coaguchek xs pt test · the coaguchek xs pt test strips are part of the coaguchek xs system. the...

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05990491001 V 6.0 2016-11 04625374160 6 CoaguChek ® XS PERSONAL USE Purpose The CoaguChek XS PT test strips are part of the CoaguChek XS System. The CoaguChek XS System measures blood‑clotting time for people who are taking anticoagulation medications such as Coumadin ® or warfarin. The CoaguChek XS System uses blood from a fingerstick. The system is intended for properly selected and suitably trained users or their caregivers on the prescription or other order of the treating doctor. Users should be stabilized on anticoagulation medications such as Coumadin or warfarin prior to self‑testing with the CoaguChek XS System. Caution: These test strips are for use outside the body only. Do not eat the test strips. For prescription use only. Before you start testing If you are new to the CoaguChek XS System, watch the CoaguChek XS System Patient Training DVD and read the CoaguChek XS System Getting Started Guide and the CoaguChek XS System User Manual for Self‑Testing before you start testing. Storing the test strips Store the test strips in their original container with the cap tightly closed. You can store test strips at room temperature or in the refrigerator (2‑30 °C or 36‑86 °F). When stored properly, the test strips can be used until the expiration date printed on the test strip container. Throw the test strips away if they are past the expiration date. Handling the test strips When you are ready to test, remove 1 test strip from the container and immediately close the container. Make sure it seals tightly. You must use the test strip within 10 minutes of removing it from the container. Otherwise, you may get an error message and you will have to repeat the test. Step 1: Getting ready to test - gather supplies Materials provided Container of CoaguChek XS PT Test strips 04625374160 Test strip code chip Materials required (but not provided) CoaguChek XS Meter Lancing device and lancets (e.g., ACCU-CHEK ® Softclix lancet device and lancet. Follow the manufacturer's instructions for use.) Place the meter on a flat surface (like a table or countertop) or hold it roughly horizontal so that it will not vibrate or move during testing. Vibrations or other movement can result in an error message. If you are using test strips from a new, unopened box, you will need to change the test strip code chip. The 3‑number code on the test strip container must match the 3‑number code on the code chip. To install the code chip, follow instructions in the Code Chip section of the CoaguChek XS System User Manual for Self‑Testing. Step 2: Getting a good drop of blood Increasing the blood flow in your finger will help you get a good drop of blood. Before you lance your finger, try the following techniques until you see that your fingertip has good color: Warm your hand by holding it under your arm, using a hand warmer, and/or washing your hand with warm water. Hold your arm down to the side so that your hand is below your waist. Massage your finger from its base. If needed, immediately after lancing, gently squeeze your finger from its base to encourage blood flow. Step 3: Performing the test 1. Wash your hands with warm, soapy water. Dry completely. 2. Remove 1 test strip from the container and immediately close the container. Make sure it seals tightly. Do not open a container of test strips or touch a test strip with wet hands. This may damage the test strips. 3. Insert a test strip as far as you can into the meter. The meter powers ON. 4. Confirm that the number displayed matches the number on the test strip container, then press M. If the numbers are different, make sure you are using the code chip that came with the test strips you are using. If they still do not match, call the Roche Diagnostics Technical Service Center at 1‑800‑428‑4674, 24 hours a day, 7 days a week, 365 days a year. 5. An hourglass appears as the meter warms up, which takes up to 30 seconds. 6. When the meter is warmed up, a flashing test strip and blood drop symbol appear and the meter begins a countdown. You have 180 seconds to apply blood to the test strip. 7. Use the lancet device to perform a fingerstick. Set the penetration depth to 5. See the CoaguChek XS System User Manual for Self‑Testing for more information. After sticking your finger, you have 15 seconds to apply blood to the test strip. If it takes longer to form a good drop of blood, lance a different finger for the test. 8. Apply 1 drop of blood to the side of the test strip. It’s important to hold the blood drop to the test strip until you hear a beep. 9. You’ll see the hourglass when the blood test begins. Then, pull your finger away from the test strip. Remember to apply only one drop of blood—don’t add more. Do not touch or remove the test strip when a test is in progress. The result appears in about 1 minute. 