Hanna E. Bloomfield, MD, MPH; Brent C. Taylor, PhD, MPH; Timothy J. Wilt, MD, MPH
Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M10-2099.
Bloomfield HE, Taylor BC, Wilt TJ. Effect of Patient Self-testing and Self-management of Long-Term Anticoagulation on Major Clinical Outcomes. Ann Intern Med. 2011;155:336-337. doi: 10.7326/0003-4819-155-5-201109060-00019
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Published: Ann Intern Med. 2011;155(5):336-337.
We thank Dr. Siebenhofer and colleagues for their interest in our article. The subgroup analysis for thromboembolism comparing patient self-testing with patient self-management indicated a significant interaction (Peto odds ratio [OR] for self-testing, 0.84 [95% CI, 0.6 to 1.1]; for self-management, 0.43 [CI, 0.3 to 0.6]; P = 0.004) (1). However, because this was one of many post hoc subgroup analyses, results should be interpreted cautiously.
With regard to our “major thromboembolic events” outcome, it is true that we only included strokes for the VA trial (2), even though our definition also included deep venous thrombosis, pulmonary embolism, and arterial embolism. We took this approach because the published VA data categorized end points as strokes or as “nonstroke thrombotic events,” which also included transient ischemic attacks (2).
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