Systematic evaluation of evidence on veterinary viscoelastic testing part 1: System comparability.
Abstract: To systematically examine the evidence on system comparability between the thromboelastography and the rotational thromboelastometry viscoelastic point-of-care instruments and to identify knowledge gaps. Methods: Standardized, systematic evaluation of the literature, categorization of relevant articles according to level of evidence and quality, and development of consensus on conclusions for application of the concepts to clinical practice. Methods: Academic and referral veterinary medical centers. Results: Medline via PubMed, CAB abstracts, and Google Scholar were searched. A total of 8 relevant articles were chosen, none were in support of the question, 1 was neutral to the question (level of evidence [LOE] 6, Poor), and 7 were in opposition to the question (LOE 3 Good; LOE 6 Good; LOE 6 Fair; LOE 6 Poor). Conclusions: Results from the 2 analyzers are not directly comparable and extrapolation of the results from one machine to the other should be avoided. Standardization of the preanalytical variables (eg, blood collection, holding time, and temperature during holding) is strongly recommended. It is recommended that each site create their own "site specific" reference values for each machine and that test samples be compared only to the standardized reference values established at that center. Start-up and consumable costs vary between countries and local comparisons should be performed. Decisions should be made based on the expected use of the machine and if multiple operators will be using it.
© Veterinary Emergency and Critical Care Society 2014.
Publication Date: 2014-01-14 PubMed ID: 24422637DOI: 10.1111/vec.12143Google Scholar: Lookup
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- Journal Article
- Analytical Methods
- Blood
- Clinical Examination
- Clinical Findings
- Clinical Pathology
- Clinical Study
- Coagulation
- Comparative Study
- Diagnosis
- Diagnostic Technique
- Disease Diagnosis
- Disease Treatment
- Equine Health
- Evidence-Based Medicine
- Hemostasis
- Laboratory Methods
- Medical Device
- Veterinary Medicine
- Veterinary Practice
- Veterinary Procedure
- Veterinary Research
Summary
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The research article explores the comparability and compatibility between two point-of-care devices used in veterinary medicine: thromboelastography and rotational thromboelastometry. The research found that the readings and results from these two machines are not directly comparable, implying the need for specific reference values for each machine and that local comparisons be performed.
Methodology
- The researchers conducted a standardized and systematic evaluation of existing literature on the comparability of these two devices.
- The process involved the categorization and assessment of relevant scientific articles based on their level of evidence and overall quality.
- The consensus conclusions about these devices’ comparability and applicability to clinical practice were derived from these evaluations.
Results
- The research process involved searching resources including Medline via PubMed, CAB abstracts, and Google Scholar.
- Eight relevant articles were selected for review. Of these, none supported a direct comparability between the two devices, one was neutral (graded as Level of Evidence [LOE] 6, Poor), and seven were opposed to the idea (rated as LOE 3 Good; LOE 6 Good; LOE 6 Fair; and LOE 6 Poor).
Conclusions and Recommendations
- The research concluded that the two analyzers (thromboelastography and rotational thromboelastometry devices) cannot be directly correlated. Therefore, the results from one should not be extrapolated to the other.
- To ensure consistent and accurate measurements, the research recommended standardizing preanalytical variables such as blood collection, holding time, and temperature during holding.
- Further, the study advised each site to create their own “site-specific” reference values for each machine. Therefore, test samples should only be compared to the standardized reference values established at that specific center.
- The research also highlighted that the start-up and operation costs of these devices vary between regions. Thus, local comparisons should be made before making decisions on choosing the device.
- Ultimately, the choice of machine should be made considering the expected use and whether multiple operators will be using it.
Cite This Article
APA
McMichael M, Goggs R, Smith S, Wagg C, Warman S, Wiinberg B.
(2014).
Systematic evaluation of evidence on veterinary viscoelastic testing part 1: System comparability.
J Vet Emerg Crit Care (San Antonio), 24(1), 23-29.
https://doi.org/10.1111/vec.12143 Publication
Researcher Affiliations
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine.
MeSH Terms
- Animals
- Blood Specimen Collection / methods
- Blood Specimen Collection / standards
- Blood Specimen Collection / veterinary
- Cats / blood
- Dogs / blood
- Horses / blood
- Reference Standards
- Thrombelastography / instrumentation
- Thrombelastography / methods
- Thrombelastography / veterinary
- Veterinary Medicine / standards
Citations
This article has been cited 5 times.- Bassan T, Pastor J, Agulla B, Jornet O, Martorell J. Reference Range of Kaolin-Activated Thromboelastography (TEG) Values in Healthy Pet Rabbits (Oryctolagus cuniculus).. Animals (Basel) 2023 Jul 23;13(14).
- Hennink I, Peters L, van Geest G, Adamik KN. Evaluation of a Viscoelastic Coagulation Monitoring System (VCM Vet(®)) and Its Correlation with Thromboelastometry (ROTEM(®)) in Diseased and Healthy Dogs.. Animals (Basel) 2023 Jan 25;13(3).
- Yozova ID, Kent MS, Jandrey KE. Effects of a single subcutaneous dose of enoxaparin on veterinary viscoelastic coagulation monitor variables in healthy cats: Double blind, placebo controlled cross-over trial.. J Vet Intern Med 2023 Jan;37(1):133-139.
- Wheeler LR, Edwards TH, Heinz JA, Scott LLF, Grantham LE 2nd, Keesee JD, Henderson AF, Gerardo AC, Hoareau G, Bynum JA. Comparison of assessment of coagulation in healthy dogs by the TEG 6s and TEG 5000 viscoelastic analyzers.. J Vet Diagn Invest 2022 Sep;34(5):780-788.
- Enk NM, Kutter APN, Kuemmerle-Fraune C, Sigrist NE. Correlation of plasma coagulation tests and fibrinogen(Clauss) with rotational thromboelastometry parameters and prediction of bleeding in dogs.. J Vet Intern Med 2019 Jan;33(1):132-140.
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