I like the Coaguchek XS

[Gail in Ca]

I am very happy with my new machine, the Coaguchek XS. Compared to the Protime, it only requires one drop of blood, and it works very fast to give the result. It warms up very fast and then only takes seconds to beep with the INR result. Also, the lancet is so much smaller, and I don't even need a bandaid! The strips don't need to be refrigerated. Also, the waste is much less, which is good when we have to use the sharps containers. What a nice upgrade from the Protime. I'm glad my insurance paid for it.

 

[Protimenow]

One brief thought -- you mentioned in another post that you are using the five channel ProTime cuvettes. I've been using the three channel cuvettes since I got the machine, and they apparently require considerably less blood. I've never used a bandaid with those tests.

I agree, though, that the CoaguChek meters are faster and use less blood. I found this out with my CoaguChek S. Now, if I can get an XS or an InRatio, I may have to think seriously about retiring my ProTime and ProTime 3.

(One other benefit that the CoaguChek S, and probably the XS has is a softer beep. The loud beep on my ProTime meters upsets one of my dogs. The CoaguChek doesn't bother her.)

 

[Bina]

Yes Gail, the Coaguchek XS seems to be the Cadillac of home monitors.

 

[lance]

Biana and Gail
You're absolutely right. XS is the best thing to come down the pike in a long, long time.

 

[ALCapshaw2]

My Coumadin Clinic recently changed from their professional model tester to Coaguchek XS.

For INR Readings above 4.5, they require a Veinous Draw for 'verification'.
I have seen instances where the XS read 5.0 or 5.1 but the Lab Draws reported 4.0
I got the impression that from their study of Finger Test instruments they all had some 'disagreement' compared with Vein Draws, especially at the higher numbers. Fortunately, the variation is less for lower (IN RANGE) numbers.

'AL Capshaw'

 

[Protimenow]

There are papers on the Roche site (and also on the ProTime site) that report the higher variations for values above 3.5 or 4. It's apparently a characteristic of the testing technology used by the XS.

 

[lance]

Hi Al,
The discrepancy between vein ans XS comes as a surprise.
Spouse and I use the XS and did comparison tests every 6 months as required. The vein draw was done in the hospital lab tested within 2-3 hrs. The greatest discrepancy was .2 and frequently they were identical. We are both within our appropriate ranges.
NOW
The vein draw blood was taken to a city about 40 miles away and test results took 3 1/2 days. The discrepancy was .8.
You may guess what I think about comparison draws under these circumstances and under what circumstances I will submit myself to one.
Cheers

 

[ALCapshaw2]

Lance -

The mathematical calculation for INR involves an exponential function which translates to "the higher the number, the greater the potential variation". My clinic personel seem confident that In-Range Numbers are reliable.

FWIW, the Blood Draws at my clinic are sent via pneumatic tubes (similar to those at Bank Drive-Ins) to the main hospital lab (1 block away) and results come back in an hour or two.

'AL Capshaw'

 

[lance]

Al,
That's great. Home monitoring in Ontario is still in the age of dinosaurs. The word isn't getting out or if it is it's not believed. Monitor results are suspected of being inaccurate. These monitors are excellent--everyone on warfarin should have one.
FWIW???? What does it mean.
I think results of every blood draw should be known the same day.

 

[Protimenow]

The discrepancies reported came from University or other labs that took a venous blood draw at practically the same time as the capillary draw from the finger. The handling of the venous blood shouldn't have been an issue in this type of testing. For some reason, however, there WAS a difference between lab results and meter results.

From personal experience, using a CoaguChek S (which hasn't had quality controls set for it), and a ProTime 3 (with quality controls built into the test strips), I've had mixed experiences. One pair of tests, minutes apart, matched exactly. Another was quite a bit off.

I think the clinic's practice of verifying high values that a meter finds with a venous blood draw is a good idea.

However, as noted previously, there IS a recorded difference above 3.5 or so, from lab results and CoaguChek S an XS results.

 

[ALCapshaw2]

FWIW = For What It's Worth

 

[COLLEEN S]

I love my Coaguchek XS! Less trips to the cardio who is 1.5 hours one way, and anytime I take a new med or supplement, I can check it on the machine to see if I'm still in range. Of course I report my INR results to the cardio's office on a regular basis and inform them of any new meds or supplements I am on.

 

[Bina]

The discrepancies reported came from University or other labs that took a venous blood draw at practically the same time as the capillary draw from the finger. The handling of the venous blood shouldn't have been an issue in this type of testing. For some reason, however, there WAS a difference between lab results and meter results.

From personal experience, using a CoaguChek S (which hasn't had quality controls set for it), and a ProTime 3 (with quality controls built into the test strips), I've had mixed experiences. One pair of tests, minutes apart, matched exactly. Another was quite a bit off.

I think the clinic's practice of verifying high values that a meter finds with a venous blood draw is a good idea.

However, as noted previously, there IS a recorded difference above 3.5 or so, from lab results and CoaguChek S an XS results
.

