Haematological Pathology

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Browsing Haematological Pathology by Subject "Anticoagulants (Medicine)"

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    Guidelines for lupus anticoagulant testing in South Africa
    (The Society of Medical Laboratory Technologists of South Africa, 2020) Bailly, J.; Louw, S.; De Koker, A.; Potgieter, J. J. C.; Coetzee, M. J.; Chapanduka, Z. C.; Opie, J. J.
    ENGLISH ABSTRACT: The lupus anticoagulant (LA) refers to the prolongation of certain coagulation tests due to the action of heterogenous autoantibodies. However, the LA is a misnomer since it is associated with thrombosis in vivo, and most commonly is detected as an incidental, transient laboratory finding associated with conditions such as autoimmune diseases, infections and even in healthy individuals. Repeatedly positive LA testing in the setting of thrombotic and/or obstetric complications is required to diagnose the antiphospholipid syndrome (APS). This review intends to provide clarity on LA testing in the South African context and to provide a national guideline in order to standardise LA testing, interpretation and reporting of results.
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    The impact of physician education regarding the importance of providing complete clinical information on the request forms of thrombophilia-screen tests at Tygerberg hospital in South Africa
    (Public Library of Science, 2020-08-06) Abdullah, Ibtisam; Jafta, Andrea D.; Chapanduka, Zivanai C.
    Background: Thrombophilia-screen tests are specialised haemostasis tests that are affected by numerous unique patient variables including the presence of acute thrombosis, the concomitant use of medication and patient demographics. Complete information on the request form is therefore crucial for the haematological pathologist to make patient-specific interpretation of patients’ results. Objectives: To assess the completeness of thrombophilia-screen test request forms and determine the impact of provision of incomplete information, on the interpretive comments generated by reporting haematological pathologists. To assess the impact of an educational session given to clinicians on the importance of providing all the relevant information on the request forms. Method: Two retrospective audits, each covering 3 months, were performed to evaluate the completeness of demographic and clinical information on thrombophilia-screen request forms and its impact on the quality of the interpretive comments before and after an educational intervention. Results: One hundred and seventy-one request forms were included in the first audit and 146 in the second audit. The first audit revealed that all 171 thrombophilia-screen request forms had complete patient demographic information but none had clinical information. Haematological pathologists only made generic comments which could not be applied to a specific patient. The second audit, conducted after a physician educational session, did not reveal any improvement in the clinical information provision by the test-ordering physicians. This was reportedly due to the lack of space on the request form. The interpretive comments therefore remained generic and not patient-specific. Conclusion: Physicians’ failure to provide relevant clinical information made it impossible for pathologists to make patient-specific interpretation of the results. A single physician education session did not change the practice, reportedly due to the inappropriate design of the test request form. Further studies are required to investigate the impact of an improved request form and the planned electronic test requesting.