External Quality Assessment of Platelet Disorder Investigations: Results of International Surveys on Diagnostic Tests for Dense Granule Deficiency and Platelet Aggregometry Interpretation

Catherine P.M. Hayward; Karen A. Moffat; Elizabeth Plumhoff; Marnie Timleck; Suzanne Hoffman; Ernie Spitzer; Elizabeth M. Van Cott; Piet Meijer

doi:10.1055/s-0032-1319767

Seminars in Thrombosis and Hemostasis, Table of Contents

Semin Thromb Hemost 2012; 38(06): 622-631
DOI: 10.1055/s-0032-1319767

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

External Quality Assessment of Platelet Disorder Investigations: Results of International Surveys on Diagnostic Tests for Dense Granule Deficiency and Platelet Aggregometry Interpretation

Catherine P.M. Hayward

¹Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada

²Hamilton Regional Laboratory Medicine Program, Special Coagulation Laboratory, Hamilton, Ontario, Canada

,

Karen A. Moffat

²Hamilton Regional Laboratory Medicine Program, Special Coagulation Laboratory, Hamilton, Ontario, Canada

³Department of Medicine, McMaster University, Hamilton, Ontario, Canada

,

Elizabeth Plumhoff

⁴Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota

,

Marnie Timleck

¹Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada

,

Suzanne Hoffman

⁵University of Wisconsin Hospital and Clinics, UWHC Special Coagulation Laboratory, Madison, Wisconsin

,

Ernie Spitzer

²Hamilton Regional Laboratory Medicine Program, Special Coagulation Laboratory, Hamilton, Ontario, Canada

,

Elizabeth M. Van Cott

⁶Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts

,

Piet Meijer

⁷ECAT Foundation, Leiden, The Netherlands

› Author Affiliations

Abstract

The quality of platelet aggregation and dense granule deficiency testing is important for diagnosing platelet function disorders. After a successful pilot exercise on diagnosing platelet dense granule deficiency by electron microscopy (EM), the North American Specialized Coagulation Laboratory Association (NASCOLA) has launched regular external quality assurance (EQA) for dense granule EM, as well as for the interpretation of platelet aggregation findings. EQA records were analyzed to assess performance. For EM EQA, between 2009 and 2011, there was excellent performance in distinguishing normal from dense granule-deficient samples and good (>70%) agreement on classifying most electron dense structures in platelets. For aggregation EQA, some normal variants were misclassified and overall case interpretations were more acceptable for rare disorders than for common findings. NASCOLA experiences with these EQAs indicate that there is a need to improve the quality of platelet disorder evaluations. For aggregometry interpretations, deficits in performance could be addressed by translating guideline recommendations into practice.

Keywords

platelet disorders - dense granule deficiency - light transmission platelet aggregometry - electron microscopy - external quality assurance

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References

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