False...unless you are referring to ONLY the S model that you have experience with.
Different hospitals and labs can still use a slightly different reagent so we don't make such broad statements hastily.
The new XS gives me identical readings when back to back testing was done with in range INRs at my hospital lab. The highest I have ever tested was a 4.3 and when I lowered my weekly dose by 5% it got me right back in range without any comparison testing at the lab.
This just goes to show that we need to stick with ONE monitor, trust it, and learn from it.

 

[Protimenow]

Bina:

From what I recall, independent tests available at the ITC site (the people who make the ProTime meters) also showed similar discrepancies with the XS.

I fully agree with you (although I don't always follow your advice) - get one meter, learn the meter, and stick with it.

 

[Bina]

Bina:

From what I recall, independent tests available at the ITC site (the people who make the ProTime meters) also showed similar discrepancies with the XS.

I fully agree with you (although I don't always follow your advice) - get one meter, learn the meter, and stick with it.

Over the years, this topic has been discussed at length and I am confident that my XS won't show any significant discrepancy until it gives me a reading of 5.0 or above.

 

[lance]

Protimenow
Hello there
I can't help but notice a couple of discrepancies in this post.
1. Coaguchek S while not having on-board controls does require the use of Chemical controls and the use of the Electronic Quality Control test meter. Do you have them?
I took my INR at 8:00 a.m. at 4.2. Unfortunately I was admitted to the ER just after 11 a.m. Of course, they wanted a vein draw. Their result was 4.1

So I suppose the INR result would have to be much higher to support your statement.

UOTE=Protimenow;475915]The discrepancies reported came from University or other labs that took a venous blood draw at practically the same time as the capillary draw from the finger. The handling of the venous blood shouldn't have been an issue in this type of testing. For some reason, however, there WAS a difference between lab results and meter results.

From personal experience, using a CoaguChek S (which hasn't had quality controls set for it), and a ProTime 3 (with quality controls built into the test strips), I've had mixed experiences. One pair of tests, minutes apart, matched exactly. Another was quite a bit off.

I think the clinic's practice of verifying high values that a meter finds with a venous blood draw is a good idea.

However, as noted previously, there IS a recorded difference above 3.5 or so, from lab results and CoaguChek S an XS results.[/QUOTE]

 

[Protimenow]

My comment was that the CoaguChek S did not have quality controls built into the strip. Yes, I know that they yave a liquid quality control for the meter. The point was hat the strips on the S didn't have the QC built in.

The statement I made about discrepancies between higher reported levels using the CoaguChek S compared to lab values wasn't about something I made up -- it was from lab tests of the blood compared to the meter's reported values.

I've tested once using the CoaguChek S and the ProTime 3 and got the same values. The thing to remember with the CoaguChek S is that they want the first drop of blood, within fifteen seconds of making the incision. Outside of those parameters, there may be errors.

And, yes, I also stated that confirming high values with a blood draw is a good idea. Because the ProTime seems to be more accurate at higher values, it may also not be bad to confirm high values with a ProTime, if you have one.

So - becauuse the original post in this thread was about the XS, I guess the point to be made is that a value above 4.0 (or maybe higher), might be higher than it actually would be on a lab test (as long as the blood is properly handled on its way to the lab).

 

[Gail in Ca]

I wasn't informed by my teaching nurse about a reading over a certain number having to be verified by a vein draw. I haven't read that in the literature that comes with the meter, either.
Good to know. I am glad my range now is lower due to the valve being placed inside the graft, no stitching to create problems with clots.
I did have an incident with my Protime 2 yrs ago when I was getting BE and didn't know it. My Protime read 6.6, I called urgent care and said I would stop coumadin and retest in 2 days.
Two days later, my machine wouldn't give a reading, only an error code, which I had to call QAS about. They told me it meant my INR was over 12 if the Protime wouldn't read it. However,
when I went to the urgent care, my INR was 9.3, I'm not sure if this was the vein draw or their Coaguchek xs meter. Maybe all machines are wacky at a higher range? I would hope to be informed of this. I will ask the nurse in the Coumadin clinic next time I talk to her.

 

[Protimenow]

Sorry, I'm not familiar with what BE is (battery error?). From what I recall in the ProTime manuals, they give an error message when the INR is 9 or above. The test wouldn't run, and you'd get an error message.

Because these meters only use the installed rechargable batteries, your meter probably SHOULD have been charged when you tried to run the test, although the batteries used in the older meters could, eventually, stop working if the meter has gone through a LOT of charge/discharge cycles.

Whether the ProTime read 6.6 or 9.3, this should have probably warranted some caution and dosage modifications - if even for short term. (Years ago, my doctor told me to be very careful because my blood was too anti-coagulated. My dosage was changed slightly. I seem to recall that my INR was something around 7.1 - though I'm not sure. In any case, the lab informed the MD quickly, and the MD called me right away).

I'm not sure about ProTime errors at high values - but whether the meter shows an 'out of range' error, or the lab shows a 9.3, it's still cause for serious concern.

It seems like always good practice to verify high readings from whatever meter is used for the test - although the decision to repeat the test or run a lab test should of course be left to a professional to make.

 

[lance]

Hi Gail
The more out of range--higher and lower--the less accurate test results are. This probably applies to vein drawa as well as POC monitors. My gosh 12. I'm glad you got it down.