Quality assurance and quality control of thrombelastography and rotational Thromboelastometry: the UK NEQAS for blood coagulation experience.
- PubMed: 20978996
Abstract
Global hemostasis devices are currently being employed in operating rooms to assess the bleeding risk and outcomes for patients undergoing surgery. Two devices currently available are the TEG (Thromboelastograph; Haemoscope Corp., Niles, IL) and the ROTEM (Rotation Thromboelastometer; Pentapharm GmbH, Munich, Germany). Both measure the speed of clot formation, the strength of the clot when formed, and clot fibrinolysis kinetics. The two devices use different parameters so no cross comparisons of results can be made. The devices are usually operated by a member of the operating team and not a laboratory scientist; thus their testing and performance is generally not laboratory controlled, despite quality control being required to ensure reliable results. The UK National External Quality Assessment Scheme (NEQAS) for Blood Coagulation has undertaken a series of exercises evaluating the provision of External Quality Assessment (EQA) material for these devices. A series of four studies have taken place using lyophilized plasmas as the test material. Up to 18 TEG users and 10 ROTEM users have been involved in testing two samples per study, for a total of eight samples tested. The samples were normal plasmas, factor VIII or XI deficient samples, or normal plasmas spiked with heparin. The precision of the tests varied greatly for both devices, with coefficients of variances ranging from 7.1 to 39.9% for TEG and 7.0 to 83.6% for ROTEM. Some centers returned results that were sufficiently different from those obtained by other participants to predict alterations in patient management decisions. Our data indicate that regular EQA/proficiency testing is needed for these devices.
Quality assurance and quality control of thrombelastography and rotational Thromboelastometry: the UK NEQAS for blood coagulation experience.
IPCC Good Practice Guidance and Uncertainty Management in National Greenhouse Gas Inventories 8.1
8
QUALITY ASSURANCE AND QUALITY
CONTROL
8.2 IPCC Good Practice Guidance and Uncertainty Management in National Greenhouse Gas Inventories
CO-CHAIRS, EDITORS AND EXPERTS
Co-Chairs of the Expert Meeting on Cross-sectoral Methodologies for
Uncertainty Estimation and Inventory Quality
Taka Hiraishi (Japan) and Buruhani Nyenzi (Tanzania)
REVIEW EDITORS
Carlos M Lòpez Cabrera (Cuba) and Leo A Meyer (Netherlands)
Expert Group: Quality Assurance and Quality Control (QA/QC)
CO-CHAIRS
Kay Abel (Australia) and Michael Gillenwater (USA)
AUTHOR OF BACKGROUND PAPER
Joe Mangino (USA)
CONTRIBUTORS
Sal Emmanuel (IPCC-NGGIP/TSU), Jean-Pierre Fontelle (France), Michael Gytarsky (Russia), Art Jaques
(Canada), Magezi-Akiiki (Uganda), and Joe Mangino (USA)
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