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Comment & Response
March 27, 2018

Genotype vs Clinically Guided Dosing of Warfarin to Prevent Adverse Events

Author Affiliations
  • 1Department of Emergency Medicine, Nanyang Wolong Hospital, Nanyang, China
JAMA. 2018;319(12):1278-1279. doi:10.1001/jama.2018.0189

To the Editor Dr Gage and colleagues1 found that genotype-guided warfarin dosing compared with clinically guided dosing reduced clinical events and improved anticoagulation control among patients undergoing hip or knee arthroplasty. I have a few concerns about the research and statistical methods.

First, the authors randomized patients receiving either hip or knee arthroplasty to genotype-guided or clinically guided warfarin dosing groups. However, patients receiving hip or knee arthroplasty should have been randomized separately and the end point calculations performed for 4 groups rather than 2.