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Published on 13 June 2008

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Computer calculated doses “safe and reliable”

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The largest ever study into the administration of blood thinning drugshas found that dosages calculated by computer are at least as safe andreliable as those provided by expert medical professionals.

Anticoagulants are used across the globe but prescribing the right oral dose of anticoagulant to patients can be problematic.

Previousstudies supporting the use of computer-assisted dosage have dependedsolely on laboratory results and have not been sufficiently large todetermine whether prolongation of normal blood clotting – measured asthe “international normalised ratio” (INR) – resulted in clinicalbenefit and improved safety.

But the five-year study carried outin 32 medical centres across the European Union has foundcomputer-assisted dosage is as good, if not better than thoseprescribed by expert medical professionals.

The study analysed nearly 400,000 INR tests, divided evenly between manual and computer-assisted dosage.

The percentage of manual tests to give the correct INR was 64.7%, compared with 65.9% for computer-assisted dosage.

Interms of safety, the number of INR tests that resulted in clinicalcomplications was 7.6% lower in all clinical groups withcomputer-assisted dosage.

While not statistically significant,the number of clinical events following treatment were significantlylower for computer dosage – 9.1 per 100 patient-years with medicalstaff dosage was reduced to 6.1 in the computer arm.

LeonPoller, from the Central Facility at Manchester’s Faculty of LifeSciences said: “The need for computer assistance arises from themassive demand for oral anticoagulants following their success attreating an increasing number of thrombotic and embolic conditions.

“Thisincreased demand has been overwhelming and stretched medical facilitiesworldwide to their limits. Computer dosage was introduced as a way tomeet this demand but its safety and effectiveness had not previouslybeen established.”

The study was published in the Journal of Thrombosis and Haemostasis.

Journal of Thrombosis and Haemostasis



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