Quality assessment of anticoagulation dose management: Comparative evaluation of measures of time-in-therapeutic range
Quality assessment of anticoagulation dose management: Comparative evaluation of measures of time-in-therapeutic range
复制标题
DOI：
10.1023/b:thro.0000011377.78585.63
复制
发表时间：
2003-06-01
影响因子：
4
通讯作者：
Ansell, J
中科院分区：
文献类型：
--
作者：
Schmitt, L;Speckman, J;Ansell, J
背景：临床试验的结果往往取决于口服抗凝治疗的质量，但这种治疗的质量往往没有被提及或衡量。治疗中时间(TTR)是衡量抗凝剂量管理质量的一项指标，但目前存在多种方法来测量TTR.目的：本研究旨在比较三种常用的TTR测量方法在同一组患者中的比较.患者/方法：在6个2个月的间隔中，对3种常见的计算治疗中时间的方法进行了回顾分析.对三个月和六个月的间隔进行了额外的分析。结果：两种方法得到的结果相似，而线性内插法在测量2个月、3个月和6个月的间隔时，得到的范围内时间显著缩短。讨论了每种方法的优缺点。结论：应根据临床规模、所需信息和临床资源来决定使用哪种方法，以便在临床实践中应用。这些方法中的每一种都有其局限性，问题是哪种方法最能反映抗凝治疗的质量。不管这些限制，研究者被敦促使用至少一种方法来测量口服抗凝治疗的质量，以便更好地评估临床结果的有效性。
Background: The results of clinical trials often hinge on the quality of oral anticoagulation management, yet the quality of such management is frequently not mentioned or measured. Time-in-therapeutic range (TTR) is one measure of quality of anticoagulation dose management, but various methodologies exist for measuring TTR.Objective: This study was initiated to compare three commonly used methodologies for measuring TTR to see how they compare within the same cohort of patients.Patients/Methods: Three common methodologies of calculating time-in-therapeutic range were analyzed retrospectively in a cohort of patients over six two-month intervals. Additional analysis was performed for three and six-month intervals. The methodologies included fraction of INRs in range; cross-section of the files; and linear interpolation.Results: Fraction of the INRs in range and cross-section of the files methodologies gave similar results, while linear interpolation yielded significantly shorter time-in-range for the two-month, three-month, and six-month intervals measured. The advantages and disadvantages of each methodology are discussed.Conclusions: The decision of which method to use should be based on clinic size, information desired, and clinic resources for ease of applying either of the methods in clinical practice. Each of these methodologies has their limitations and the question remains as to which method best reflects the quality of anticoagulation management. Regardless of these limitations, investigators are urged to employ at least one method of measuring the quality of oral anticoagulation management so as to better assess the validity of the clinical outcomes.