New Coag-Sense meter

Protimenow

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I'm not sure how many visit this site, or how often, but I'd like to say that Coag-Sense (my most trusted meter) has just received FDA approval for a new meter - the PT2. It's more compact than the meter that I've been using for years, and has many new features that seem to put it ahead of other meters available in the United States.
I haven't gotten my hands on one, but the coag-sense website has posted information about it (coag-sense.com).

Once I've been able to do some testing with it, I'll probably post a review--if there's anyone out there who wants to learn more about this new meter.

I may watch for replies.
 

LondonAndy

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Definitely interested, though I am not sure the Coag-Sense is available in the UK. I have only ever used a CoaguChek XS, which they have now replaced with the CoaguChek Inrange, which again is INR only.
 

Protimenow

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I don't know about CoagSense outside the United States. You can get more information on the CoagSense site - coagusense.com, coag-sense.com. I now have the new model - CoagSense PT2. It's probably the most advanced PT/INR meter currently available (although I don't know a lot about the CoaguChek InRange). This new meter is compact. I don't have an InRange to compare it to. The CoagSense IS portable -- if I had any need to test while traveling, it would fit nicely in any carry on or traveling bag. The meter has WiFi, USB, Bluetooth, an Ethernet port, and an NFC reader. The NFC reader is used to scan the lot and barcode numbers from the bottom of a box of strips -- switch to a new box, and it's easy to accurately enter the codes. The ports are useful for reporting results and doing firmware upgrades. You can also attach a proprietary printer or barcode scanner. (These features should make the meter attractive to clinics, hospitals, doctors' offices, and other locations that use the meters). A color display helps guide you through testing and setting the meter up. Results can be viewed in a chart, or the actual numbers. Each result shows the strip lot number, prothrombin time, INR, and time and date of the test. This new meter can hold 2000 results -- again, a feature that's good for professional offices (for self testers doing a test a week, we're looking at decades of stored results -- by the time you get anywhere NEAR that number, the lithium battery will be unusable, you may be able to check your INR with a small touch sensor, and global warming may have killed everyone off). The lithium battery that is built into the unit is charged with mini-usb and can do up to 200 tests. I like this meter. It takes a minute or two to start (as opposed to almost immediate start-up for the original meter), and it seems like almost fun to use. Tests aren't any faster (because it's still testing ACTUAL clotting time on either meter), but better memory storage, not having to face the 'replace batteries' message, color touchscreen display, and overall 'sexiness' make this my new favorite meter. For users and clinics in the United States, there seems to be an issue with current strips not being usable in the new PT2 meter, but I'm sure CoagSense will probably resolve this. I've tested many meters - from the original Protime, through InRatio 1 and 2, updated ProTime, CoaguChek S and XS, and the two CoagSense meters. I determined, years ago, that CoagSense compared most closely to blood draws of all the meters I've tested. This new meter just pushes the technology for professional testing and self testing to another level.
 

LondonAndy

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I agree it is a sexy meter! I watched their video and it looks good as well as having some cool features. Just seems a bit more is involved for doing each test, transferring the blood via a sort of pipette whereas the CoaguCheck XS is a drop of blood directly to the test strip of course.

I am content with the XS meter's slightly less accurate readings which I don't consider significant to my treatment, but it is good to keep abreast of what else is coming onto the market for the day I am looking to replace it. No sign of that at 4 and a half years old so far, I am pleased to say.
 

Protimenow

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Yes. It's a slight extra step. Instead of touching your finger to the XS strip, you touch the transfer tube to your finger, and it draws the drop of blood into the tube. The extra step: place the tube into the well on the strip and press the plunger. Yes, it's an extra step, but, to me, the accuracy is worth that extra step. (OTOH - if your drop of blood when you touch the side of the XS strip isn't adequate, the test fails, and you end up wasting a strip - with the Coag-Sense, you KNOW when enough blood has been collected, because you can SEE it in the transfer tube). Also - Coag-Sense strips are individually wrapped - there's no damaging other strips if you don't cap the tube holding the strips quickly or firmly enough.

Neither of the points above would probably motivate you to change meters. Because your XS is working for you, and you're comfortably in range, you'll probably want to stay with it.
 

Thomas

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I am content with the XS meter's slightly less accurate readings [/QUOTE said:
Since I'm in the middle of doing research on which system to purchase so I can start testing at home, could you or someone elaborate on the differences in accuracy between systems like the Coag-Sense and Coaguchek.

