Premium
Lupus anticoagulant testing: improvements in performance in a UK NEQAS proficiency testing exercise after dissemination of national guidelines on laboratory methods
Author(s) -
Jennings Ian,
Greaves Mike,
Mackie Ian J.,
Kitchen Steve,
Woods Timothy A. L.,
Preston F. Eric
Publication year - 2002
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.2002.03821.x
Subject(s) - medicine , external quality assessment , medical physics , standardization , lupus anticoagulant , test (biology) , medical laboratory , pathology , computer science , thrombosis , paleontology , biology , operating system
Summary. Laboratory screening for lupus anticoagulant (LA) has been shown to be suboptimal in several studies. Guidelines have recently been published by an expert group for the British Committee for Standards in Haematology, in an attempt to standardize and improve screening procedures. The value of using screening tests conforming with these guidelines was investigated in a United Kingdom National External Quality Assessment Scheme (UK NEQAS) proficiency testing exercise. The correct diagnosis was achieved by 97% of laboratories for a LA‐negative sample. However, 18·3% of centres reported a false‐negative result for a sample from a LA‐positive subject. A significantly higher proportion of centres that used methods conforming with the published guidelines achieved the correct diagnosis for this sample ( P < 0·002, chi‐square test). A wide variety of screening tests were used by laboratories in this study. Within‐method agreement could be improved by the use of a common normal pooled plasma to determine ratios. However, between‐method agreement was not improved by this procedure. We conclude that adoption of methods compliant with national guidelines may improve the diagnosis of LA. There is a need, however, for reference and standardization materials to ensure further improvement in the accuracy of LA methods.