10. Record the result on the CoaguChek XS System Prothrombin Time Self‑Testing Log Book. Call your doctor with the test result. 11. Properly dispose of the used lancet and test strip. 12. Power the meter OFF. If you need to redo a test, use a new lancet, a new test strip, and a different finger. Limitations of procedure Information for you and your physician The CoaguChek XS System for patient self‑testing should not be used for patients being treated with any direct thrombin inhibitors, including Hirudin, Lepirudin, Bivalirudin and Argatroban. The CoaguChek XS PT Test for patient self‑testing uses only fresh capillary blood from a fingerstick. The blood drop must be a minimum of 8 μL in volume. Low sample volume will cause an error message. Never add more blood to test strip after test has begun or perform another test using the same fingerstick. When a patient is on intravenous infusion therapy, do not collect fingerstick sample from arm receiving the infusion line. Hematocrit ranges between 25‑55 % do not significantly affect results. Testing has confirmed that PT/INR test results are not affected by: Bilirubin up to 30 mg/dL Lipemic samples containing up to 500 mg/dL of triglycerides Hemolysis up to 1000 mg/dL Clopidogrel (Plavix®) up to 20 mg/dL Fondaparinux (Arixtra®) up to 5 mg/L Heparin concentrations up to 0.8 U/mL Low molecular weight heparins (LMWH) up to 2 IU anti‑factor Xa activity/mL The presence of anti‑phospholipid antibodies (APAs) such as Lupus antibodies (LA) can potentially lead to prolonged clotting times, i.e., elevated INR values. If you have or suspect that you have APAs, contact your doctor. Differences in reagents, instruments, and pre‑analytical variables can affect prothrombin time results. These factors should be considered when comparing results from different test methods. Results obtained with the CoaguChek XS System for patient self‑testing may not consistently correlate with clinical laboratory results, particularly for certain types of laboratory reagents. Your doctor can provide additional information regarding results comparison. In rare cases, patients with long clotting times ( > 8 INR) may receive an “error 7” message on the meter display. If this error message appears again after repeating the test, call your doctor immediately to arrange for testing using another method. The results obtained cannot be used for the determination or the assessment of a therapy with factor II and factor X antagonists. Very low or very high test results The CoaguChek XS PT test strips provide test results if the INR value is 0.8 to 8.0. If the meter displays < (less than) 0.8 or > (greater than) 8.0, repeat the test. If, when you repeat the test, you get the same display (either <0.8 or > 8.0), call your doctor. Error messages Is the meter displaying “ERROR 6”? Sporadically occurring “ERROR 6” are generally due to an activation of the system fail safe mechanisms that are designed to prevent the release of wrong measurement results. However, in rare cases, “ERROR 6” may be received by patients under clinical conditions leading to extremely high coagulation times (> 10 INR, < 5 % Quick), e.g. treatment with warfarin (vitamin K antagonists) in combination with antibiotics and/or chemotherapeutics. If “ERROR 6” is displayed repeatedly, please contact your physician without delay. If you see “error 7”, this means the meter was unable to detect a clot. Repeat the test. Be sure to carefully follow the steps in the CoaguChek XS System User Manual for Self‑Testing. For example, make sure the fingertip is thoroughly dry, use the meter on a surface free of vibrations, and apply the blood drop within 15 seconds of sticking the fingertip. If you still get “error 7”, call your doctor immediately to arrange for testing using another method. If the meter displays any other error message, refer to the Error Messages section of the CoaguChek XS System User Manual for Self‑Testing. Built-in controls The CoaguChek XS System has built‑in quality control functions in the meter and test strips. The meter automatically runs its own quality control test as part of every blood test, so you never have to run quality control tests with liquid quality control solutions. For more information about the built‑in quality control functions, see the CoaguChek XS System User Manual for Self‑Testing. Performance Characteristics Measuring range: The CoaguChek XS PT System has a PT measuring range of 0.8‑8.0 INR and 9.6‑96.0 seconds. Accuracy: A study was conducted comparing test results obtained by trained users with those obtained by healthcare professionals, when both were using the CoaguChek XS System. The correlation was very good, as indicated by the following statistics: N=463, Slope=1.000, Intercept=0.0 and Correlation Coefficient=0.977. This study shows that trained users are able to obtain results that are as accurate as those obtained by healthcare professionals trained in the use of the CoaguChek XS System. CoaguChek XS PT Test

