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12 years of testing weekly 624 tests is probably much less than an anticoagulation clinic (sill often called a Coumadin clinic) would do in a few weeks. These meters HAVE to be robust. They have to keep running,. They have to be accurate.
but would a clinic use a Coaguchek or something like an i-Stat?

I know that the local nursing home (less than 200 residents) has a INRange, and I recall that on the ward at the hospital which did my valve they used a Coaguchek. But I'm curious to know what a commercial lab uses.

I recall that the INRange has something like a 5000 test block out where you need to return it to Roche for inspection, searching isn't working for me at the moment. However lets say that on average (because I do test more than weekly occasionally I would be somewhere between 2 tests a week (averaged) and 1.
12 x 52 x 2 = 1248 tests in the time I've had it.
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One of the anticoagulation clinics that I was FORCED to go to by my HMO used CoaguChek XS exclusively.

A decade ago, the clinic at UCLA Holy Cross alternated between Hemochron and Protime meters. These were considered to be the most accurate (the Hemochrom was certified for use in operating rooms). I have no idea whether this clinic eventually moved to the XS.

I've been to a few doctor's offices and convinced them that I self test and self manage, so they didn't try to force me into using their in house services (they use the XS), or a blood draw at a lab. The test in the office is faster.

I have an XS Pro, designed for hospitals, recording patient ID numbers (it has a strip reader) and ID for the person running the test. I'm not sure how many tests it stores in memory, or what's supposed to happen to it when the memory is full (like the InRange, perhaps it has to be sent to Roche for calibration). There IS a test mode that runs a test against known samples and confirms that the meter is still accurate.

But, again, some (or at least the one that I was forced to go to) anticoagulation clinics ARE using XS meters for INR testing. They have more than one meter at each location and I'm guessing that they run 60 or 80 tests each week.