{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T03:11:24Z","timestamp":1785899484428,"version":"3.56.0"},"reference-count":27,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,6,20]],"date-time":"2020-06-20T00:00:00Z","timestamp":1592611200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Increased awareness of von Willebrand Disease (VWD) has led to more frequent diagnostic laboratory testing, which insurers often dictate be performed at a facility with off\u2010site laboratory processing, instead of a coagulation facility with onsite processing. Off\u2010site processing is more prone to preanalytical variables causing falsely low levels of von Willebrand Factor (VWF) due to the additional transport required. Our aim was to determine the percentage of discordance between off\u2010site and onsite specimen processing for VWD in this multicenter, retrospective study. We enrolled females aged 12 to 50\u2009years who had off\u2010site specimen processing for VWF assays, and repeat testing performed at a consulting institution with onsite coagulation phlebotomy and processing. A total of 263 females from 17 institutions were included in the analysis. There were 251 subjects with both off\u2010site and onsite VWF antigen (VWF:Ag) processing with 96 (38%) being low off\u2010site and 56 (22%) low onsite; 223 subjects had VWF ristocetin co\u2010factor (VWF:RCo), 122 (55%) were low off\u2010site and 71 (32%) were low onsite. Similarly, 229 subjects had a Factor VIII (FVIII) assay, and 67 (29%) were low off\u2010site with less than half, 29 (13%) confirmed low with onsite processing. Higher proportions of patients demonstrated low VWF:Ag, VWF:RCo, and\/or FVIII with off\u2010site processing compared to onsite (McNemar\u02bcs test <jats:italic>P<\/jats:italic>\u2010value &lt;.0005, for all assays). These results emphasize the need to decrease delays from sample procurement to processing for VWF assays. The VWF assays should ideally be collected and processed at the same site under the guidance of a hematologist.<\/jats:p>","DOI":"10.1002\/ajh.25869","type":"journal-article","created":{"date-parts":[[2020,5,18]],"date-time":"2020-05-18T06:47:03Z","timestamp":1589784423000},"page":"1022-1029","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Laboratory misdiagnosis of von Willebrand disease in <scp>post\u2010menarchal<\/scp> females: A <scp>multi\u2010center<\/scp> study"],"prefix":"10.1002","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1175-7266","authenticated-orcid":false,"given":"Julie","family":"Jaffray","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Hematology\/Oncology\/Bone Marrow Transplant Children\u02bcs Hospital Los Angeles  Los Angeles California USA"},{"name":"Keck School of Medicine University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janice M.","family":"Staber","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Hematology\/Oncology University of Iowa Stead Family Children\u02bcs Hospital  Iowa City Iowa USA"},{"name":"Department of Pediatrics, Division of Hematology\/Oncology Carver College of Medicine  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jemily","family":"Malvar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Hematology\/Oncology\/Bone Marrow Transplant Children\u02bcs Hospital Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9509-9415","authenticated-orcid":false,"given":"Robert","family":"Sidonio","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Hematology\/Oncology Children\u02bcs Healthcare of Atlanta  Atlanta Georgia USA"},{"name":"Department of Pediatrics, Division of Hematology\/Oncology Emory University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4801-843X","authenticated-orcid":false,"given":"Kristina M.","family":"Haley","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Hematology\/Oncology Oregon Health &amp; Science University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Stillings","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Hematology\/Oncology\/Bone Marrow Transplant Children\u02bcs Hospital Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Weyand","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Hematology\/Oncology C.S. Mott Children\u02bcs Hospital  Ann Arbor Michigan USA"},{"name":"Department of Pediatrics, Division of Hematology\/Oncology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerry","family":"Hege","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Hematology\/Oncology Riley Hospital for Children at IU Health  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shilpa","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Hematology\/Oncology University of Buffalo  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9340-305X","authenticated-orcid":false,"given":"Sweta","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Hematology\/Oncology Indiana Hemophilia and Thrombosis Center  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Agnew","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Hematology\/Oncology St. Christopher\u02bcs Hospital for Children  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Wheeler","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Hematology\/Oncology Vanderbilt University  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjali","family":"Pawar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Hematology\/Oncology University of California Davis  Davis California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukta","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Hematology\/Oncology Children\u02bcs Mercy Hospital  Kansas City Missouri USA"},{"name":"Department of Pediatrics, Division of Hematology\/Oncology University of Missouri Kansas City  Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meera","family":"Chitlur","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Hematology\/Oncology Children\u02bcs Hospital of Michigan  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah H.","family":"O\u02bcBrien","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Hematology\/Oncology Nationwide Children\u02bcs Hospital  Columbus Ohio USA"},{"name":"Department of Pediatrics, Division of Hematology\/Oncology The Ohio State University College of Medicine  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Kouides","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hematology\/Oncology Mary M. 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