血液学家和实验室专业人员在凝血因子活性检测方面的教育需求。

Educational needs of hematologists and laboratory professionals regarding factor activity assays.

作者信息

Adcock Dorothy M, Rasulnia Mazi, Holot Natalia, Cooper David L

机构信息

Laboratory Corporation of America Holdings, Burlington, NC.

M Consulting LLC, Birmingham, AL.

出版信息

J Blood Med. 2018 Apr 13;9:51-59. doi: 10.2147/JBM.S157428. eCollection 2018.

DOI:10.2147/JBM.S157428

PMID:29713208

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5908211/

Abstract

INTRODUCTION

Diagnosis and management of hemophilia require accurate and precise measurements of factor activity levels. Activity is traditionally measured via one-stage (OS) clot-based assay; however, chromogenic substrate (CS) assays may be needed for certain cases. A survey was performed to understand assay-related knowledge gaps among hematologists and laboratory professionals.

METHODS

Separate web-based surveys were administered to hematologists who manage hemophilia and to laboratory professionals and queried practice patterns, knowledge of/attitudes toward CS assays, and interest in continuing education.

RESULTS

A total of 51 hematologists participated in this study; 67% managed hemophilia patients for ≥10 years and 24% were affiliated with a hemophilia treatment center (HTC). Most (80%) stated familiarity with general assay interpretation. Majorities of non-HTC and HTC respondents agreed that CS assays are more accurate than OS assays (62%/67%), although non-HTC hematologists indicated less understanding of when to order a CS assay (49%/67%). Fewer non-HTC respondents expressed concerns regarding the reliability of OS assays for diagnosis (38%/67%) and monitoring (38%/75%). Most (80%) expressed an interest in factor assay education, especially on available assays, efficacy, and best practices (39%). A total of 57 laboratory professionals participated, averaging 10 years in their current position; most (88%) were hospital based. More performed OS (72%) than CS (10%) or both (17%) assays; only 11% reported confidence with the interpretation of CS results. Few expressed concerns regarding the reliability of OS for diagnosis (9%) or monitoring (12%). Reported barriers to CS use included infrequent need (68%), lack of US Food and Drug Administration (FDA) approval (61%), and need for validation work (56%). Most (70%) were interested in CS assay education; top interests included advantages over traditional assays, general information on CS assays, and indications for testing (each 18%).

CONCLUSION

Future educational efforts may focus on limitations of OS assays, indications for CS assay diagnosis/monitoring, and support for clinic-laboratory dialog.

摘要

引言

血友病的诊断和管理需要准确精确地测量凝血因子活性水平。传统上，活性是通过基于一步法（OS）凝血的检测来测量的；然而，某些情况下可能需要采用发色底物（CS）检测。开展了一项调查，以了解血液科医生和实验室专业人员在检测相关知识方面的差距。

方法

分别对管理血友病患者的血液科医生和实验室专业人员进行了基于网络的调查，询问了他们的实践模式、对CS检测的了解/态度以及对继续教育的兴趣。

结果

共有51名血液科医生参与了本研究；67%的医生管理血友病患者≥10年，24%的医生隶属于血友病治疗中心（HTC）。大多数（80%）表示熟悉一般检测结果解读。非HTC和HTC的受访者大多认为CS检测比OS检测更准确（62%/67%），尽管非HTC血液科医生表示对何时订购CS检测的了解较少（49%/67%）。较少有非HTC受访者对OS检测用于诊断（38%/67%）和监测（38%/75%）的可靠性表示担忧。大多数（80%）表示对凝血因子检测教育感兴趣，尤其是对现有检测方法、疗效和最佳实践方面的教育（39%）。共有57名实验室专业人员参与，他们目前职位的平均工作年限为10年；大多数（88%）在医院工作。进行OS检测的人员更多（72%），进行CS检测的人员较少（10%），同时进行两种检测的人员占17%；只有11%的人表示对解读CS检测结果有信心。很少有人对OS检测用于诊断（9%）或监测（12%）的可靠性表示担忧。报告的CS检测使用障碍包括需求不频繁（68%）、缺乏美国食品药品监督管理局（FDA）批准（61%）以及需要进行验证工作（56%）。大多数（70%）对CS检测教育感兴趣；最感兴趣的内容包括比传统检测方法的优势、CS检测的一般信息以及检测指征（各占18%）。