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05990491001

V 6.02016-11

04625374160 6 CoaguChek® XS

PERSONAL USE

PurposeThe CoaguChek XS PT test strips are part of the CoaguChek XS System. TheCoaguChek XS System measures blood‑clotting time for people who are takinganticoagulation medications such as Coumadin® or warfarin.The CoaguChek XS System uses blood from a fingerstick. The system is intendedfor properly selected and suitably trained users or their caregivers on theprescription or other order of the treating doctor. Users should be stabilized onanticoagulation medications such as Coumadin or warfarin prior to self‑testing withthe CoaguChek XS System.Caution: These test strips are for use outside the body only. Do not eat thetest strips. For prescription use only. Before you start testingIf you are new to the CoaguChek XS System, watch the CoaguChek XS SystemPatient Training DVD and read the CoaguChek XS System Getting Started Guideand the CoaguChek XS System User Manual for Self‑Testing before you starttesting.

Storing the test stripsStore the test strips in their original container with the cap tightly closed. You canstore test strips at room temperature or in the refrigerator (2‑30 °C or 36‑86 °F).When stored properly, the test strips can be used until the expiration date printedon the test strip container.Throw the test strips away if they are past the expiration date.

Handling the test stripsWhen you are ready to test, remove 1 test strip from the container andimmediately close the container. Make sure it seals tightly. You must use the test strip within 10 minutes of removing it from the container.Otherwise, you may get an error message and you will have to repeat the test.Step 1: Getting ready to test - gather suppliesMaterials provided▪ Container of CoaguChek XS PT Test strips  04625374160▪ Test strip code chipMaterials required (but not provided)▪ CoaguChek XS Meter▪ Lancing device and lancets (e.g., ACCU-CHEK® Softclix lancet device and

lancet. Follow the manufacturer's instructions for use.)

Place the meter on a flat surface (like a table or countertop) or hold it roughlyhorizontal so that it will not vibrate or move during testing. Vibrations or othermovement can result in an error message.If you are using test strips from a new, unopened box, you will need to change thetest strip code chip. The 3‑number code on the test strip container must match the3‑number code on the code chip. To install the code chip, follow instructions in theCode Chip section of the CoaguChek XS System User Manual for Self‑Testing.

Step 2: Getting a good drop of blood Increasing the blood flow in your finger will help you get a good drop of blood.Before you lance your finger, try the following techniques until you see that yourfingertip has good color:

▪ Warm your hand by holding it under your arm, using a hand warmer, and/orwashing your hand with warm water.

▪ Hold your arm down to the side so that your hand is below your waist.▪ Massage your finger from its base.▪ If needed, immediately after lancing, gently squeeze your finger from its base

to encourage blood flow.Step 3: Performing the test1. Wash your hands with warm, soapy water. Dry completely.2. Remove 1 test strip from the container and immediately close the container.Make sure it seals tightly. Do not open a container of test strips or touch a teststrip with wet hands. This may damage the test strips.3. Insert a test strip as far as you can into the meter. The meter powers ON.4. Confirm that the number displayed matches the number on the test stripcontainer, then press M. If the numbers are different, make sure you are using thecode chip that came with the test strips you are using. If they still do not match,call the Roche Diagnostics Technical Service Center at 1‑800‑428‑4674, 24 hoursa day, 7 days a week, 365 days a year.

5. An hourglass appears as the meter warms up, which takes up to 30 seconds.6. When the meter is warmed up, a flashing test strip and blood drop symbolappear and the meter begins a countdown. You have 180 seconds to apply bloodto the test strip.7. Use the lancet device to perform a fingerstick. Set the penetration depth to 5.See the CoaguChek XS System User Manual for Self‑Testing for moreinformation. After sticking your finger, you have 15 seconds to apply blood tothe test strip. If it takes longer to form a good drop of blood, lance a differentfinger for the test.

8. Apply 1 drop of blood to the side of the test strip. It’s important to hold the blood drop to the test strip until you hear a beep.

9. You’ll see the hourglass when the blood test begins. Then, pull your finger awayfrom the test strip.Remember to apply only one drop of blood—don’t add more. Do not touch orremove the test strip when a test is in progress.The result appears in about 1 minute.

10. Record the result on the CoaguChek XS System ProthrombinTime Self‑Testing Log Book. Call your doctor with the test result.11. Properly dispose of the used lancet and test strip.12. Power the meter OFF.If you need to redo a test, use a new lancet, a new test strip, and a different finger.Limitations of procedureInformation for you and your physician▪ The CoaguChek XS System for patient self‑testing should not be used for

patients being treated with any direct thrombin inhibitors, including Hirudin,Lepirudin, Bivalirudin and Argatroban.

▪ The CoaguChek XS PT Test for patient self‑testing uses only fresh capillaryblood from a fingerstick.

▪ The blood drop must be a minimum of 8 μL in volume. Low sample volume willcause an error message.

▪ Never add more blood to test strip after test has begun or perform another testusing the same fingerstick.

▪ When a patient is on intravenous infusion therapy, do not collect fingersticksample from arm receiving the infusion line.

▪ Hematocrit ranges between 25‑55 % do not significantly affect results.▪ Testing has confirmed that PT/INR test results are not affected by:

▪ Bilirubin up to 30 mg/dL▪ Lipemic samples containing up to 500 mg/dL of triglycerides▪ Hemolysis up to 1000 mg/dL▪ Clopidogrel (Plavix®) up to 20 mg/dL▪ Fondaparinux (Arixtra®) up to 5 mg/L▪ Heparin concentrations up to 0.8 U/mL▪ Low molecular weight heparins (LMWH) up to

2 IU anti‑factor Xa activity/mL

▪ The presence of anti‑phospholipid antibodies (APAs) such as Lupus antibodies(LA) can potentially lead to prolonged clotting times, i.e., elevated INR values.If you have or suspect that you have APAs, contact your doctor.

