We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress hp
Sign In
Advertise with Us
PURITAN MEDICAL

Download Mobile App




Streamlined Approach to Testing for Heparin-Induced Thrombocytopenia Improves Diagnostic Accuracy

By LabMedica International staff writers
Posted on 07 Jan 2025

Heparin-induced thrombocytopenia (HIT), a serious side effect of the blood thinner heparin, is difficult to diagnose because thrombocytopenia, or low platelet count, can be caused by a variety of factors and is common among hospitalized patients. More...

Although only 1%-5% of patients on heparin develop HIT, those who do are at significant risk for life-threatening complications such as bleeding or heart attacks. It is essential for doctors to identify which cases are directly linked to heparin, so they can switch those patients to alternative blood thinners. However, non-heparin anticoagulants are costly and difficult to monitor, so clinicians prefer to reserve them for those who truly need them for safety. The challenge is compounded by the fact that two lab tests are used to diagnose HIT. The ELISA (enzyme-linked immunosorbent assay) test helps rule out non-HIT cases, while the Serotonin Release Assay (SRA) is considered the gold standard for confirming HIT. However, since the SRA is expensive and only available at specialized labs, clinicians often rely on a combination of ELISA results, patient symptoms, and other clinical information to arrive at a diagnosis.

Now, a new study by researchers at University of Iowa Health Care (Iowa City, IA, USA) has found that a simplified version of the standard screening method for HIT outperformed the full technique in identifying affected patients. This study provides compelling evidence that systematic, data-driven healthcare approaches can improve patient care while saving time and resources. The research, published in ADLM’s Journal of Applied Laboratory Medicine (JALM), emphasizes the importance of diagnostic stewardship, a collaborative effort to enhance clinical laboratory testing. In the study, the team analyzed lab results from 1,011 ELISA tests and 169 SRA tests conducted between December 2016 and December 2021 on patients in the University of Iowa Health Care System.

The researchers specifically compared two methods for interpreting ELISA results, using optical density (OD) measures to detect HIT-specific antibodies. The first method, called "percent inhibition," involves testing samples under both high- and low-heparin conditions, following the manufacturer's guidelines. The second, simpler method, called "low-heparin OD," only uses the low-heparin preparation, making it faster, easier, and less resource-intensive. The researchers discovered that the low-heparin OD method more accurately identified true HIT cases (confirmed by SRA) compared to the percent inhibition method among patients with positive or ambiguous ELISA results.

Since the more complex method showed no additional benefits, the health system updated their ELISA reporting guidelines in 2023 to recommend only the low-heparin OD approach. The researchers then compared HIT test results from two 5-month periods: one before and one after the change. They found that the new approach reduced the rate of ELISA positivity from 13% to 5% and decreased the number of SRA confirmatory tests ordered, indicating more efficient use of testing resources and a likely reduction in the unnecessary administration of non-heparin anticoagulants. Additionally, in the pre-intervention period, 7 out of 9 (78%) positive or ambiguous ELISA results were followed by an SRA confirmatory test, while only 3 out of 7 (43%) were in the post-intervention period.

“Elimination of the heparin-inhibition step significantly simplifies manual work for laboratorians performing the testing, saves reagent costs, and increases testing throughput,” wrote lead study author Dr. Meredith G. Parsons. “The removal of heparin inhibition also simplifies ELISA reporting and increases its utility for clinicians in guiding next steps in patient management.”


New
Gold Member
Quality Control Material
iPLEX Pro Exome QC Panel
Serological Pipet Controller
PIPETBOY GENIUS
New
Gold Member
Blood Gas Analyzer
Stat Profile pHOx
New
Host Response Immunoassay Test
MeMed BV
Read the full article by registering today, it's FREE! It's Free!
Register now for FREE to LabMedica.com and get access to news and events that shape the world of Clinical Laboratory Medicine.
  • Free digital version edition of LabMedica International sent by email on regular basis
  • Free print version of LabMedica International magazine (available only outside USA and Canada).
  • Free and unlimited access to back issues of LabMedica International in digital format
  • Free LabMedica International Newsletter sent every week containing the latest news
  • Free breaking news sent via email
  • Free access to Events Calendar
  • Free access to LinkXpress new product services
  • REGISTRATION IS FREE AND EASY!
Click here to Register








DIASOURCE (A Biovendor Company)

Channels

Molecular Diagnostics

view channel
Image: The discovery of early markers for ovarian cancer that would have improved sensitivity could aid detection (Photo courtesy of Adobe Stock)

Highly Accurate Biomarkers Could Detect Ovarian Cancer Before Clinical Diagnosis

Ovarian cancer is a deadly and challenging disease, primarily because early detection is difficult. Most women (70-75%) are diagnosed only after the cancer has already spread, which significantly reduces... Read more

Immunology

view channel
Image: CellLENS enables the potential precision therapy strategies against specific immune cell populations in the tissue environment (Photo courtesy of MIT)

New AI System Uncovers Hidden Cell Subtypes to Advance Cancer Immunotherapy

To produce effective targeted therapies for cancer, scientists need to isolate the genetic and phenotypic characteristics of cancer cells, both within and across different tumors. These differences significantly... Read more

Technology

view channel
Image: The Check4 gene-detection platform (Photo courtesy of IdentifySensors)

Electronic Biosensors Used to Detect Pathogens Can Rapidly Detect Cancer Cells

A major challenge in healthcare is the early and affordable detection of serious diseases such as cancer. Early diagnosis remains difficult due to the complexity of identifying specific genetic markers... Read more
Copyright © 2000-2025 Globetech Media. All rights reserved.