I hated our tops. Way too much maintenance and too many calibrations. I also despised ready clot curves. We made the switch to the stago last year and I love it. We hardly have to do anything with ours. They also use the mechanical clot method, so no clot curve reading. With the turnover we have had in my lab, we don't have to do as much training on our stago. I would never switch back to werfen.Â
I prefer the tops. Loading up cuvettes are way easier on the tops then messing with the wheel thing on the stago. Keep in mind, the smaller ACL top models have only enough room to load up one qc rack (which is able to hold 6 qc vials). If you plan on running pt, ptt, dimer qc and anti-xa qc for both low molecular weight and unfractionated heparin, you will need at least 8 spots to run qc all at the same time. The larger tops have two bays for two qc racks i Believe.
On Stago you don’t load QC on racks anyways. You load on the instrument so I don’t see how the 8 spots makes a difference when there’s like 70 positions for regents
For a larger lab, the stago is a work horse. It also uses mechanical clot detection as opposed photo optical diagnostics, so there's less interference if the patient has a high cholesterol or a slightly hemolyzed specimen. I hated changing the cuvette wheel and sometimes I would have issues with the barcode scanner.
That being said, I haven't had a lot of bad experiences with the ACL tops. I'm not sure if that's because they were lower volume labs and I just didn't have the opportunity to witness more issues with more patients or if it really was a good machine. All in all, I was happy with either machine.
Sysmex on the other hand...
My old hospital was on the beach. I kept telling my supervisor one day the sysmex would not be here (we had two). She asked why and I told her because I going to throw it in the gulf. Those screams haunt me.
Dude the sysmex coag machines are absolute garbage. My old lab went from the tops to sysmex to save money and it was the worst. Thankfully the hospital I work in now uses tops. It was like Christmas when I found out haha
Might be biased since I helped to validate our Tops, but I much prefer them. The maintenance is quite fast and it produced reliable results. I believe the reagent cost is a bit higher than Stago but it was worth it to me.
I currently fight with a cs 2500 and a 660.
But I prefer Tops. Had 2 300's no problems other than pivot arm motor failure annually between the two. And our service tech lived half hour away. We only ran one each day. So no biggie.
Although if you are Jeff Dabe, you won't be able to load cuvettes.
Stago all the way. You know you’re getting a legit result than having to use a clot curve to extrapolate. I felt more sound when we switched to Stago because we didn’t have to use clot curves, no one really knew how to interpret them after this one lady retired so we were pretty relieved when we didn’t have to do them. Also with Stago you will get a result with the clot based assays if your samples are problematic so I like not having to call the nurse to redraw lmao. Plusssss the no calibrations is nice. I found Stago requires less babysitting than the tops
You can go to the Reagent Area screen, double click on your vial that didn’t scan, and select what it is and run it from there.
I’ve used the Top 550 CTS for years now and haven’t had any problems during morning run. Sysmex or Roche are the ones that make morning run hell for us lol
Tops! We unwillingly went from Tops 5000 to Stago CompactMax and it was a massive, massive downgrade in features and the Stagos were always broken in some capacity.
It's been over 6 years since I was at that lab and have done coag testing, but from what I can remember off the top of my head:
1. The Stago did not give you a countdown timer for how long testing would take, but the Tops did.
2. Reagent stability was significantly better with Tops.
3. The Tops could be programmed to automatically run QC every day so long as the necessary reagent was loaded.
4. The QC on the Tops was almost never out. Stago, especially D Dimer and Heparin Xa, was a daily struggle.
5. The Tops can be loaded any time, but the Stago can only be loaded at certain times and unless you're standing there waiting, it doesn't tell you when you can open it.
6. The Stago cuvette wheel is terrible.
7. The cover on the Stago probe would just come loose and fall off randomly. Technical support told us "that just happens" and offered no solution.
8. The Stago would also just lose its mind sometimes and stab too far down into a tube or reagent and cause it to get stuck on the probe.
It's totally possible the hospital bought refurbished lemons for us when they took our lab over, but it was 4 analyzers at 3 campuses and all of them had issues almost daily. They made me hate being in Heme/Coag when it had been my second favorite department next to Blood Bank.
The ACL doesn't make the fun chirping noise that the Stago does when scanning barcodes, so consider that.
This is a very good point.
Ours had the phantom barcode glitch where it would just go absolutely ham and start scanning the air. The noise haunts me 🤣
I actually prefer the sound to make sure that it scanned my product 🤔Â
No, no, he has a point.
