Semin Thromb Hemost 2015; 41(03): 294-299
DOI: 10.1055/s-0035-1544196
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Changing Face of Hemostasis Testing in Modern Laboratories: Consolidation, Automation, and Beyond

Giuseppe Lippi
1   Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy
,
Mario Plebani
2   Department of Laboratory Medicine, University-Hospital of Padova, Padova, Italy
,
Emmanuel J. Favaloro
3   Department of Haematology, Institute of Clinical Pathology and Medical Research (ICPMR), Pathology West, NSW Health Pathology, Westmead Hospital, Westmead, New South Wales, Australia
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
19. Februar 2015 (online)

Abstract

The reality of laboratory diagnostics as a whole, and hemostasis testing in particular, is evolving under new paradigms of efficiency. The driving forces of health care and laboratory diagnostics in the third millennium are mainly represented by macro- and microeconomics. In a world with limited resources, shattered by an unprecedented economic crisis, laboratory diagnostics is undergoing a substantial reorganization, with emergence of new models under the imperative of terms, such as bedside testing, consolidation, and networking. The paradigms under which these changes are being developed include a variety of environment, preanalytical, technological, professional, and health-care aspects. The maintenance of continued quality is indeed the major challenge to be faced in the foreseeable future. In fact, some challenges prepotently emerge during a consolidation process, which basically involve delayed testing, centrifugation, transportation, and stability of the specimens, as well as the potential mismatch of sample matrix. This article is aimed to provide an overview of the current economic scenario of laboratory diagnostics and discuss the changing face of hemostasis testing in modern laboratories, providing a synthetic overview about potential drawbacks of actualized solutions.

