Cost-Effective Use of the Protein S Algorithm in Thrombophilia Testing

Authors

Marian A. Rollins-Raval, Department of Pathology, University of New Mexico Health Sciences Center, TriCore Reference Laboratories, Albuquerque, NM
John V. Mitsios, Siemens Healthcare Diagnostics Inc., Tarrytown, NY
Richard A. Marlar, Department of Pathology, University of New Mexico Health Sciences Center, TriCore Reference Laboratories, Albuquerque, NM

Document Type

Article

Publication Date

5-4-2022

Abstract

BACKGROUND: One of the most complex risk factors for the laboratory assessment of thrombophilia is Protein S (PS). The testing algorithm for PS employs the plasma-based assays of free PS antigen, total PS antigen, and PS activity creating a complex diagnostic scheme that can lead to misdiagnosis if incorrectly used, and a potential waste of resources and money.

CONTENT: This paper compares the recently published evidence-based algorithm from the International Society for Hemostasis and Thrombosis (ISTH) with several commonly performed nonevidence-based testing schemes, to demonstrate the efficiency of the evidence-based algorithm for diagnostic efficiency with improved patient care and increased cost savings for the laboratory.

SUMMARY: Significant savings (31%-60%) can be realized when the evidence-based algorithm is used in place of other testing modalities of initial PS activity testing (31%) or testing with all 3 assays simultaneously (60%). This study utilizing the PS testing evidence-based algorithm as part of a thrombophilia evaluation demonstrates that the appropriate testing methods can be used to limit wasteful practices while achieving the maximum level of information in this time of limited resources and need for increase monetary savings.

Recommended Citation

Rollins-Raval MA, Mitsios JV, Marlar RA. Cost-Effective Use of the Protein S Algorithm in Thrombophilia Testing. J Appl Lab Med. 2022 May 4;7(3):794-802. doi: 10.1093/jalm/jfab175. PMID: 35060606.