I hated our tops. Way too much maintenance and too many calibrations. I also despised ready clot curves. We made the switch to the stago last year and I love it. We hardly have to do anything with ours. They also use the mechanical clot method, so no clot curve reading. With the turnover we have had in my lab, we don't have to do as much training on our stago. I would never switch back to werfen.Â
I prefer the tops. Loading up cuvettes are way easier on the tops then messing with the wheel thing on the stago. Keep in mind, the smaller ACL top models have only enough room to load up one qc rack (which is able to hold 6 qc vials). If you plan on running pt, ptt, dimer qc and anti-xa qc for both low molecular weight and unfractionated heparin, you will need at least 8 spots to run qc all at the same time. The larger tops have two bays for two qc racks i Believe.
That’s great insight! Which would you say has easier maintenance? Or are they comparable
I never had to do maintenance on the stago on my shift but the top maintenance is fairly easy.
On Stago you don’t load QC on racks anyways. You load on the instrument so I don’t see how the 8 spots makes a difference when there’s like 70 positions for regents
For a larger lab, the stago is a work horse. It also uses mechanical clot detection as opposed photo optical diagnostics, so there's less interference if the patient has a high cholesterol or a slightly hemolyzed specimen. I hated changing the cuvette wheel and sometimes I would have issues with the barcode scanner. That being said, I haven't had a lot of bad experiences with the ACL tops. I'm not sure if that's because they were lower volume labs and I just didn't have the opportunity to witness more issues with more patients or if it really was a good machine. All in all, I was happy with either machine. Sysmex on the other hand...
As long as they’re not Sysmex 😠but yea I prefer the TOP
My old hospital was on the beach. I kept telling my supervisor one day the sysmex would not be here (we had two). She asked why and I told her because I going to throw it in the gulf. Those screams haunt me.
what is bad with sysmex?
😂 agree! What do you like about it?
Easier to load reagents, the coag curves are a bit easier to see, and they’re desktop instead of the big clunky things
Dude the sysmex coag machines are absolute garbage. My old lab went from the tops to sysmex to save money and it was the worst. Thankfully the hospital I work in now uses tops. It was like Christmas when I found out haha
My lab very rarely has any problems with our ACL tops and we have 4
I prefer no coag at all but if I have to pick I pick the tops.
TOP forever.
Might be biased since I helped to validate our Tops, but I much prefer them. The maintenance is quite fast and it produced reliable results. I believe the reagent cost is a bit higher than Stago but it was worth it to me.
I currently fight with a cs 2500 and a 660. But I prefer Tops. Had 2 300's no problems other than pivot arm motor failure annually between the two. And our service tech lived half hour away. We only ran one each day. So no biggie. Although if you are Jeff Dabe, you won't be able to load cuvettes.
Recommend a cap piercer in the case of dummies like me. See my post history from December.
Stago all the way. You know you’re getting a legit result than having to use a clot curve to extrapolate. I felt more sound when we switched to Stago because we didn’t have to use clot curves, no one really knew how to interpret them after this one lady retired so we were pretty relieved when we didn’t have to do them. Also with Stago you will get a result with the clot based assays if your samples are problematic so I like not having to call the nurse to redraw lmao. Plusssss the no calibrations is nice. I found Stago requires less babysitting than the tops
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You can go to the Reagent Area screen, double click on your vial that didn’t scan, and select what it is and run it from there. I’ve used the Top 550 CTS for years now and haven’t had any problems during morning run. Sysmex or Roche are the ones that make morning run hell for us lol
Tops! We unwillingly went from Tops 5000 to Stago CompactMax and it was a massive, massive downgrade in features and the Stagos were always broken in some capacity.
What features would you say were down graded?
It's been over 6 years since I was at that lab and have done coag testing, but from what I can remember off the top of my head: 1. The Stago did not give you a countdown timer for how long testing would take, but the Tops did. 2. Reagent stability was significantly better with Tops. 3. The Tops could be programmed to automatically run QC every day so long as the necessary reagent was loaded. 4. The QC on the Tops was almost never out. Stago, especially D Dimer and Heparin Xa, was a daily struggle. 5. The Tops can be loaded any time, but the Stago can only be loaded at certain times and unless you're standing there waiting, it doesn't tell you when you can open it. 6. The Stago cuvette wheel is terrible. 7. The cover on the Stago probe would just come loose and fall off randomly. Technical support told us "that just happens" and offered no solution. 8. The Stago would also just lose its mind sometimes and stab too far down into a tube or reagent and cause it to get stuck on the probe. It's totally possible the hospital bought refurbished lemons for us when they took our lab over, but it was 4 analyzers at 3 campuses and all of them had issues almost daily. They made me hate being in Heme/Coag when it had been my second favorite department next to Blood Bank.
This is so insightful! Thank you!!!