Physicians "should use one of two validated computer-dosage programs from this study," lead author Dr. Leon Poller from University of Manchester, UK, told Reuters Health. "No other computer-dosage program, of which there are many in the market, has been validated by a clinical end-point study."
Dr. Poller and colleagues investigated whether the two computer-assisted dosage programs (PARMA 5 and DAWN AC), compared with manual dosage by experienced medical staff, reduced thrombotic or bleeding events.
Although the differences did not reach statistical significance, there were fewer clinical events, especially in the first 3 weeks of patients entering the study, in the computer-assisted dosage arm than in the manual dosage arm of the study, the authors report.
Times in target INR range were superior in the computer-assisted dosage arm than in the manual dosage arm after adjusting for computer program used, gender, age, clinical indication, and target INR range, the researchers report in the June issue of the Journal of Thrombosis and Haemostasis.
Times in target INR range became progressively superior in the computer-assisted dosage arm with increasing duration of treatment, the researchers note.
"There is no evidence that computer assistance with anticoagulant dosage puts patients at any added risk of clinical events as compared with dosage by experienced medical staff," the authors conclude. "This is reassuring to hospitals and community clinics wishing to move to computer-assisted dosage to reduce heavy demands on medical staff time and resources."
A separate report on the cost-effectiveness of computer-assisted dosage "should be submitted for publication in the next few weeks and is favorable to computer-dosage," Dr. Poller said.
He is also preparing a Guideline for the International Society of Thrombosis and Haemostasis to screen out computer programs that lack "minimum safety standards."
J Thromb Haemost 2008;6:935-943.
来源：http://www.reutershealth.com/archive/2008/07/11/professional/links/20080711clin017.html
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