Document Detail


Computer-aided dosage in oral anticoagulation therapy using phenprocoumon. Problems and approaches.
MedLine Citation:
PMID:  21057712     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Oral anticoagulation using vitamin K antagonists has been established for over 50 years. Although it is highly effective in preventing thromboembolic incidents, its therapeutic control still remains problematic. Therefore, a computer-aided approach is recommended for deriving dosages. Up to now, the dosage is often based on the visual inspection of previous INR measurements, average weekly doses, and the INR target range. Statistical variations of measurement results and time-delayed effects of dosages, however, frequently result in the misinterpretation of data and suggest pseudo-trends. Treating physicians are not only responsible for determining the patient-specific maintenance dose, but must also respond to deviating INR values, overdosage or underdosage, initiate the oral anticoagulation therapy, and control the INR level in case of a new target range (bridging). Instructive examples are provided to illustrate the described difficulties. A computer-aided expert system is currently developed to ensure the therapeutic safety under the specified conditions. We present preliminary results from a study designed to validate mathematical models underlying such expert systems.
Authors:
L Cromme; H Völler; F Gäbler; A Salzwedel; U Taborski
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Hämostaseologie     Volume:  30     ISSN:  0720-9355     ISO Abbreviation:  Hamostaseologie     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8204531     Medline TA:  Hamostaseologie     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  183-9     Citation Subset:  IM    
Affiliation:
Lehrstuhl Mathematik, insbesondere Numerische und Angewandte Mathematik, Postfach 101344, 03013 Cottbus, Germany. cromme@tu-cottbus.de
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