Related Experiment Video
Updated: Aug 23, 2025
11:17
Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
Published on: October 12, 2012
13.8K
Data mining for prothrombin time and international normalized ratio reference intervals in children
Muhammad Shariq Shaikh1, Sibtain Ahmed1
1Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan.
Plos One
|October 27, 2022
Summary
Establishing pediatric reference intervals (RIs) for prothrombin time (PT) and International Normalized Ratio (INR) is crucial. An indirect data mining method using the KOSMIC algorithm was effective for determining these PT/INR RIs in children.
Area of Science:
- Clinical Biochemistry
- Pediatric Hematology
- Data Mining in Healthcare
Background:
- Reference intervals (RIs) are essential for clinical diagnosis, but establishing them for coagulation tests like prothrombin time (PT) and International Normalized Ratio (INR) in children presents challenges.
- Interlaboratory variability in PT/INR measurements arises from differences in instruments and reagents.
- Direct methods for determining pediatric RIs are often logistically difficult, costly, and ethically restricted.
Purpose of the Study:
- To determine pediatric reference intervals (RIs) for prothrombin time (PT) and International Normalized Ratio (INR) using an indirect data mining approach.
- To evaluate the feasibility of the KOSMIC algorithm for establishing PT/INR RIs in a pediatric population.
- To provide age-stratified PT/INR RIs for improved clinical decision-making in children.
Main Methods:
- Retrospective analysis of PT/INR measurements from 37,356 (PT) and 37,192 (INR) children aged 0-18 years.
- Application of the indirect KOSMIC algorithm, assuming Gaussian distribution of non-pathologic samples after Box-Cox transformation.
- Stratification of RIs into nine distinct age groups.
Main Results:
- The KOSMIC algorithm successfully computed PT/INR reference intervals for the pediatric cohort.
- Calculated RIs showed good agreement with established pediatric thrombosis and hemostasis guidelines across different age groups.
- The study demonstrated the utility of data mining for establishing PT/INR RIs in resource-limited settings.
Conclusions:
- Indirect data mining using the KOSMIC algorithm is a viable and efficient alternative for establishing pediatric PT/INR reference intervals.
- The derived RIs can aid clinicians in better interpreting coagulation test results in children.
- This approach facilitates understanding of age-related coagulation pathway dynamics and supports evidence-based clinical practice.
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
18
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
18
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
849
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...
849
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
1.3K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.3K