COLLEGE-OF-AMERICAN-PATHOLOGISTS CONFERENCE XXXI ON LABORATORY MONITORING OF ANTICOAGULANT-THERAPY - LABORATORY MONITORING OF ORAL ANTICOAGULANT-THERAPY

Objective.-To review the state of the art of laboratory monitoring of oral anticoagulant therapy, as reflected by the medical literature and the consensus opinion of recognized experts in the field, and to make recommendations for improvement in laboratory monitoring of oral anti coagulant therapy. Data Sources.-Review of the medical literature, pri marily from the last 10 years, and current laboratory practices by a p anel of 8 international experts in the field of oral anticoagulant mon itoring. Data Extraction and Synthesis.-After an initial assessment of the literature, key points were identified. Experts were assigned to do an in-depth review of the literature and current practices relevant to each of the key points and to prepare a summary of their findings and recommendations. A draft manuscript was prepared and circulated to every participant in the College of American Pathologists Conference XXXI on Laboratory Monitoring of Anticoagulant Therapy prior to the co nference. Each of the key points and associated recommendations was th en presented for discussion at the Conference. Recommendations were ac cepted if a consensus of the 26 experts attending the Conference was r eached. The results of the discussion were used to revise the manuscri pt into its final form. Conclusions.-Consensus was reached on 12 recom mendations concerning the laboratory monitoring of oral anticoagulant therapy. Detailed discussion of the rationale for each of these recomm endations is found in the text of this article. Discussion of points o n which consensus was not reached is also included in the text. It is hoped that widespread adoption of these recommendations will further i mprove the laboratory monitoring of oral anticoagulant therapy.