Validity of Criteria Used to Evaluate Fingerstick Devices That Assess International Normalized Ratio

Kenneth M. Shermock, Jason T. Connor, Nicole T. Smith, Jodie M. Fink and Lee Bragg
Additional contact information
Kenneth M. Shermock: Center for Pharmaceutical Outcomes and Policy, The Johns Hopkins Hospital, Baltimore, MD, kshermo1@jhmi.edu
Jason T. Connor: Department of Biostatistics and Epidemiology, The Cleveland Clinic Foundation, Cleveland, OH, Department of Statistics and H. John Heinz III School of Public Policy and Management, Carnegie Mellon University, Pittsburgh, PA
Nicole T. Smith: Department of Statistics, Brigham Young University, Provo, UT
Jodie M. Fink: Department of Pharmacy, The Cleveland Clinic Foundation, Cleveland, OH
Lee Bragg: Pharmacy Systems, Inc., Department of Pharmacy, St. West Shore Hospital, Westlake OH

Medical Decision Making, 2006, vol. 26, issue 3, 239-246

Abstract: Background . Investigators commonly rely on unvalidated, mainly arithmetic criteria to predict if point-of-care fingerstick devices that assess International Normalized Ratio (INR) lead to the same warfarin dosing decisions as a standard measure. Methods . Criteria that predict warfarin dosing agreement between 2 INR measurements were evaluated using clinicians’ actual dosing decisions as the standard. Bayesian hierarchical modeling was used to rank the criteria by the proportion of correct dosing predictions and the magnitude of difference between actual and predicted dosing agreement. Results . The prediction criteria misclassified dosing agreement for between 19% and 38% of paired INR values ( x̄x: 27%). The magnitude of misclassification varied inconsistently throughout the INR scale. Conclusion . The unvalidated criteria used to predict warfarin dosing agreement between 2 INR measurements are associated with large error. Warfarin dosing decisions should be measured directly in such assessments.

Keywords: International Normalized Ratio; validity; outcome assessment; bias; warfarin; point of care systems (search for similar items in EconPapers)
Date: 2006
References: View complete reference list from CitEc
Citations:

Downloads: (external link)
https://journals.sagepub.com/doi/10.1177/0272989X06288681 (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:26:y:2006:i:3:p:239-246

DOI: 10.1177/0272989X06288681

Access Statistics for this article

More articles in Medical Decision Making
Bibliographic data for series maintained by SAGE Publications ().