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Related Concept Videos

Disorders of Hemostasis01:24

Disorders of Hemostasis

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Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
Thromboembolic Disorders
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Variability: Analysis01:11

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Measures of variability are statistical metrics that reveal the dispersion pattern within a dataset. They are pivotal in biostatistics, providing insights into the heterogeneity within health and biological data. Variability signifies the degree to which data points diverge from one another, helping researchers understand the potential range of values and associated uncertainty within the data.
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Colloidal solids are solid particles suspended in solution. They are usually negatively charged, attracting a compact primary layer of positively charged ions, which attract more counterions to form an electrical double layer. Electrostatic repulsion between the charged double layers prevents the particles from colliding, stabilizing the colloids. These solids are often undesirable because they can contain toxins that are difficult to remove. Coagulation is a technique that helps aggregate and...
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Coagulation01:09

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The coagulation phase is a critical part of the body's process to prevent blood loss following injury to blood vessels. It involves chemical reactions that form a clot to seal the injured area. The clotting process begins shortly after injury, within 15-20 seconds for severe damage and 1-2 minutes for minor injuries.
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Related Experiment Video

Updated: Mar 20, 2026

Microfluidic Flow Chambers Using Reconstituted Blood to Model Hemostasis and Platelet Transfusion In Vitro
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Microfluidic Flow Chambers Using Reconstituted Blood to Model Hemostasis and Platelet Transfusion In Vitro

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Biological variation outweighs pre-analytical factors in coagulation reference intervals: a multicenter big data

Fabio Del Ben1, Gabriella Azzarini2, Alessandra Brocca3

  • 1CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy; Study group AI and Big Data of the Italian Society of Clinical Biochemistry and Laboratory Medicine (SIBioC), Milano, Italy.

Clinica Chimica Acta; International Journal of Clinical Chemistry
|March 18, 2026
PubMed
Summary

Establishing reliable reference intervals for Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT) is now feasible across hospital networks. Age and sex significantly impact PT, suggesting the need for stratified reference intervals.

Keywords:
Coagulation testingIndirect methodsMulticenter studyReference IntervalsRefineR algorithm

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Author Spotlight: Biological Standardization to Ensure Reproducibility and Harmonization in Research
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Author Spotlight: Biological Standardization to Ensure Reproducibility and Harmonization in Research
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Author Spotlight: Biological Standardization to Ensure Reproducibility and Harmonization in Research

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Area of Science:

  • Clinical Chemistry
  • Hematology
  • Medical Diagnostics

Background:

  • Establishing reference intervals (RIs) for coagulation tests like PT and APTT is difficult due to pre-analytical variability and donor recruitment challenges.
  • This study addresses the need for accurate RIs by employing a "Big Data" indirect approach across a harmonized hospital network.

Purpose of the Study:

  • To define RIs for Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT) using an indirect "Big Data" method.
  • To evaluate the impact of pre-analytical and biological variables on these coagulation test RIs.

Main Methods:

  • A multicenter retrospective study analyzed data from over 300,000 patients across nine hospitals using the refineR algorithm.
  • Local estimates were aggregated via random-effects meta-analysis and validated against direct methods on healthy donors.

Main Results:

  • Indirect estimates strongly correlated with direct methods.
  • Harmonized upper reference limits (URLs) were established for APTT ratio (1.19) and PT ratio (1.25, or 1.17 excluding inpatients).
  • Age and sex significantly influenced PT, with a J-shaped increase after 50 and higher values in males.

Conclusions:

  • Harmonizing RIs across hospital networks is achievable, with minimal impact from technical variations.
  • Age and sex stratification for PT RIs in patients over 50 may enhance diagnostic specificity.