▪ Differences in reagents, instruments, and pre‑analytical variables can affectprothrombin time results. These factors should be considered when comparingresults from different test methods. Results obtained with theCoaguChek XS System for patient self‑testing may not consistently correlatewith clinical laboratory results, particularly for certain types of laboratoryreagents. Your doctor can provide additional information regarding resultscomparison.

▪ In rare cases, patients with long clotting times ( > 8 INR) may receive an“error 7” message on the meter display. If this error message appears againafter repeating the test, call your doctor immediately to arrange for testingusing another method.

▪ The results obtained cannot be used for the determination or the assessmentof a therapy with factor II and factor X antagonists.

Very low or very high test resultsThe CoaguChek XS PT test strips provide test results if the INR value is0.8 to 8.0. If the meter displays < (less than) 0.8 or > (greater than) 8.0, repeat thetest. If, when you repeat the test, you get the same display (either <0.8 or > 8.0),call your doctor.

Error messagesIs the meter displaying “ERROR 6”? Sporadically occurring “ERROR 6” aregenerally due to an activation of the system fail safe mechanisms that aredesigned to prevent the release of wrong measurement results. However, in rarecases, “ERROR 6” may be received by patients under clinical conditions leadingto extremely high coagulation times (> 10 INR, < 5 % Quick), e.g. treatment withwarfarin (vitamin K antagonists) in combination with antibiotics and/orchemotherapeutics. If “ERROR 6” is displayed repeatedly, please contact yourphysician without delay.If you see “error 7”, this means the meter was unable to detect a clot. Repeat thetest. Be sure to carefully follow the steps in the CoaguChek XS SystemUser Manual for Self‑Testing. For example, make sure the fingertip is thoroughlydry, use the meter on a surface free of vibrations, and apply the blood drop within15 seconds of sticking the fingertip.

If you still get “error 7”, call your doctor immediately toarrange for testing using another method. If the meterdisplays any other error message, refer to the ErrorMessages section of the CoaguChek XS System UserManual for Self‑Testing.

Built-in controlsThe CoaguChek XS System has built‑in quality control functions in the meter andtest strips. The meter automatically runs its own quality control test as part ofevery blood test, so you never have to run quality control tests with liquid qualitycontrol solutions. For more information about the built‑in quality control functions,see the CoaguChek XS System User Manual for Self‑Testing.

Performance CharacteristicsMeasuring range: The CoaguChek XS PT System has a PT measuring range of0.8‑8.0 INR and 9.6‑96.0 seconds.Accuracy: A study was conducted comparing test results obtained by trainedusers with those obtained by healthcare professionals, when both were using theCoaguChek XS System. The correlation was very good, as indicated by thefollowing statistics: N=463, Slope=1.000, Intercept=0.0 and CorrelationCoefficient=0.977. This study shows that trained users are able to obtain resultsthat are as accurate as those obtained by healthcare professionals trained in theuse of the CoaguChek XS System.

CoaguChek XS PT Test

05990491001

V 6.02016-11

The test results obtained by trained users were also compared to results obtainedusing a laboratory-based reference method. Results are shown in the followingplot.

Study user demographics: A clinical study was conducted by RocheDiagnostics, consisting of four visits to the clinical site. Informed consent andrandomization occurred at Visit 1. Testing began at Visit 2. Ninety‑one patientscompleted at least one visit after Visit 1. The following table outlines thedemographic information for the trained users who completed at least one visitafter Visit 1.

Demographic Number PercentTotal number of users 91 100%

Caregivers 4 4.4%

Males 51 56%

Females 40 44%

Age range (years) 32‑89 N/A

Mean age (years) 64 N/A

Age 65 – 69 years 16 17.6%

Age 70 – 74 years 13 14.3%

Age 75 years and up 16 17.6%

Education level- eighth grade or lessthrough advanced college degree 91 100%

Median education level Some college N/A

On warfarin 3 – 12 months 19 20.9%

On warfarin 1 – 2 years 22 24.2%

On warfarin 3 – 5 years 23 25.3%

On warfarin > 5 years 27 29.7%

Atrial fibrillation 38 41.8%

Valve replacement 25 27.5%

Stroke/stroke prevention 7 7.7%

DVT 5 5.5%

Other heart conditions 6 6.6%

Other clotting disorders 10 11%

There were 107 patients enrolled. A total of 88 patients completed all four visits tothe site. The reasons for drop‑outs were as follows:

Reason for Drop-Out # of Subjects

Felt it was too stressful 2

Didn’t have time 3

Didn’t want to use meter on his own 1

Didn’t think he could learn to use meter 1

Was having knee surgery 1

Study terminated prior to Visit 4 1

Unknown 7

Disqualified due to target INRrange outside of study protocol

3

Precision: A study was conducted and the precision of duplicates for capillaryblood results was calculated for both trained users and healthcare professionals.The following results were obtained:

User Professional Results Results

N 214 249

Mean, INR 2.57 2.52

SD 0.13 0.13

CV, % 5.13 5.36

This study shows that trained users are able to obtain results that are as preciseas those obtained by healthcare professionals trained in the use of theCoaguChek XS System.