Also, is there a calibration option so that you can make adjustments to the home unit or at least know that there's a consistent discrepancy over a bit of time that you can rely on?
Thanks.
Thomas
 

tom in MO

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Thomas;n886934 said:
Since I'm in the middle of doing research on which system to purchase so I can start testing at home, could you or someone elaborate on the differences in accuracy between systems like the Coag-Sense and Coaguchek.

Also, is there a calibration option so that you can make adjustments to the home unit or at least know that there's a consistent discrepancy over a bit of time that you can rely on?
Thanks.
Thomas
I believe that INR meters are self calibrating using materials on the disposable strip. That's why you don't need to send your meter back for "calibration" and you don't really need to compare your meter reading to a office blood draw...which could be read on a meter as well :)
 

LondonAndy

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Hi Thomas. You will find many posts about the issues of measuring INR, particularly by Pellicle who has much more biology knowledge than I do. Here's my take as an amateur with about 4.5 years of experience of self testing.

I think it is a reasonable summary to say that CoaguChek XS readings are about +/- 0.2 of a well processed lab result from a blood draw taken at an anti-coagulation clinic. It seems from my own experience and comments by others here that the meter is more likely to show 0.2 BELOW a lab result. So if, like me, you are on a therapeutic range of 2.5 to 3.5, a result of 3.0 could be 2.8 or 3.2. I am content with that - it is sufficient for me to confirm I am comfortably in range and don't need to make any changes.

If the meter result was 2.7 then I would not be quite so happy, because that might mean the reading is really 2.5. I would increase my dose by 1mg or maybe 2mg for one day to get it closer to the centre of my therapeutic range.

Personally I am more concerned about low readings than high readings - I would not mind if a result was 3.6, for example, as for me, somebody who does not do activities such as contact sports or hiking that might give rise to injury and "bleed outs", a low INR is a greater risk of stroke.

There is no adjustment possible with the CoaguCheck XS. It is worth noting that in the UK this meter is the only one approved by our national regulator, and is seen as the "gold standard" of INR monitoring. See this report for details, and the massively better outcomes than less frequent testing at clinics.
 

Thomas

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Thanks for the response gentlemen.
Since we're trying to stay within a range (2.5-3.5 with a target of 3.0 for me). It would seem that a result within .2 is a reasonable variation from a lab result. As you say L.A., higher is better. Assuming the manufacturers are striving for the most accurate and consistent readings possible, either of the two mentioned companies products would be good.
I know the CoaguChek line is offered in Canada. I'm not sure about the Coag-Sense. I haven't been able to find it locally online yet.
 

pellicle

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Hi

Thomas;n886938 said:
Since we're trying to stay within a range (2.5-3.5 with a target of 3.0 for me). It would seem that a result within .2 is a reasonable variation from a lab result.
I would agree and think this is a very sound assessment. An important part of understanding INR is that its meaningless to consider differences of less than (say) 0.2 because 1) there just isn't sufficient accuracy in the system anywhere 2) it makes essentially no difference to you in outcomes of any kind.

Once you consider how the number is produced you need to delve into a world of reagents and chemistry and physical movement cessation determining that shows that this is no "Vernier Caliper" for measuring the thickness of steel here. Consider this document:


which makes it clear that depending on reagent used there will be quite some variation in readings.

Then there is the notion of "clinically significant difference" in obtained reading. For instance if your INR was 3.1 or 3.3 would that make any difference to your response to that reading? What if it was 3.9 or 4.1?


So my approach has been two fold: use the meter I have which was available to me and which has a good and convenient supply of strips. In my case this was the Roche (I'm Australian and its to my knowledge the only one on our market) and secondly to go to get a blood draw periodically to compare with it. That's typically 6months or yearly for me.

I don't know if you're self managing your dose (I have been for at least 7 years now) and have written up a few notes on my blog to assist any who find it.

http://cjeastwd.blogspot.com/2014/09/managing-my-inr.html

indeed you'll see a Label cloud on the left (unless using a phone which is a shitty internet experience anyway) where you can find topics under tags, everything I've written about INR is under the label of INR http://cjeastwd.blogspot.com/search/label/INR

It seems your already on the right path to me ;-)
Best Wishes
 

Jamey T

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I did see that new meter, and I am considering it. I have to say, that when I find something that works well for me, I am a little resistant to change. My current CoagSense is very accurate for me so I am not in a hurry to buy the new one.
 

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