{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T19:22:22Z","timestamp":1772997742876,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T00:00:00Z","timestamp":1761350400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T00:00:00Z","timestamp":1761350400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Lab Hematology"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Coagulation tests are crucial for diagnosing hemostatic disorders. However, preanalytical errors, particularly sample clotting, may compromise test accuracy and lead to clinical misinterpretation. As not all clots are detectable by visual inspection, this study characterized clotted citrated samples to establish objective criteria for clot identification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Routine coagulation assays\u2014including PT, APTT, fibrinogen, D\u2010dimer, FDP, fibrin monomer complex (FMC), plasmin\u2010\u03b12 plasmin inhibitor complex (PIC), and thrombin\u2010antithrombin complex (TAT)\u2014were performed, and 101 paired specimens from 101 patients who required blood recollection were analyzed. Among the 77 specimens with visible clots, coagulation profiles were analyzed to identify cut\u2010off values and develop logistic regression models. The models were subsequently validated using an additional 24 abnormal but clot\u2010free specimens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Clotted samples showed significantly shortened APTT and elevated FDP, FMC, PIC, and TAT levels. Shortening of APTT by \u2265\u20093.1\u2009s relative to the reference was a reliable indicator of clotting. Combining APTT with TAT or FMC provided high diagnostic accuracy (AUC: 0.969 and 1.000, respectively). We established a \u201cClotting Score\u201d to assess sample viability even without visible clots. FDP and PIC increased progressively with time in clotted samples.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Sample clotting substantially affects the accuracy of coagulation tests. Shortened APTT and elevated FMC and TAT serve as reliable indicators, with FDP and PIC offering time\u2010sensitive supplementary clues. This multimodal approach could help standardize criteria for sample rejection and recollection, thereby improving test reliability and supporting clinical decisions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijlh.70019","type":"journal-article","created":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T09:01:28Z","timestamp":1761382888000},"page":"384-391","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Investigation and Characterization of Clotting Artifacts in Coagulation Testing for the Development of Screening Criteria to Identify Clotted Plasma"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3910-4488","authenticated-orcid":false,"given":"Jeong Hui","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory Nagoya University Hospital  Nagoya Japan"},{"name":"Department of Clinical Laboratory Kobe University Hospital  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7194-3183","authenticated-orcid":false,"given":"Atsuo","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Nagoya University Hospital  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moe","family":"Kawakami","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Nagoya University Hospital  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayuko","family":"Hirotsu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Nagoya University Hospital  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saki","family":"Shirota","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Nagoya University Hospital  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadashi","family":"Matsushita","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Nagoya University Hospital  Nagoya Japan"},{"name":"Department of Transfusion Medicine Nagoya University Hospital  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,25]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538\u20107836.2007.02495.x"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/10760296241228239"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation\u20102003.1.520"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019\u20105049.144657"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000004520"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines9030262"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mbc.0000245290.57021.46"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100028\u20101104540"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12185\u2010020\u201002983\u2010x"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.13584"},{"key":"e_1_2_11_12_1","volume-title":"Collection, Transport, and Processing of Blood Specimens for Testing Plasma\u2010Based Coagulation Assays and Molecular Hemostasis Assays; 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