SymbolsRoche Diagnostics uses the following symbols and signs for this product.

Catalogue number

Batch code

In vitro diagnostic medical device

Manufacturer

Contains sufficient for <n> tests

Use-by date

Temperature limit

Consult instructions for use

Analyzers/Instruments on which reagents can beused

Global Trade Item Number

Additional informationThe CoaguChek XS System User Manual for Self‑Testing contains moreinformation. If you need technical help, call the Roche Diagnostics TechnicalService Center at 1‑800‑428‑4674, 24 hours a day, 7 days a week, 365 days ayear.LIMITED WARRANTYRoche Diagnostics warrants that this product will meet the specifications stated inthe labeling when used in accordance with such labeling and will be free fromdefects in material and workmanship until the expiration date printed on the label.THIS LIMITED WARRANTY IS IN LIEU OF ANY OTHER WARRANTY,EXPRESS OR IMPLIED, INCLUDING ANY IMPLIED WARRANTY OFMERCHANTABILITY OR FITNESS FOR PARTICULAR PURPOSE. IN NOEVENT SHALL ROCHE DIAGNOSTICS BE LIABLE FOR INCIDENTAL,INDIRECT, SPECIAL OR CONSEQUENTIAL DAMAGES. ACCU-CHEK, COAGUCHEK, and SOFTCLIX are trademarks of Roche.

All other product names and trademarks are the property of their respective owners.

Additions, deletions or changes are indicated by a change bar in the margin.

© 2015, Roche Diagnostics

Roche Diagnostics GmbHSandhofer Strasse 116D‑68305 Mannheimwww.roche.com

Distribution in USA by:Roche Diagnostics, Indianapolis, INUS Customer Technical Support 1-800-428-4674www.coaguchek-usa.com

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04625374160 6 CoaguChek® XS

USO PERSONAL

FinalidadLas tiras reactivas CoaguChek XS PT forman parte del sistema CoaguChek XS.El sistema CoaguChek XS mide el tiempo de coagulación de la sangre de laspersonas que están tomando medicamentos anticoagulantes tales comowarfarina (Coumadin®).El sistema CoaguChek XS utiliza sangre obtenida mediante la punción de undedo. Este sistema está destinado a ser utilizado por usuarios (o sus cuidadores)debidamente seleccionados y adiestrados bajo prescripción u otro tipo de solicituddel médico tratante. Los usuarios deben estar estables con los medicamentosanticoagulantes tales como warfarina (Coumadin) antes de realizar el autoanálisiscon el sistema CoaguChek XS.Atención: Estas tiras reactivas están indicadas para utilizarse únicamentefuera del cuerpo. No ingiera las tiras reactivas. Uso exclusivamente bajoprescripción. Antes de comenzar el análisisSi no ha usado anteriormente el sistema CoaguChek XS, vea el DVD CoaguChekXS System Patient Training DVD (DVD de adiestramiento del paciente sobre elsistema CoaguChek XS) y lea los manuales CoaguChek XS System GettingStarted Guide (Guía de inicio del sistema CoaguChek XS) y CoaguChek XSSystem User Manual for Self‑Testing (Manual del usuario del sistemaCoaguChek XS para autoanálisis) antes de comenzar a realizar el análisis.

Conservación de las tiras reactivasConserve las tiras reactivas en el tubo original con la tapa firmemente cerrada.Puede conservar las tiras reactivas a temperatura ambiente o en el frigorífico(2‑30 °C o 36‑86 °F). Si se conservan en las condiciones adecuadas, las tirasreactivas pueden usarse hasta la fecha de caducidad impresa en el tubo de tirasreactivas.Deseche las tiras reactivas cuya fecha de caducidad se haya sobrepasado.

Manipulación de las tiras reactivasCuando esté listo para realizar el análisis, extraiga una tira reactiva del tubo ycierre el tubo inmediatamente. Asegúrese de que quede firmemente cerrado. Debe usar la tira reactiva en el plazo de 10 minutos tras su extracción del tubo.De lo contrario, podría obtener un mensaje de error y tener que repetir el análisis.Paso 1: Preparación para el análisis: reúna el materialMaterial suministrado▪ Tubo de tiras reactivas CoaguChek XS PT  04625374160▪ Chip de codificación de tiras reactivasMaterial necesario adicionalmente (no suministrado)▪ Medidor CoaguChek XS▪ Dispositivo de punción con lanceta y lancetas (p. ej., dispositivo de punción

con lanceta y lanceta ACCU-CHEK® Softclix; siga las instrucciones de uso delfabricante).

Coloque el medidor sobre una superficie plana (como una mesa o una encimera)o sujételo en posición aproximadamente horizontal de manera que no vibre ni semueva durante el análisis. Las vibraciones u otros movimientos pueden causar unmensaje de error.Si va a usar tiras reactivas de una caja nueva sin abrir, tendrá que cambiar el chipde codificación de tiras reactivas. El código de tres números indicado en el tubode tiras reactivas debe coincidir con el código de tres números indicado en el chipde codificación. Para instalar el chip de codificación, siga las instruccionespresentadas en el apartado Code Chip (Chip de codificación) del manualCoaguChek XS System User Manual for Self‑Testing.

Paso 2: Obtención de una buena gota de sangre Si aumenta el flujo de sangre del dedo, le será más fácil obtener una buena gotade sangre. Antes de pincharse el dedo con la lanceta, pruebe las siguientestécnicas hasta que vea que la yema del dedo tiene un buen color:

▪ Caliéntese la mano sujetándola bajo el brazo, utilizando un calentador demanos o lavándose la mano con agua templada.

▪ Coloque el brazo hacia abajo al costado de manera que la mano quede pordebajo de la muñeca.

▪ Masajee el dedo desde su base.▪ En caso necesario, presione suavemente el dedo desde su base justo

después de la punción con la lanceta para favorecer el flujo de sangre.Paso 3: Realización del análisis1. Lávese las manos con agua templada con jabón. Séqueselascompletamente.2. Extraiga una tira reactiva del tubo y cierre el tubo inmediatamente.Asegúrese de que quede firmemente cerrado. No abra un tubo de tirasreactivas ni toque una tira reactiva con las manos húmedas. Esto podría dañar lastiras reactivas.3. Inserte una tira reactiva lo máximo posible en el medidor. El medidor seenciende.4. Confirme que el número mostrado en la pantalla coincide con el númeroindicado en el tubo de tiras reactivas y, a continuación, pulse M. Si los númerosson diferentes, asegúrese de que está utilizando el chip de codificación que veníacon las tiras reactivas que está usando. Si siguen sin coincidir, llame al Centro deservicio técnico de Roche Diagnostics al número de teléfono 1‑800‑428‑4674,24 horas al día, 7 días a la semana, 365 días al año.

5. Aparecerá un reloj de arena mientras se calienta el medidor, lo cual lleva unmáximo de 30 segundos.6. Una vez calentado el medidor, aparecerá un símbolo de gota de sangre y tirareactiva parpadeando y el medidor comenzará una cuenta atrás. Dispone de180 segundos para aplicar la sangre a la tira reactiva.7. Use el dispositivo de punción con lanceta para realizar una punción del dedo.Ajuste la profundidad de penetración en 5. Consulte el manualCoaguChek XS System User Manual for Self‑Testing si desea obtener másinformación. Una vez que se haya pinchado el dedo, tiene 15 segundos paraaplicar la sangre a la tira reactiva. Si lleva más tiempo que se forme una buenagota de sangre, pínchese otro dedo para el análisis.

8. Aplique una gota de sangre en el lateral de la tira reactiva. Es importante que mantenga la gota de sangre aplicada a la tira reactiva hasta

que oiga un pitido. 9. Aparecerá un reloj de arena cuando comience el análisis de sangre. Acontinuación, aparte el dedo de la tira reactiva.Recuerde aplicar una sola gota de sangre: no añada más. No toque ni retire la tirareactiva durante el análisis.El resultado aparecerá en aproximadamente 1 minuto.

10. Anote el resultado en el diario CoaguChek XS System ProthrombinTime Self‑Testing Log Book (Diario de autoanálisis del tiempo de protrombina conel sistema CoaguChek XS). Llame a su médico para informarle del resultado delanálisis.11. Deseche debidamente la lanceta y la tira reactiva usadas.12. Apague el medidor.Si necesita repetir un análisis, utilice una nueva lanceta, una nueva tira reactiva yun dedo diferente.Limitaciones del procedimientoInformación para usted y para su médico▪ El sistema CoaguChek XS para autoanálisis por el paciente no debe utilizarse

para pacientes que estén recibiendo tratamiento con algún inhibidor directo dela trombina, tales como hirudina, lepirudina, bivalirudina y argatrobán.

▪ La prueba CoaguChek XS PT para autoanálisis por el paciente utilizaúnicamente sangre capilar fresca obtenida mediante una punción en el dedo.

▪ La gota de sangre utilizada tiene que tener un volumen de aplicación mínimode 8 μL. En caso de aplicar un volumen de muestra insuficiente aparecerá unmensaje de error.