 
  • References

  • 1 Centers for Disease Control and Prevention. Health Expenditures 2012. http://www.cdc.gov/nchs/data/hus/hus12.pdf#111 . Last accessed on November 15, 2014.
  • 2 Lippi G, Mattiuzzi C. Testing volume is not synonymous of cost, value and efficacy in laboratory diagnostics. Clin Chem Lab Med 2013; 51 (2) 243-245
  • 3 Lippi G, Simundic AM. Laboratory networking and sample quality: a still relevant issue for patient safety. Clin Chem Lab Med 2012; 50 (10) 1703-1705
  • 4 Plebani M, Lippi G. Is laboratory medicine a dying profession? Blessed are those who have not seen and yet have believed. Clin Biochem 2010; 43 (12) 939-941
  • 5 Plebani M, Lippi G. WITHDRAWN: Focused factories and boutique laboratories. The truth might lie in between. Clin Biochem 2010; 43: 1484-1485
  • 6 Plebani M, Lippi G. Point of care testing: evolving scenarios and innovative perspectives. Clin Chem Lab Med 2014; 52 (3) 309-311
  • 7 Lippi G, Plebani M, Favaloro EJ. Quality in hemostasis and thrombosis, part II. Semin Thromb Hemost 2013; 39 (3) 229-232
  • 8 Plebani M. Clinical laboratories: production industry or medical services?. Clin Chem Lab Med [published online ahead of print November 18, 2014] doi: 10.1515/cclm-2014-1007
  • 9 Adcock Funk DM, Lippi G, Favaloro EJ. Quality standards for sample processing, transportation, and storage in hemostasis testing. Semin Thromb Hemost 2012; 38 (6) 576-585
  • 10 Adcock DM, Hoefner DM, Kottke-Marchant K, Marlar RA, Szamosi DI, Warunek DJ. Collection, Transport, and Processing of Blood Specimens for Testing Plasma-Based Coagulation Assays and Molecular Hemostasis Assays: Approved Guideline. 5th ed. Clinical Laboratory Standards Institute. Wayne, PA: CLSI document H21–A5; 2008
  • 11 Lippi G, Rossi R, Ippolito L , et al. Influence of residual platelet count on routine coagulation, factor VIII, and factor IX testing in postfreeze-thaw samples. Semin Thromb Hemost 2013; 39 (7) 834-839
  • 12 Daves M, Giacomuzzi K, Tagnin E , et al. Influence of centrifuge brake on residual platelet count and routine coagulation tests in citrated plasma. Blood Coagul Fibrinolysis 2014; 25 (3) 292-295
  • 13 Salvagno GL, Lippi G, Montagnana M, Franchini M, Poli G, Guidi GC. Influence of temperature and time before centrifugation of specimens for routine coagulation testing. Int J Lab Hematol 2009; 31 (4) 462-467
  • 14 Zaninotto M, Tasinato A, Padoan A , et al. Effects of sample transportation on commonly requested laboratory tests. Clin Chem Lab Med 2012; 50 (10) 1755-1760
  • 15 Lippi G, Lima-Oliveira G, Nazer SC , et al. Suitability of a transport box for blood sample shipment over a long period. Clin Biochem 2011; 44 (12) 1028-1029
  • 16 Lippi G, Plebani M, Favaloro EJ. Interference in coagulation testing: focus on spurious hemolysis, icterus, and lipemia. Semin Thromb Hemost 2013; 39 (3) 258-266
  • 17 Lippi G, Salvagno GL, Adcock DM, Gelati M, Guidi GC, Favaloro EJ. Right or wrong sample received for coagulation testing? Tentative algorithms for detection of an incorrect type of sample. Int J Lab Hematol 2010; 32 (1 Pt 2) 132-138
  • 18 Lippi G, Plebani M, Favaloro EJ. Technological advances in the hemostasis laboratory. Semin Thromb Hemost 2014; 40 (2) 178-185
  • 19 Lippi G, Mattiuzzi C, Plebani M. Laboratory preparedness to face infectious outbreaks. Ebola and beyond. Clin Chem Lab Med 2014; 52 (12) 1681-1684
  • 20 Olsen K. The first 110 years of laboratory automation: technologies, applications, and the creative scientist. J Lab Autom 2012; 17 (6) 469-480
  • 21 Da Rin G, Lippi G. Total Laboratory Automation of Routine Hemostasis Testing. J Lab Autom 2013; 19 (4) 419-422
  • 22 Da Rin G, Lippi G. Sample rerun after short-term refrigerated storage: impact on routine coagulation testing. Int J Lab Hematol 2014; 36 (5) e71-e73
  • 23 Plebani M, Favaloro EJ, Lippi G. Patient safety and quality in laboratory and hemostasis testing: a renewed loop?. Semin Thromb Hemost 2012; 38 (6) 553-558
  • 24 Plebani M. Interpretative commenting: a tool for improving the laboratory-clinical interface. Clin Chim Acta 2009; 404 (1) 46-51
  • 25 Favaloro EJ, Lippi G. Laboratory reporting of hemostasis assays: the final post-analytical opportunity to reduce errors of clinical diagnosis in hemostasis?. Clin Chem Lab Med 2010; 48 (3) 309-321
  • 26 Lippi G, Favaloro EJ. Laboratory hemostasis: milestones in Clinical Chemistry and Laboratory Medicine. Clin Chem Lab Med 2013; 51 (1) 91-97
  • 27 Favaloro EJ, Meijer P, Jennings I , et al. Problems and solutions in laboratory testing for hemophilia. Semin Thromb Hemost 2013; 39 (7) 816-833
  • 28 Carubbi C, Masselli E, Gesi M , et al. Cytofluorimetric platelet analysis. Semin Thromb Hemost 2014; 40 (1) 88-98
  • 29 Flood VH. Perils, problems, and progress in laboratory diagnosis of von Willebrand disease. Semin Thromb Hemost 2014; 40 (1) 41-48
  • 30 World Health Organization. Health Policy. Available at: http://www.who.int/topics/health_policy/en/ . Last accessed on November 15, 2014.
  • 31 Lippi G, Plebani M. The “Obamanomics”: a revolution in laboratory diagnostics. Clin Chem Lab Med 2010; 48 (6) 741-743
  • 32 Ramsey SD, Veenstra DL, Garrison Jr LP , et al. Toward evidence-based assessment for coverage and reimbursement of laboratory-based diagnostic and genetic tests. Am J Manag Care 2006; 12 (4) 197-202
  • 33 Favaloro EJ, Lippi G, Plebani M. Quality in hemostasis and thrombosis—part III. Preface. Semin Thromb Hemost 2014; 40 (2) 140-145
  • 34 Lippi G, Becan-McBride K, Behúlová D , et al. Preanalytical quality improvement: in quality we trust. Clin Chem Lab Med 2013; 51 (1) 229-241