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Article of the Week

Week of May 3rd

Reference:   Download this article

Stein PD et al. Gadolinium-enhanced Magnetic Resonance Angiography for Pulmonary Embolism: A Multicenter Prospective Study (PIOPED III). Ann Intern Med 2010;152:434-443.

Dr. Streiff's Review:

This is an interesting article examining the utility of a simplified warfarin dosing nomogram conceived by Scott Kaatz, an internist who has worked with the AC clinic at Henry Ford Hospital for a long time. Using a historical controlled before-after design, the authors demonstrated that the simplified warfarin dose adjustment nomogram significantly increased the time in therapeutic range compared with traditional dosing by experienced clinicians.

Strengths: Large subject population, consistent providers during both phases of the study, tests a strategy that is widely applicable – i.e., does not require special equipment, large financial investment.

Weaknesses: Not randomized, other factors could be responsible for the outcomes observed. Did not evaluate clinical outcomes.


Week of April 5th

Reference:   Download this article

Kim Y-K, Nieuwlaat R, Connolly SJ, Schulman S, Meijer K, Raju N, Kaatz S, Eikelboom JW. Effect of a simple two-step warfarin dosing algorithm on anticoagulant control as measured by time in therapeutic range: a pilot study. J Thromb Haemost 2010; 8: 101–6.

Dr. Streiff's Review:

This is an interesting article examining the utility of a simplified warfarin dosing nomogram conceived by Scott Kaatz, an internist who has worked with the AC clinic at Henry Ford Hospital for a long time. Using a historical controlled before-after design, the authors demonstrated that the simplified warfarin dose adjustment nomogram significantly increased the time in therapeutic range compared with traditional dosing by experienced clinicians.

Strengths: Large subject population, consistent providers during both phases of the study, tests a strategy that is widely applicable – i.e., does not require special equipment, large financial investment

Weaknesses: Not randomized, other factors could be responsible for the outcomes observed. Did not evaluate clinical outcomes

 

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