▪ No añada nunca más sangre a la tira reactiva una vez iniciado el análisis nirealice otro análisis utilizando la misma punción del dedo.

▪ Si el paciente está recibiendo tratamiento por perfusión intravenosa, lamuestra de sangre mediante punción en el dedo no debe proceder del brazoque tiene colocada la vía de perfusión.

▪ Los resultados no se ven afectados de manera importante dentro de unintervalo del hematócrito del 25‑55 %.

▪ Las pruebas realizadas han confirmado que los resultados del análisis deltiempo de protrombina (TP)/cociente internacional normalizado (INR, por sussiglas en inglés) no se ven afectados por:▪ Bilirrubina hasta 30 mg/dL.▪ Muestras lipémicas que contengan hasta 500 mg/dL de triglicéridos.▪ Hemólisis hasta 1000 mg/dL.▪ Clopidogrel (Plavix®) hasta 20 mg/dL.▪ Fondaparinux (Arixtra®) hasta 5 mg/L.▪ Concentraciones de heparina hasta 0.8 U/mL.▪ Heparinas de bajo peso molecular (HBPM) hasta 2 UI de actividad

anti‑factor Xa/mL.▪ La presencia de anticuerpos anti‑fosfolípidos (AAF) tales como anticuerpos

lúpicos (AL) podría dar lugar a un aumento de los tiempos de coagulación, esdecir, a una elevación de los valores del INR. Si usted tiene o sospecha quetiene AAF, póngase en contacto con su médico.

▪ Las diferencias en los reactivos, los instrumentos y las variables preanalíticaspueden afectar a los resultados del tiempo de protrombina. Estos factoresdeben tenerse en cuenta al comparar resultados obtenidos con diferentesmétodos de análisis. Los resultados obtenidos con el sistema CoaguChek XSpara autoanálisis por el paciente pueden no coincidir de manera constante conlos resultados de los análisis clínicos, especialmente con ciertos tipos dereactivos de laboratorio. Su médico puede proporcionarle más informaciónsobre la comparación de resultados.

▪ En casos raros, en pacientes con tiempos de coagulación prolongados(INR > 8) puede aparecer en la pantalla del medidor el mensaje “error 7”. Siaparece de nuevo este mensaje de error al repetir el análisis, llame a sumédico inmediatamente para organizar la realización del análisis utilizandootro método.

▪ Los resultados obtenidos no sirven para determinar o valorar el tratamientocon inhibidores del factor II y del factor X.

Resultados muy bajos o muy altos del análisisLas tiras reactivas CoaguChek XS PT proporcionan resultados analíticos si elvalor del INR está comprendido entre 0.8 y 8.0. Si el medidor muestra en lapantalla los mensajes < (menor que) 0.8 o > (mayor que) 8.0, repita el análisis. Si,al repetir el análisis, el medidor muestra el mismo mensaje (< 0.8 o > 8.0), llame asu médico.

Mensajes de error¿Ha aparecido en el medidor el mensaje “ERROR 6”? Cuando el mensaje“ERROR 6” solo aparece esporádicamente, suele tratarse de una activación delmecanismo que evita que se indiquen resultados de medición erróneos. Sinembargo, en casos muy raros, el mensaje “ERROR 6” puede aparecer enpacientes en situaciones clínicas que llevan a tiempos de coagulaciónextremadamente altos (INR > 10, tiempo de Quick < 5 %), por ejemplo, en casode tratamiento con warfarina (antagonistas de la vitamina K) junto con antibióticosy/o medicamentos quimioterápicos. Si el mensaje “ERROR 6” aparece repetidasveces, consulte inmediatamente a su médico.Si aparece el mensaje “error 7”, significa que el medidor no ha podido detectar uncoágulo. Repita el análisis. Asegúrese de seguir atentamente los pasos descritosen el manual CoaguChek XS System User Manual for Self‑Testing. Por ejemplo,asegúrese de que la yema del dedo esté completamente seca, use el medidorsobre una superficie libre de vibraciones y aplique la gota de sangre en los15 segundos siguientes a la punción de la yema del dedo.

Si sigue apareciendo el mensaje “error 7”, llame a su médicoinmediatamente para organizar el análisis con otro método.Si el medidor muestra cualquier otro mensaje de error,consulte el apartado Error Messages (Mensajes de error) delmanual CoaguChek XS System User Manual forSelf‑Testing.

Controles incorporadosEl sistema CoaguChek XS dispone de funciones de control de calidadincorporadas en el medidor y en las tiras reactivas. El medidor ejecutaautomáticamente su propia prueba de control de calidad como parte de cadaanálisis de sangre, por lo que usted nunca tiene que realizar pruebas de controlde calidad con soluciones de control de calidad líquidas. Si desea másinformación sobre las funciones de control de calidad incorporadas, consulte elmanual CoaguChek XS System User Manual for Self‑Testing.

