title: [Computer aided dosage management of phenprocoumon anticoagulation therapy. Clinical validation].
abstract: A recently developed multiparameter computer-aided expert system (TheMa) for guiding anticoagulation with phenprocoumon (PPC) was validated by a prospective investigation in 22 patients. The PPC-INR-response curve resulting from physician guided dosage was compared to INR values calculated by "twin calculation" from TheMa recommended dosage. Additionally, TheMa was used to predict the optimal time to perform surgery or invasive procedures after interruption of anticogulation therapy.
  
  
  RESULTS
  Comparison of physician and TheMa guided anticoagulation showed almost identical accuracy by three quantitative measures: Polygon integration method (area around INR target) 616.17 vs. 607.86, INR hits in the target range 166 vs. 161, and TTR (time in therapeutic range) 63.91 vs. 62.40 %. After discontinuation of anticoagulation therapy, calculating the INR phase-out curve with TheMa INR prognosis of 1.8 was possible with a standard deviation of 0.50 ± 0.59 days.
  
  
  CONCLUSIONS
  Guiding anticoagulation with TheMa was as accurate as Physician guided therapy. After interruption of anticoagulant therapy, TheMa may be used for calculating the optimal time performing operations or initiating bridging therapy.
authors.affiliation: Priv.-Doz. Dr. med. Rüdiger Dissmann, Medizinische Klinik II (Kardiologie und Nephrologie), 27574 Bremerhaven, Germany, Tel. 047 71/299 33 65, Fax 047 71/299 33 67, E-mail: ruediger.dissmann@klinikum-bremerhaven.de.
authors.forename: R
authors.initials: R
authors.lastname: Dissmann
authors.forename: L J
authors.initials: LJ
authors.lastname: Cromme
authors.forename: A
authors.initials: A
authors.lastname: Salzwedel
authors.forename: U
authors.initials: U
authors.lastname: Taborski
authors.forename: J
authors.initials: J
authors.lastname: Kunath
authors.forename: F
authors.initials: F
authors.lastname: Gäbler
authors.forename: K
authors.initials: K
authors.lastname: Heyne
authors.forename: H
authors.initials: H
authors.lastname: Völler
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000097:blood; D001777:Blood Coagulation / Q000187:drug effects; D016903:Drug Monitoring / Q000379:methods*; D004360:Drug Therapy, Computer-Assisted / Q000379:methods*; D005260:Female; D006801:Humans; D019934:International Normalized Ratio / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010644:Phenprocoumon / Q000008:administration & dosage* / Q000097:blood; D011517:Prothrombin Time / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013927:Thrombosis / Q000097:blood* / Q000175:diagnosis / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D010644:Phenprocoumon
keywords: Oral anticoagulation therapy; computer aided dosage; expert system; phenprocoumon; warfarin