Trial reportBMC medicine2019
Implementation of genotype-guided dosing of warfarin with point-of-care genetic testing in three UK clinics: a matched cohort study.
Trial report in BMC medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed.
- Health inequalities in precision medicine: A systematic review.European journal of human genetics : EJHG · 2026Review
- A simple formula for predicting the warfarin dose in atrial fibrillation: development, external validation, and model comparison.Thrombosis journal · 2025Article
- Assessment of physician preparedness for implementation of pathology-supported genetic testing: solution-driven post-COVID-19 survey.Frontiers in genetics · 2025Article
- Revolutionizing healthcare and medicine: The impact of modern technologies for a healthier future-A comprehensive review.Health care science · 2024Review
- Tribulations and future opportunities for artificial intelligence in precision medicine.Journal of translational medicine · 2024Review
- Precision Medicine-Are We There Yet? A Narrative Review of Precision Medicine's Applicability in Primary Care.Journal of personalized medicine · 2024Review
- Being precise with anticoagulation to reduce adverse drug reactions: are we there yet?The pharmacogenomics journal · 2024Review
- Navigating the Intersection of Technology and Depression Precision Medicine.Advances in experimental medicine and biology · 2024Review
- Real-world evidence that among atrial fibrillation patients warfarin is associated with reduced nonelective admissions compared with those on DOACs.Clinical cardiology · 2023Article
- Impact of Pharmacogenomics in Clinical Practice.Pharmaceuticals (Basel, Switzerland) · 2023Review
- Anticoagulant use in older persons at risk for falls: therapeutic dilemmas-a clinical review.European geriatric medicine · 2023Review
- Advancing Pharmacogenomics from Single-Gene to Preemptive Testing.Annual review of genomics and human genetics · 2022Review
- Rapid Point-of-Care Genotyping to Avoid Aminoglycoside-Induced Ototoxicity in Neonatal Intensive Care.JAMA pediatrics · 2022Article
- The role of pharmacogenomics in contemporary cardiovascular therapy: a position statement from the European Society of Cardiology Working Group on Cardiovascular Pharmacotherapy.European heart journal. Cardiovascular pharmacotherapy · 2022Article
- Emerging technologies and their impact on regulatory science.Experimental biology and medicine (Maywood, N.J.) · 2022Review
- Pharmacogenetics to guide cardiovascular drug therapy.Nature reviews. Cardiology · 2021Review
- Review
- Precision Medicine, AI, and the Future of Personalized Health Care.Clinical and translational science · 2021Review
- Pharmacogenomics for Primary Care: An Overview.Genes · 2020Review
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundWarfarin is a widely used oral anticoagulant. Determining the correct dose required to maintain the international normalised ratio (INR) within a therapeutic range can be challenging. In a previous trial, we showed that a dosing algorithm incorporating point-of-care genotyping information ('POCT-GGD' approach) led to improved anticoagulation control. To determine whether this approach could translate into clinical practice, we undertook an implementation project using a matched cohort design.
methodsAt three clinics (implementation group; n = 119), initial doses were calculated using the POCT-GGD approach; at another three matched clinics (control group; n = 93), patients were dosed according to the clinic's routine practice. We also utilised data on 640 patients obtained from routinely collected data at comparable clinics. Primary outcome was percentage time in target INR range. Patients and staff from the implementation group also provided questionnaire feedback on POCT-GGD.
resultsMean percentage time in INR target range was 55.25% in the control group and 62.74% in the implementation group; therefore, 7.49% (95% CI 3.41-11.57%) higher in the implementation group (p = 0.0004). Overall, patients and staff viewed POCT-GGD positively, suggesting minor adjustments to allow smooth implementation into practice.
conclusionsIn the first demonstration of the implementation of genotype-guided dosing, we show that warfarin dosing determined using an algorithm incorporating genetic and clinical factors can be implemented smoothly into clinic, to ensure target INR range is reached sooner and maintained. The findings are like our previous randomised controlled trial, providing an alternative method for improving the risk-benefit of warfarin use in daily practice.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.