinolysis 2020; 31:459-468. [PMID: 32826393 PMCID: PMC7752206 DOI: 10.1097/mbc.0000000000000947] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
: Utility of coagulation analyzers in real-world settings depends on characteristics that are often not studied comprehensively. This study aimed to investigate the analytical performance, system functionality, practicability, consistency and throughput of two new automated coagulation analyzers in routine laboratory practice. Real-world settings were simulated in three major European hemostasis laboratories and multiple assays were performed in anonymized plasma samples in parallel with routine clinical practice on the cobas t 711 (high-throughput) and cobas t 511 (mid-throughput) analyzers using activated partial thromboplastin time (aPTT), aPTT Lupus, aPTT Screen, Antithrombin (AT), D-Dimer, Fibrinogen, Prothrombin Time (PT)-derived Fibrinogen, PT Owren, PT Rec (recombinant human thromboplastin reagent) and Thrombin Time assays. Precision was tested in a 21-day experiment and accuracy was compared with reference methods of the same laboratory. A number of experiments simulated challenging real-life situations. Pearson's correlation coefficient was more than 0.98 in all assays. Across assays, coefficients of variation ranged from 0.0 to 1.5% for intermediate precision; 0.2 to 3.0% for repeatability and 0.4 to 3.7% for total precision. Good between-run comparability was seen when testing samples under random conditions. Calculated maximum throughput was 197 and 387-402 tests/h for the cobas t 511 and 711 analyzers, respectively. Practicability met or exceeded user expectations in 98% of cases. In a simulated real-life setting of three major laboratories, the new cobas t 511 and cobas t 711 coagulation analyzers demonstrated a good functionality, practicability and performance and the throughput was high.
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Oostendorp M, Noorman RL, Nijenhuis JD, de Kok JB. Performance of 6 routine coagulation assays on the new Roche Cobas t711 analyzer. Pract Lab Med 2019; 17:e00146. [PMID: 31799361 PMCID: PMC6881685 DOI: 10.1016/j.plabm.2019.e00146] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 10/24/2019] [Accepted: 11/06/2019] [Indexed: 11/03/2022] Open
Abstract
Objectives For new analyzers or tests, analytical evaluation is required before implementation in the clinical laboratory. We evaluated the novel Roche Cobas t711 analyzer with six newly developed coagulation assays: the activated partial thromboplastin time (aPTT), prothrombin time (PT), international normalized ratio (INR), fibrinogen, d-dimer and anti-Xa. The evaluation included imprecision experiments, method comparison with the currently used Stago STA-R Evolution, monitoring of unfractionated heparin (UFH) with aPTT, a fast centrifugation protocol to improve turn-around time, and determination of sample stability in whole blood and plasma. Design and methods Imprecision and method comparison were assessed using commercial quality control samples and patient samples, respectively. For dose monitoring of UFH with the aPTT, samples from patients treated with UFH were used. Samples from healthy volunteers were collected for evaluation of the fast centrifugation protocol (5’ 2750×g) and for investigating sample stability over 6–8 h. Results Results for between-run precision were within the desirable specification. Method comparison showed an excellent agreement for fibrinogen, d-dimer and anti-Xa. For aPTT, PT and INR, a good correlation was found, but results were significantly lower on the t711 compared to the STA-R Evolution, which is caused by different coagulation activators. Results from the fast centrifugation protocol differed not significantly from the standard protocol (15’ 2500×g). Blood and plasma samples were stable at room temperature up to 6 and 8 h, respectively. Conclusions The t711 coagulation analyzer with 6 novel tests is suitable for routine use in clinical laboratories.
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Affiliation(s)
- Marlies Oostendorp
- Laboratory of Clinical Chemistry, Deventer Hospital, Deventer, the Netherlands.,Department of Clinical Chemistry and Hematology, Rijnstate Hospital, Arnhem, the Netherlands
| | - Roefke L Noorman
- Laboratory of Clinical Chemistry, Deventer Hospital, Deventer, the Netherlands
| | - J Dinant Nijenhuis
- Laboratory of Clinical Chemistry, Deventer Hospital, Deventer, the Netherlands
| | - Jacques B de Kok
- Laboratory of Clinical Chemistry, Deventer Hospital, Deventer, the Netherlands
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Salvagno GL, Lippi G, Gelati M, Poli G, Favaloro EJ. Analytical performance of the new D-dimer and antithrombin assay on Roche cobas t 711 analyzer. Int J Lab Hematol 2018; 41:e54-e56. [PMID: 30561892 DOI: 10.1111/ijlh.12957] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 10/29/2018] [Accepted: 11/03/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Gian Luca Salvagno
- Section of Clinical Biochemistry, Department of Neurological, Biomedical and Movement Sciences, University of Verona, Verona, Italy
| | - Giuseppe Lippi
- Section of Clinical Biochemistry, Department of Neurological, Biomedical and Movement Sciences, University of Verona, Verona, Italy
| | - Matteo Gelati
- Section of Clinical Biochemistry, Department of Neurological, Biomedical and Movement Sciences, University of Verona, Verona, Italy
| | - Giovanni Poli
- Section of Clinical Biochemistry, Department of Neurological, Biomedical and Movement Sciences, University of Verona, Verona, Italy
| | - Emmanuel J Favaloro
- Department of Haematology, Sydney Centres for Thrombosis and Haemostasis, Institute of Clinical Pathology and Medical Research, NSW Health Pathology, Westmead Hospital, Westmead, New South Wales, Australia
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