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Cost-effectiveness of Ximelagatran for Stroke PreventionReply
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| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
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In Reply: We suspect that many physicians share the opinion of Drs Perret-Guillaume and Wahl that the utility of warfarin therapy that we used seemed too high, since physicians tend to be more averse to warfarin therapy than are patients with atrial fibrillation.1 As physicians, we need to take care that our own preferences (or our personal desire to avoid monitoring warfarin) do not usurp our patients preferences.
Similarly, as researchers, we need to conduct studies that minimize interviewer bias. Thus, the 1996 study2 elicited utilities for warfarin, aspirin, and stroke using a computer-aided utility assessment tool, U-Titer.3 U-Titer was used to standardize the description of warfarin therapy and to iteratively determine utilities on a quality-of-life scale ranging from 0 (tantamount to death) to 1 (ideal health). The mean utility of warfarin from the 70 participants was 0.987, the value that we used in the base case analysis in the . . . [Full Text of this Article]
Cara L. OBrien, MD
Internal Medicine Residency Program Duke University Durham, NC
Brian F. Gage, MD, MSc
bgage@im.wustl.edu Washington University School of Medicine St Louis, Mo
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