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Hoffmann, R. A wiki for the life sciences where authorship matters. Nature Genetics (2008)

Point-of-care (POC) versus central laboratory instrumentation for monitoring oral anticoagulation.

Point-of-care (POC) instruments employing fingerstick whole blood to monitor patients treated with warfarin are a popular alternative to complex, central laboratory coagulation analyzers utilizing citrated plasma derived from venipuncture. We investigated the accuracy of two widely utilized POC instruments for oral anticoagulation monitoring compared with a central laboratory instrument. Instrument-to-instrument variation differed for the two POC instruments, which correlated with the central laboratory instrument, but exhibited positive bias of 0.24 - 0.35 INR units. Positive bias increased as the INR values increased. We conclude that clinicians should exercise caution when interpreting results generated by POC monitors, particularly at high INR values. A high POC measurement of INR does not necessarily warrant decreasing the warfarin dose. Instead, a predefined cut-off range for high INR values generated by POC instruments should mandate confirmatory testing with central laboratory instrumentation.[1]


  1. Point-of-care (POC) versus central laboratory instrumentation for monitoring oral anticoagulation. Dorfman, D.M., Goonan, E.M., Boutilier, M.K., Jarolim, P., Tanasijevica, M., Goldhaber, S.Z. Vascular medicine (London, England) (2005) [Pubmed]
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