CLSI H47-A2

Clinical and Laboratory Standards Institute document H47-A2--One-Stage Prothrombin Time (PT) Test and Activated Partial Thromboplastin Time (APTT) Test; Approved Guideline--Second Edition describes the principles and procedures necessary for the routine performance of the PT and APTT by conventional techniques using citrated plasma. Each of the two tests measures the time for a fibrin clot to develop in test plasma after activation. The chemical reactions are complex and, characteristically, results are affected by preexamination (preanalytical) and examination (analytical) variables. The PT and APTT are important screening tests used in laboratory evaluation of patients suspected to have disorders of blood coagulation, including the presence of circulating coagulation inhibitors. The PT measures the extrinsic or tissue factor pathway of the coagulation system and is used to monitor oral anticoagulant therapy. The APTT measures the intrinsic coagulation pathway and is used in monitoring heparin therapy. The objective of this guideline is to improve test reproducibility through standardization of technique and ensure clinical relevance by setting test performance goals. The document also highlights the international effort for standardization of the PT through the use of the international normalized ratio (INR).