CoaguChek XS PT Test

05990491001

V 6.02016-11

Características de funcionamientoIntervalo de medición: El sistema CoaguChek XS PT tiene un intervalo demedición del TP de 0.8‑8.0 de INR y 9.6‑96.0 segundos.Exactitud: Se llevó a cabo un estudio para comparar los resultados analíticosobtenidos por usuarios adiestrados con los obtenidos por profesionales sanitarios,en ambos casos con el sistema CoaguChek XS. La correlación fue muy buena, talcomo indican los siguientes valores estadísticos: N = 463, pendiente = 1.000,intersección = 0.0 y coeficiente de correlación = 0.977. Este estudio muestra quelos usuarios adiestrados pueden obtener resultados tan exactos como losobtenidos por profesionales sanitarios adiestrados en el uso del sistemaCoaguChek XS.

Los resultados analíticos obtenidos por usuarios adiestrados también secompararon con los obtenidos con el método de análisis de laboratorio dereferencia. Los resultados se muestran en la siguiente gráfica.

Datos demográficos de los usuarios participantes en el estudio: RocheDiagnostics realizó un estudio clínico consistente en cuatro visitas al centroclínico. El consentimiento informado y la aleatorización tuvieron lugar en lavisita 1. El análisis se inició en la visita 2. Noventa y un pacientes realizaron almenos una visita después de la visita 1. En la tabla siguiente se resume lainformación demográfica de los usuarios adiestrados que realizaron al menos unavisita después de la visita 1.

Datos demográficos Número PorcentajeNúmero total de usuarios 91 100 %

Cuidadores 4 4.4 %

Hombres 51 56 %

Mujeres 40 44 %

Intervalo de edad (años) 32‑89 N/A

Media de edad (años) 64 N/A

Edad de 65-69 años 16 17.6 %

Edad de 70-74 años 13 14.3 %

Edad de 75 años o más 16 17.6 %

Nivel de educación: octavo grado(EE. UU.) o menos hasta posgrado 91 100 %

Mediana del nivel de educación Estudiosuniversitarios sinfinalizar

N/A

En tratamiento con warfarina3-12 meses

19 20.9 %

En tratamiento con warfarina 1-2 años 22 24.2 %

En tratamiento con warfarina 3-5 años 23 25.3 %

En tratamiento con warfarina > 5 años 27 29.7 %

Fibrilación auricular 38 41.8 %

Sustitución valvular 25 27.5 %

Ictus/prevención de ictus 7 7.7 %

Trombosis venosa profunda 5 5.5 %

Otros trastornos cardíacos 6 6.6 %

Otros trastornos de la coagulación 10 11 %

Se incluyó a 107 pacientes. Un total de 88 pacientes realizó las cuatro visitas alcentro. Los motivos de retirada fueron los siguientes:

Motivo de retirada N.° de sujetos

El sujeto sentía demasiado estrés 2

El sujeto no tenía tiempo 3

El sujeto no deseaba usar el medidor por sí mismo 1

El sujeto no se creía capaz de aprender a usar el medidor 1

El sujeto se sometió a cirugía de rodilla 1

El estudio finalizó de forma prematura antes de la visita 4 1

Desconocido 7

No apto debido a que el intervalo deseado del INRestaba fuera del protocolo del estudio

3

Precisión: Se realizó un estudio y se calculó la precisión de los resultados depruebas duplicadas en sangre capilar para usuarios y para profesionalessanitarios adiestrados. Se obtuvieron los siguientes resultados:

Usuarios Profesionales

Resultados ResultadosN 214 249

Media, INR 2,57 2,52

DE 0,13 0,13

CV, % 5,13 5,36

Este estudio muestra que los usuarios adiestrados pueden obtener resultados tanprecisos como los obtenidos por profesionales sanitarios adiestrados en el usodel sistema CoaguChek XS.

SímbolosPara este producto, Roche Diagnostics emplea los siguientes símbolos y signos.

Número de catálogo

Código de lote

Producto sanitario para diagnóstico in vitro

Fabricante

Contenido suficiente para <n> ensayos

Fecha de caducidad

Límite de temperatura

Consulte las instrucciones de uso

Analizadores/instrumentos adecuados para losreactivos

Número mundial de artículo comercial

La barra del margen indica suplementos, eliminaciones o cambios.

© 2015, Roche Diagnostics

Roche Diagnostics GmbHSandhofer Strasse 116D‑68305 Mannheimwww.roche.com

Distribuido en EE. UU. por:Roche Diagnostics, Indianapolis, IN, EE. UU.Apoyo técnico al cliente estadounidense 1-800-428-4674www.coaguchek-usa.com