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Clinical and laboratory practice for lupus anticoagulant testing: An International Society of Thrombosis and Haemostasis Scientific and Standardization Committee survey

Cohen, H; Mackie, IJ; Devreese, KMJ; (2019) Clinical and laboratory practice for lupus anticoagulant testing: An International Society of Thrombosis and Haemostasis Scientific and Standardization Committee survey. Journal of Thrombosis and Haemostasis , 17 (10) pp. 1715-1732. 10.1111/jth.14560. Green open access

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Abstract

Background: Current guidelines have contributed to more uniformity in the performance and interpretation of lupus anticoagulant (LA ) testing. However, points to reconsider include testing for LA in patients on anticoagulation, cut‐off values, and interpretation of results. Objectives: The aim of this International Society of Thrombosis and Haemostasis Scientific and Standardization committee (ISTH SSC ) questionnaire was to capture the spectrum of clinical and laboratory practice in LA detection, focusing on variability in practice, so that the responses could inform further ISTH SSC recommendations. Methods: Members of the ISTH SSC on Lupus Anticoagulant/Antiphospholipid Antibodies and participants of the Lupus Anticoagulant/Antiphospholipid Antibodies Programme of the External quality Control of diagnostic Assays and Tests Foundation were invited to complete a questionnaire on LA testing that was placed on the ISTH website using RedCap, with data tallied using simple descriptive statistics. Results: There was good agreement on several key recommendations in the ISTH and other guidelines on LA testing, such as sample processing, principles of testing, choice of tests, repeat testing to confirm persistent positivity and the use of interpretative reporting. However, the results highlight that there is less agreement on some other aspects, including the timing of testing in relation to thrombosis or pregnancy, testing in patients on anticoagulation, cut‐off values, and calculation and interpretation of results. Conclusions: Although some of the variability in practice in LA testing reflects the lack of substantive data to underpin evidence‐based recommendations, a more uniform approach, based on further guidance, should reduce the inter‐center variability of LA testing.

Type: Article
Title: Clinical and laboratory practice for lupus anticoagulant testing: An International Society of Thrombosis and Haemostasis Scientific and Standardization Committee survey
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/jth.14560
Publisher version: https://doi.org/10.1111/jth.14560
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Hematology, Peripheral Vascular Disease, Cardiovascular System & Cardiology, anticoagulation, antiphospholipid antibodies, confirmatory testing, cut-off values, lupus anticoagulant, pre-analytical, SNAKE-VENOM TIME, ANTIPHOSPHOLIPID ANTIBODIES, COAGULATION ACTIVATION, ECARIN TIME, PREGNANCY, GUIDELINES, QUALITY, UPDATE, RECOMMENDATIONS, RIVAROXABAN
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Haematology
URI: https://discovery.ucl.ac.uk/id/eprint/10105701
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