Computer-adjusted dosage of anticoagulant therapy improves the quality of anticoagulation.
Stud Health Technol Inform
; 52 Pt 2: 819-23, 1998.
Article
en En
| MEDLINE
| ID: mdl-10384574
ABSTRACT
OBJECTIVE:
Risks and benefits of anticoagulant therapy depend directly of the quality of anticoagulation. We performed a meta-analysis of published randomized trials to assess the overall effectiveness of computer-based prescription systems on the quality of anticoagulation.DESIGN:
Randomized controlled trials were identified through electronic searches of the Medline database (1966-1997) and systematic analyses of the references of articles. Two investigators selected relevant papers and summarized data from the studies.METHODS:
The outcome variable was the proportion of days within the target range of anticoagulation. A pooled estimate of the common odds ratio of being in the target range and its confidence interval was obtained by the Mantel-Haenszel method.RESULTS:
Seven trials having included 1217 patients were identified. Computer systems were based on a pharmacokinetic-pharmacodynamic model and a bayesian prediction method. Most of them concerned the oral anticoagulant warfarin. The global odds ratio of being in the target range was 1.58 [95% CI 1.34-1.86], thus meaning that the use of a computer for anticoagulation optimization increased by 58% the proportion of visits where patients were appropriately treated. The proportion of clinical events was too low for allowing a summary analysis.CONCLUSION:
Evidence from randomized controlled trials supports the effectiveness of computer-aided anticoagulant prescription. Diffusion of these systems in ambulatory care could increase the benefit/risk ratio of anticoagulant treatment at a low cost.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Quimioterapia Asistida por Computador
/
Anticoagulantes
Tipo de estudio:
Clinical_trials
/
Etiology_studies
/
Prognostic_studies
/
Systematic_reviews
Aspecto:
Equity_inequality
Límite:
Humans
Idioma:
En
Revista:
Stud Health Technol Inform
Asunto de la revista:
INFORMATICA MEDICA
/
PESQUISA EM SERVICOS DE SAUDE
Año:
1998
Tipo del documento:
Article
País de afiliación:
Francia