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Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
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Post-analytical Issues in Hemostasis and Thrombosis Testing.

Emmanuel J Favaloro1, Giuseppe Lippi2

  • 1Haematology Department, Sydney Centres for Thrombosis and Haemostasis, Institute of Clinical Pathology and Medical Research (ICPMR), Westmead Hospital, NSW Health Pathology, Westmead, NSW, 2145, Australia. emmanuel.favaloro@health.nsw.gov.au.

Methods in Molecular Biology (Clifton, N.J.)
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Summary

Modern hemostasis and thrombosis testing shows fewer analytical errors due to better technology and quality control. This overview focuses on improving post-analytical reporting to prevent clinical diagnostic errors.

Keywords:
Diagnostic errorsExtra-analytical variablesHemostasisPost-analytical variablesPre-analytical variablesReporting guidelinesTest interpretation

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Area of Science:

  • Clinical diagnostics
  • Laboratory medicine
  • Hemostasis and thrombosis

Background:

  • Analytical concerns in hemostasis and thrombosis testing are decreasing.
  • Improvements in instrumentation, test reliability, and quality control measures contribute to this trend.
  • Newer instrumentation addresses pre-analytical issues like hemolysis, icteria, lipemia, and sample collection problems.

Purpose of the Study:

  • To provide an overview of post-analytical issues in hemostasis and thrombosis testing.
  • To offer guidance for the prevention and minimization of post-analytical errors.
  • To propose strategies for improved post-analytical reporting of hemostasis assays.

Main Methods:

  • Review of current literature and practices in hemostasis and thrombosis testing.
  • Analysis of common post-analytical issues related to test result reporting and interpretation.
  • Development of strategies for enhanced post-analytical reporting.

Main Results:

  • Post-analytical issues, primarily concerning test result reporting and interpretation, remain a critical area.
  • Improved reporting and interpretation strategies can serve as a final safeguard against clinical errors.
  • Implementing proposed strategies can significantly minimize diagnostic errors.

Conclusions:

  • While analytical and pre-analytical issues are improving, post-analytical reporting requires focused attention.
  • Effective post-analytical reporting is crucial for accurate diagnosis and patient safety in hemostasis and thrombosis.
  • Strategies for improved post-analytical reporting offer a vital opportunity to prevent clinical errors.