My current favoirte meter

[Protimenow]

I've started a thread asking for input on your favorite meter (many of you have upgraded in the past), but have seen ZERO response.

I've been fortunate enough to be able to try the ProTime Classic, Protime 3, CoaguChek S and, recently, the InRatio. I've also been fortunate enough to get a supply of InRatio strips.

I'm voting for my current favorite - the InRatio.

I have a few reasons:

Ease of use - it's pretty simple to get that relatively small drop of blood onto the strip

Built-in Quality Controls - I like the fact that it runs two controls during each test.

Good tech support - in dealing with the Hemosense people, I wasn't made to feel like an
idiot for having a question about it or a criminal because I didn't get my meter retail

Easy strip storage - no need for refrigeration except during VERY HOT summer days

Doesn't time out if the strips expire - Although I have current strips, I was able to use the meter with strips that have expired -- the meter didn't refuse them like the ProTime and ProTime 3 do

While the ProTime and ProTime 3 also had quality controls built into the strips, the strips required refrigeration, were more expensive than InRatio strips, and took considerably more blood. The meter also refused to use expired strips -- even though they had quality controls and would have been usable. Changing the data on the meter allowed me to run tests, and quality controls showed no issues.

I had issues with the CoaguChek S. Strips require refrigeration. The meter is designed ONLY for medical practitioners. Liquid or an electronic quality control are supposed to be run each day before use. I had a hell of a time getting the blood drop onto that tiny strip.

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The InRatio 2 sounds interesting - and one day, perhaps I'll get one - but the differences are small, according to the company. The meter is smaller, it stores more results, and the test runs more quickly. The meter uses icons, instead of text prompts - which may be more important to the company than to the users, because they don't have to bother with support for people who accidentally end up with the wrong language when they get their meters.

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I've heard that the CoaguChek XS is even better. However, for me, the InRatio seems to be all the meter I'll be needing for quite some time.

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(ITC is supposed to be awaiting approval for a new meter that has many of the features that we all seem to like -- but there's still no date on when it'll be approved and become available.)

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I've packed up my ProTime and ProTime 3 and put them into storage. I'm not sure what to do with the CoaguChek S (in part because there will be NO strips after April 2012 and no vendor support after October 2011).

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I'd be interested in hearing about YOUR favorite meter...

 

[bdryer]

Hi

I will be home testing after my late Jan surgery, for replacement of the AV and ascending aorta. Bina has stated thru our messaging that she is very happy with the CoaguChek XS. They carry this device in my home city, at a local pharmacy. They also provide the training. Presently, this is what I am considering.

 

[Protimenow]

From what I'm seeing on the forum, the CoaguChek XS is a good choice. Many seem to prefer this meter. I know that it's easier to get the blood onto the strip than the InRatio because you only have to touch the drop of blood to the side of the strip, rather than dropping it on or touching it from above.

It's good to hear that a local pharmacy carries the meter and does the training.

Good luck wih your surgeries.

 

[Marty]

My INRatio functions perfectly after five years frequent use by Alice and me. I can now get strips without prescription for @ $4.40 from Amazon. No problem with blood drop onto green light. I give it five stars.

 

[Protimenow]

It took me a bit more experimenting to find the right spot on my finger to incise, but I'm getting the right sized drop, too. My first few tests seemed to take two strips to get it right -- and two finger incisions. With practice, I'm pretty sure I'll be doing one strip per test. Yes, I also prefer the InRatio over the others I've used so far.

You may be able to save a few dollars if you go to eBay instead of Amazon but, of course, this is entirely your choice.

 

[Duff Man]

what do you folks think about the study that showed where the higher the INR is, the higher the rate of inaccuracy with a bias toward the high side?

here's the link to it:
http://www.protimesystem.com/support/A_Comparative_Evaluation.pdf

I wasn't able to find a coaguchek xs comparative evaluation, so i'm not sure if this is par for the course with the newer meters

 

[Protimenow]

I've read that study a few times in the past. Now, with the perspective of an InRatio user, I've read it with a slightly different set of eyes.

One thing that struck me was the description of the method. It wasn't clear that the blood collection for the InRatio was different from the one for the ProTime 3. In fact, these meters use different methods for determining INR. The ProTime requires that you discard the first drop of blood, and then collect a fair amount in a special cup that is part of the incision device (tenderlette). The InRatio wants the FIRST drop of blood, and it should be applied within fifteen seconds of making the incision. (The CoaguChek S and XS also want that first drop of blood, and want it fairly quickly after incising)

The InRatio factors in the platelets and other clotting factors just under the skin, while the ProTime discards those factors and wants 'capillary' blood that is more closely similar to venous blood, because the platelets and other clotting factors are discarded.

If the testing by this group discarded the first drop that would otherwise have been used by the InRatio, it can be expected that INRs would be reported to be higher than the ProTime meter because the InRatio is designed to expect faster clotting from the first drop of blood. The paper you listed didn't make it clear whether the required blood collection procedure was used by the InRatio.

The paper also noted that there were more 'failed' tests with the InRatio than with the ProTime 3. The failures were primarily 'not enough blood' errors in the InRatio. The ProTime cuvettes use a cup on the collection device that must be filled, then attached to the meter. The amount of blood is quite a bit more than that for the InRatio, and it's pretty obvious whether or not the cup is adequately filled. It's harder to tell with the InRatio, which uses what they call a 'hanging drop'. Use of a capillary collection tube that indicates whether or not enough blood has been collected should reduce the failures of the InRatio due to inadequate sample size.

There are a few reports that show the InRatio results being higher than venous draws above 2.5 or higher. The higher the value is, the more error is possible. At many labs, a reading above 4 (or so) prompts confirmation with a blood draw.

Having used the ProTime and ProTime 3 meters for about 20 months, I've been pretty confident in the assumed accuracy of the meter. Because of the design of the collection device, I've had few failed tests - although getting enough blood from finger to tenderlette has sometimes been a problem. Also - because I had to 'milk' my finger to get enough blood, interstitial fluid in the finger may have mixed with the capillary blood and, possibly, caused an erroneous result. The InRatio, to me, seems faster and easier to use than the ProTime3.

The report also said that at higher INRs, the results of the InRatio may be as much as .4 INR higher than the lab draw. I'm not sure if this would bother me much - unless it reported an INR of 4 or higher.

(I think that the InRatio site may have some results comparing the InRatio to the CoaguChek XS - and Roche may also have some comparative reports.)

The newer meters apparently overreport values for higher INRs. (Perhaps newer firmware will accommodate for these errors)