Effect of increasing the number of repeated measurements on the accuracy of determining factor VIII activity and fibrinogen concentrations in blood plasma

Introduction. Highly accurate determination of hemostatic indices of plasma and blood plasma products is important for industrial transfusiology and monitoring the effi cacy of their clinical application. Repeated measurements increase statistical power, thereby reducing the likelihood of committing a second-order error, which is described as a false negative result and occurs when a test fails to detect a truly existing effect.

Aim: to evaluate the effect of increasing the number of repeated measurements on the accuracy of factor VIII activity and fi brinogen concentrations in donor plasma.

Materials and methods. Human donor plasma used in the study was obtained by centrifugation of whole blood. The criterion for inclusion of biomaterial in the study was the presence of a non-repeatable combination of donor characteristics: sex, age, blood group and Rhesus affi liation by the presence of D antigen. Whole blood donors for this work were male and female aged between 38 and 53 years with groups: O(I), A(II) and B(III). 27 repeated measurements of factor VIII activity by the one-stage clotting method and fi brinogen concentrations by the Clauss clotting method were performed on automatic coagulometer ACL TOP 300 with HemosIL reagents.

Results. For factor VIII activity, the difference in values recorded in repeated measurements reached 20 IU/100 ml, and for fi brinogen concentrations the maximum difference was 0.29 g/L. The calculation of the change in the size of the confi dence interval with increasing number of repeated measurements is presented. While the decrease in size from the second to the fourth repeated measurement averaged 83.5 % for the measurement of factor VIII activity and 61.7 % for fi brinogen concentrations, from the fi fth to the seventh it was 16.9 % and 21.5 %, respectively.

Conclusions. Despite the pre-analytical measures taken to reduce random error, blood plasma parameters of the same donation can take values in a wide range. Increasing the number of repeat measurements from one to three in the case of measuring factor VIII activity and fi brinogen concentrations is an effective means of improving the accuracy of these indices. However, with subsequent repeated measurements there will be a decrease in statistical power growth.

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