Evaluating errors in the laboratory identification of von Willebrand disease in the real world.

摘要: Abstract Introduction von Willebrand disease (VWD), reportedly the most common bleeding disorder, arises from deficiency and/or defects of factor (VWF). Assessment requires a wide range tests, including VWF activity and antigen. Appropriate diagnosis differential identification qualitative vs quantitative has important management implications, but remains problematic for many laboratories clinicians. Methods Data using large set (n = 29) varied plasma samples comprising both ‘quantitative’ (‘Type 1 3’ VWD) ‘qualitative’ 2 VWD’) tested in cross-laboratory setting been evaluated to assess ability real world differentially identify these sample types. Results Different assays activity/antigen ratios show different utility VWD type identification. errors were often linked high inter-laboratory test variation result misinterpretation (i.e., failed correctly interpret their own panel findings). Thus, moderate deficient misinterpreted as on 30/334 occasions (9% error rate); 17% due misinterpreting data, which was instead consistent with deficiencies. Conversely, whilst deficiencies at similar rate (~ 9%), this more data (~ 50% errors). For test-associated errors, ristocetin cofactor associated highest variability rate, least twice that collagen binding. Conclusion These findings part explain diagnosis.