Lupus anticoagulant testing: improvements in performance in a UK NEQAS proficiency testing exercise after dissemination of national guidelines on laboratory methods
Open accessAbstract
Laboratory screening for lupus anticoagulant (LA) has been shown to be suboptimal in several studies. Guidelines have recently been published by an expert group for the British Committee for Standards in Haematology, in an attempt to standardize and improve screening procedures. The value of using screening tests conforming with these guidelines was investigated in a United Kingdom National External Quality Assessment Scheme (UK NEQAS) proficiency testing exercise. The correct diagnosis was achieved by 97% of laboratories for a LA-negative sample. However, 18.3% of centres reported a false-negative result for a sample from a LA-positive subject. A significantly higher proportion of centres that used methods conforming with the published guidelines achieved the correct diagnosis for this sample (P < 0.002, chi-square test). A wide variety of screening tests were used by laboratories in this study. Within-method agreement could be improved by the use of a common normal pooled plasma to determine ratios. However, between-method agreement was not improved by this procedure. We conclude that adoption of methods compliant with national guidelines may improve the diagnosis of LA. There is a need, however, for reference and standardization materials to ensure further improvement in the accuracy of LA methods.
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Screen and mix ratios and ICA values were similar between the two dRVVT reagents.
“Screen and mix ratios and ICA values were similar between the two dRVVT reagents, possibly due, at least in part, to normalizing the data reducing between reagent differences.28, 29”
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- Authors
- Jennings, I., Greaves, M., Mackie, I. J., Kitchen, S., Woods, T. A. L., Preston, F. E., & ation, O. B. O. T. U. N. E. Q. A. S. F. B. C.
- Affiliations
- University of Aberdeen (GB)
- University College London (GB)
- Corresponding author
- Jennings, Ian
- on behalf of the UK National External Quality Assessment Scheme for Blood Coagul ation
- Venue
- British Journal of Haematology
- Publisher
- Wiley
- Published
- 2002-10-30
- Volume
- 119
- Issue
- 2
- Pages
- 364-369
- ISSN
- 0007-1048 (ISSN-L)
- 1365-2141
- OpenAlex
- W2048370365
- Cited by
- 72
- References
- 20
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 3 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 2 · 2018: 2 · 2017: 2 · 2016: 1 · 2015: 1 · 2014: 4 · 2013: 2 · 2012: 8
- FWCI
- 3.00
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal of Haematology (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Keywords
- lupus anticoagulant, laboratory standardization, proficiency testing, false-negative results, diagnostic accuracy, antiphospholipid syndrome
- MeSH terms
- Anticoagulants, Hematology, Humans, Laboratories, Lupus Erythematosus, Systemic, Quality Control, Sensitivity and Specificity, Thrombosis, Lupus Coagulation Inhibitor, Guidelines as Topic, Guideline Adherence
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