Are we ordering CAGG wisely? An audit of cold agglutinin requests and a rational testing algorithm | Synapse
February 22, 2026
Are we ordering CAGG wisely? An audit of cold agglutinin requests and a rational testing algorithm
Key Points
This research aims to evaluate the appropriateness of cold agglutinin requests and the effectiveness of current testing practices.
Conducted an audit of cold agglutinin requests
Reviewed completeness of haemolytic screens performed prior to testing
Developed a rational testing algorithm based on findings.
Found low diagnostic yield for cold agglutinin requests
Identified significant number of requests made without complete haemolytic assessment
Recommended a new testing algorithm to improve diagnostic efficiency.
Abstract
CAG testing is ordered in practice even when complete haemolytic screen has not been performed, leading to low diagnostic yield and unnecessary workload.