Key result
Unvalidated criteria used to predict warfarin dosing agreement between two INR measurements misclassified dosing decisions for 19% to 38% (mean 27%) of paired values.
Why the study?
Do unvalidated arithmetic criteria accurately predict warfarin dosing agreement between point-of-care INR devices and standard measures?
Observational
Do unvalidated arithmetic criteria accurately predict warfarin dosing agreement between point-of-care INR devices and standard measures?
Answers are grounded in this paper and cite their sources.
Unvalidated criteria used to predict warfarin dosing agreement between INR measurements have large error rates, suggesting dosing decisions should be measured directly.
BACKGROUND: Investigators commonly rely on unvalidated, mainly arithmetic criteria to predict if point-of-care fingerstick devices that assess International Normalized Ratio (INR) lead to the same warfarin dosing decisions as a standard measure. METHODS: Criteria that predict warfarin dosing agreement between 2 INR measurements were evaluated using clinicians' actual dosing decisions as the standard. Bayesian hierarchical modeling was used to rank the criteria by the proportion of correct dosing predictions and the magnitude of difference between actual and predicted dosing agreement. RESULTS: The prediction criteria misclassified dosing agreement for between 19% and 38% of paired INR values (x: 27%). The magnitude of misclassification varied inconsistently throughout the INR scale. CONCLUSION: The unvalidated criteria used to predict warfarin dosing agreement between 2 INR measurements are associated with large error. Warfarin dosing decisions should be measured directly in such assessments.
No takes yet. Share an insight, caveat, or question.
Shermock et al. (2006) conducted an observational in Warfarin therapy. Unvalidated prediction criteria for INR fingerstick devices vs. Clinicians' actual dosing decisions was evaluated on Misclassification of dosing agreement. Unvalidated criteria used to predict warfarin dosing agreement between two INR measurements misclassified dosing decisions for 19% to 38% (mean 27%) of paired values.
Synapse has enriched 10 related papers. Consider them for comparative context: