A survey of coagulation laboratory practice in Thailand: The first step to establish a National External Quality Assessment Scheme (NEQAS) for blood coagulation

Abstract

Background: External quality assessment (EQA) is an essential component of laboratory quality assurance. In Thailand, there is no EQA program for coagulation tests at the national level. Objective: To collect the necessary data in the first step to set up a National External Quality Assessment Scheme (NEQAS) and to assess the status of coagulation laboratory practice in Thailand. Material and Method: Questionnaires were sent to hospitals to obtain information about the hospitals, their coagulation laboratory practice and EQA. Results: From a dispatch of 220 questionnaires, 124 (56.4%) were returned. Of the 112 hospitals that had coagulation tests, all of them performed prothrombin time (PT), and 110 laboratories performed activated partial thromboplastin time (APTT) as well. Thirty eight percent of laboratories still used 3.8% sodium citrate as the anticoagulant for coagulation tests. The majority of laboratories (65%) reported normal control value with the patient results. Only 42% of coagulation laboratories established their own reference range. The denominators of PT ratio and APTT ratio calculations were derived from several sources apart from the mean of normal subjects. Seven of 112 (6%) laboratories participated in an EQA program. Conclusion: The present survey represents an overview of the current laboratory practice for coagulation tests in Thailand. Improvement is necessary, and the survey results emphasize the need for establishing an EQA program in Thailand.