Variability between laboratories performing coagulation tests with identical platforms: a nationwide evaluation study.

Nagler, Michael; Bachmann, Lucas M.; Alberio, Lorenzo; Angelillo, Anne; Asmis, Lars M.; Korte, Wolfgang; Mendez, Adriana; Reber, Guido; Stricker, Hans; Tsakiris, Dimitrios A.; Wuillemin, Walter A. (2013). Variability between laboratories performing coagulation tests with identical platforms: a nationwide evaluation study. Thrombosis journal, 11(1), p. 6. BioMed Central 10.1186/1477-9560-11-6

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BACKGROUND While the assessment of analytical precision within medical laboratories has received much attention in scientific enquiry, the degree of as well as the sources causing variation between them remains incompletely understood. In this study, we quantified the variance components when performing coagulation tests with identical analytical platforms in different laboratories and computed intraclass correlations coefficients (ICC) for each coagulation test. METHODS Data from eight laboratories measuring fibrinogen twice in twenty healthy subjects with one out of 3 different platforms and single measurements of prothrombin time (PT), and coagulation factors II, V, VII, VIII, IX, X, XI and XIII were analysed. By platform, the variance components of (i) the subjects, (ii) the laboratory and the technician and (iii) the total variance were obtained for fibrinogen as well as (i) and (iii) for the remaining factors using ANOVA. RESULTS The variability for fibrinogen measurements within a laboratory ranged from 0.02 to 0.04, the variability between laboratories ranged from 0.006 to 0.097. The ICC for fibrinogen ranged from 0.37 to 0.66 and from 0.19 to 0.80 for PT between the platforms. For the remaining factors the ICC's ranged from 0.04 (FII) to 0.93 (FVIII). CONCLUSIONS Variance components that could be attributed to technicians or laboratory procedures were substantial, led to disappointingly low intraclass correlation coefficients for several factors and were pronounced for some of the platforms. Our findings call for sustained efforts to raise the level of standardization of structures and procedures involved in the quantification of coagulation factors.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory

UniBE Contributor:

Nagler, Michael and Angelillo, Anne


600 Technology > 610 Medicine & health




BioMed Central




Verena Zwahlen

Date Deposited:

23 May 2014 16:44

Last Modified:

26 Jun 2016 01:50

Publisher DOI:


PubMed ID:





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