{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T20:37:24Z","timestamp":1790973444646,"version":"4.1.0"},"reference-count":68,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Thromb Hemost"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Clot waveform analysis (CWA) extends routine coagulation assays (activated partial thromboplastin time [aPTT] and prothrombin time [PT]) by incorporating continuous optical monitoring to generate kinetic profiles of clot formation. This method provides both qualitative and quantitative information on hemostasis, with increasing evidence for its clinical utility in detecting factor deficiencies and characterizing thrombotic and bleeding disorders. Despite the growing body of evidence, translation of CWA into routine clinical practice remains limited.<\/jats:p>\n                  <jats:p>This review identifies three principal barriers: (1) variability arising from differences in optical detection methods (absorbance vs. transmittance), (2) interreagent variation even within the same analyzer platform, and (3) lack of a clear distinction between standard CWA, performed with commercially available reagents, and modified CWA, incorporating in-house adjustments. To address these challenges, we encourage adopting distinct nomenclature for detection modalities (CWA-A; A for absorbance and CWA-T; T for transmittance), establishing standardized reporting requirements including reagent and platform details, and establishing quality assurance frameworks for CWA.<\/jats:p>\n                  <jats:p>Standardization of terminology and reporting will enhance reproducibility, enable cross-study comparisons, and accelerate the clinical translation of CWA from the laboratory bench to the bedside.<\/jats:p>","DOI":"10.1055\/a-2778-9810","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:58:01Z","timestamp":1767920281000},"page":"460-475","source":"Crossref","is-referenced-by-count":1,"title":["Decoding Clot Waveform Analysis: Toward Better Understanding and Harmonization"],"prefix":"10.1055","volume":"52","author":[{"given":"Jing Yuan","family":"Tan","sequence":"first","affiliation":[{"name":"Department of Haematology, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0741-9552","authenticated-orcid":false,"given":"Marvin Raden Torres","family":"De Guzman","sequence":"first","affiliation":[{"name":"Department of Haematology, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan Hui","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Haematology, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi Kiat","family":"Yeo","sequence":"additional","affiliation":[{"name":"Department of Haematology, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guan Hao","family":"Goh","sequence":"additional","affiliation":[{"name":"Department of Haematology, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heng Joo","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Haematology, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuen Wen","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Haematology, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1477-9560-13-1","article-title":"A general review of major global coagulation assays: thrombelastography, thrombin generation test and clot waveform analysis","volume":"13","author":"M D Lanc\u00e9","year":"2015","journal-title":"Thromb 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Yoo","year":"2018","journal-title":"Blood Res"},{"issue":"05","key":"ref46","doi-asserted-by":"crossref","first-page":"e427","DOI":"10.1111\/hae.13266","article-title":"Clot waveform analysis using CS-2000i\u2122 distinguishes between very low and absent levels of factor VIII activity in patients with severe haemophilia A","volume":"23","author":"T Matsumoto","year":"2017","journal-title":"Haemophilia"},{"issue":"02","key":"ref47","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1007\/s12185-016-2108-x","article-title":"A combined approach using global coagulation assays quickly differentiates coagulation disorders with prolonged aPTT and low levels of FVIII activity","volume":"105","author":"T Matsumoto","year":"2017","journal-title":"Int J Hematol"},{"key":"ref48","doi-asserted-by":"crossref","first-page":"1076029620978810","DOI":"10.1177\/1076029620978810","article-title":"The first-derivative curve of the coagulation waveform reveals the cause of aPTT 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hemodilution on clot waveform analysis parameters, clotting factors, and thrombin generation assays in a dilutional model based on analysis of 11 healthy male blood donors","volume":"28","author":"J Ichikawa","year":"2022","journal-title":"Med Sci Monit"},{"issue":"01","key":"ref64","doi-asserted-by":"crossref","first-page":"14186","DOI":"10.1038\/s41598-020-71063-1","article-title":"Assessment of aPTT-based clot waveform analysis for the detection of haemostatic changes in different types of infections","volume":"10","author":"C W Tan","year":"2020","journal-title":"Sci Rep"},{"key":"ref65","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.thromres.2021.03.030","article-title":"Evaluation of hemostatic abnormalities in patients who underwent major hepatobiliary pancreatic surgery using activated partial thromboplastin time-clot waveform analysis","volume":"201","author":"K Maeda","year":"2021","journal-title":"Thromb 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