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IN THIS ISSUE |
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2007 15th User Group
Events Time Table
North American User Group
Intracranial Bleeds in AF Patients
Risks of Computer Aided Therapy
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Happy New Year...
...and all the best for 2007 from
all of us here at 4S!
Welcome to the first edition of
the DAWN AC Anticoagulation Software E-Newsletter for
2007.
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Dawn AC Anticoagulation Software
15th User Group 2007 |
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From talking to those of you
who could not make last years User Group, and those
of you who did attend and filled out the feedback
form, we have discovered that September was a better
month to hold the annual event and that the Rheged
Centre in Penrith was a great location and venue.
However we have acknowledged
that we need to give you as much notice as possible
in order for you to get your requests for leave in
early.
Therefore... We can
announce that the 15th User Group for 2007 will be
held on the 17th and 18th of September!
So we will be
looking for very short talks please on practical
tips and solutions that you have used to help
make your anticoagulation service better or on any
related subject. Speakers are given a discount of
£100 on the cost of the conference.
More details of this years
User Group will follow in later newsletters and we
will be mailing our invites out to you as soon as
possible. Therefore, can we ask if anyone has had a
change of address or job role recently to let us
know in advance.
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2nd North
American User Group, Denver, Colorado, USA |
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A North
American User Group is being planned by Dan Witt, Kaiser
Permanante on the 12th October 2007. This is being held
just before the 7th Annual Southwest Symposium on
Thrombosis and Hemostasis - held also in Denver on the
13th and 14th of October 2007.
Stand by for further
announcements...
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Other Events
Coming Up in 2007 |
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If you
are attending the following meetings we would be
pleased to see you:
British Society of Haematology;
Bournemouth, UK - 30th April - 2nd May on stand No
46
Anticoagulation Forum; Chicago, USA
ISTH (International Society on Thrombosis
and Haemostasis) Geneva, Switzerland -
6th - 12th July on Stand No 1302
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Intracranial
Bleeds in AF Patients with a High Risk of Falls |
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A study1 has revealed that atrial fibrillation
(AF) patients who are at a high risk of falls are also at
substantially increased risk of intracranial bleeds.
Rates
(95% CI) of intracranial hemorrhage per 100 patient-years
were 2.8 (1.9-4.1) in patients at high risk for falls and
1.1 (1.0-1.3) in other patients. Also rates (95% CI) of
traumatic intracranial hemorrhage were 2.0 (1.3-3.1) in
patients at high risk for falls and 0.34 (0.27-0.45) in
other patients.
So how do you identify
patients with falling tendencies?
 A
paper in JAMA2
this
month indicates that screening for risk of
falling during the clinical examination begins
with determining if the patient has fallen in
the past year. For patients who have not previously
fallen, screening consists of an assessment of
gait and balance. Patients who have fallen or
who have a gait or balance problem are at
higher risk of future falls.
One template for the risk
assessment of falls is given at
http://www.bhps.org.uk/falls/documents/FRATtool.pdf.
as part of the East
Berkshire, UK Falls Prevention programme (http://www.bhps.org.uk/falls/)
Could this be incorporated into screening of new AF
patients in the anticoagulation clinics?
1.
Incidence of intracranial hemorrhage in patients with
atrial fibrillation who are prone to fall. Brian F. Gage
MD, Am J Med.
2005 Jun;118(6):612-7
2. Will My Patient Fall? David
A. Ganz, MD, MPH; Yeran Bao, MD; Paul G. Shekelle, MD,
PhD; Laurence Z. Rubenstein, MD, MPH JAMA. 2007;297:77-86
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What are the
Risks of Computer Aided Anticoagulation Therapy? |
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How
does the risk of computer aided
anticoagulation therapy compare with the risks arising in
everyday life? Extensive research undertaken by the UK
Government Health and Safety Executive suggests that
levels of annual risk (of death) broadly accepted by the
UK population include:
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Risk
to a worker in a relatively high risk industry such as
mining is 1 in 1000 per person year
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Risk
of death in a road traffic accident 1 in 10 000 per person
year
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Risk
of death in an industrial accident in the very safest
parts of industry 1 in 100 000 per person year
From work we did with an independent risk consultant in
2001 assuming a clinic with 2000 patients the predicted
likelihood of a serious error causing patient harm
(assuming only 1 in 100 errors is serious) with and
without software and with and without checking of the
computer output:
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‘All manual clinic’: 1 in 700 patient years
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Software, manual label printing or telephone: 1 in 1000
patient years
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Software, book printer or direct letter: 1 in 2000 patient
years
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Software, manual printing, with check: 1 in 700,000
patient years
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Software, book printer or direct letter, with check: 1 in
1,400,000 patient years
In the last two cases above you can see that independent
checking of the output from the computer by a competent
person places management of anticoagulation therapy in a
very acceptable risk zone. Read more
at:
http://www.4s-dawn.com/dawnac/rmcon.htm
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