TY - JOUR
T1 - A superior method to report clinically relevant quality information about the point-of-care INR device performance compared with the International Organization for Standardization guidelines
AU - Shermock, Kenneth M.
AU - Clarke, William
AU - Streiff, Michael B.
PY - 2010/11
Y1 - 2010/11
N2 - Background: A revised ISO guideline was recently published that recommended methods to assess the quality of point-of-care INR measures. We assessed the relative performance of the ISO methods and a method that we developed. Methods: We compared the ability of the ISO and the Shermock methods to predict when the INR measures lead to identical or different clinical decisions. Clinical decisions that were directly measured in a previous trial were used as a standard. Results: The Shermock method was significantly better (82% of predictions correct) than the revised ISO method (61% correct, p < 0.0001) at predicting when two INR measures lead to identical or different clinical decisions. Only 41% of decisions predicted to disagree by the revised ISO method actually disagreed; while only 51% of decisions that actually agreed were correctly predicted. Conclusions: The Shermock method is superior in providing information that clinicians and patients care most about regarding the quality of the INR measures used to guide clinical decisions. Regulatory agencies should strongly consider incorporating the Shermock method into the device approval process. Local clinical laboratories should consider using the Shermock method in quality assurance assessments.
AB - Background: A revised ISO guideline was recently published that recommended methods to assess the quality of point-of-care INR measures. We assessed the relative performance of the ISO methods and a method that we developed. Methods: We compared the ability of the ISO and the Shermock methods to predict when the INR measures lead to identical or different clinical decisions. Clinical decisions that were directly measured in a previous trial were used as a standard. Results: The Shermock method was significantly better (82% of predictions correct) than the revised ISO method (61% correct, p < 0.0001) at predicting when two INR measures lead to identical or different clinical decisions. Only 41% of decisions predicted to disagree by the revised ISO method actually disagreed; while only 51% of decisions that actually agreed were correctly predicted. Conclusions: The Shermock method is superior in providing information that clinicians and patients care most about regarding the quality of the INR measures used to guide clinical decisions. Regulatory agencies should strongly consider incorporating the Shermock method into the device approval process. Local clinical laboratories should consider using the Shermock method in quality assurance assessments.
KW - Coagulation monitoring
KW - Healthcare quality assurance
KW - POCT
KW - PT INR
KW - Point-of-care testing
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U2 - 10.1016/j.cca.2010.07.023
DO - 10.1016/j.cca.2010.07.023
M3 - Article
C2 - 20667446
AN - SCOPUS:77956489425
SN - 0009-8981
VL - 411
SP - 1756
EP - 1760
JO - Clinica Chimica Acta
JF - Clinica Chimica Acta
IS - 21-22
ER -