Sorry, Midge, incorrect assumption that the lab provides a gilt service!
Robert
> -----Original Message-----
> From: GP-UK [mailto:[log in to unmask]] On Behalf Of Adrian Midgley
> Sent: 01 September 2004 23:41
> To: [log in to unmask]
> Subject: Re: Anticoagulation Monitoring
>
> On Wednesday 01 September 2004 22:39, Stephen wrote:
>
> > Having started this a few months ago we're rather regretting it although
> > perhaps things will settle down. The machine (machine and strips
> > provided by the PCT) we have in the surgery consistently reports INR
> > levels of 0.5-1 points below the hospital lab reading on the same
> > sample, resulting in patients who were previously stable for months
> > having dosage changes and weekly recalls.
>
> It seems vanishingly likely that there has been a change in the patient,
so I
> would have thought this is part of your calibration of the test-system
> against the gilt standard the lab provides.
>
> Once you know the calibration curve of the system, you can read the truer
INR
> off a graph or chart and substitute that into whatever you use.
>
> I tend to make changes in dose on the close order of 1 mg per week, which
> makes me wonder how often there would be any point in recalling people
after
> so little time as a week - having had one mg more or less than they would
> before the change.
> I suggest that the time to retest is not before they have had say 10mg
more or
> less than they would have if no change had been made.
>
> I have some code of my own that I don't like enough to use, and just use a
> template in the database to make admin easier - if there was an Open
Source
> tracking system that interfaced with our master patient index I probably
> would use it. I don't care to use two separate patient indexes though.
>
> --
> Adrian Midgley Open Source software is better
> GP, Exeter http://www.defoam.net/
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