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Joseph J. Muscato, MD
Columbia, Mo

JAMA. 1993;269(23):2985.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—Drs Mennemeyer and Winkelman¹ are to be congratulated on attempting to tackle a very difficult problem. However, in their discussion they passed over what might be crucial data they uncovered in their analysis.

They point out in the results, but don't discuss, the role of close physician follow-up of these patients. If these patients were receiving warfarin, then 1 PT measurement in a 6-month period is a prescription for disaster. I suspect that most of the patients in this category were not receiving warfarin. However, those who had 5 to 10 PTs in the prior 6 months were almost certainly receiving warfarin, and they had a significantly lower incidence of adverse reactions. Interestingly, those patients tested in physician office laboratories had fewer tests performed (despite a self-referral bias?). Were those patients being tested in physician office laboratories seen less often? One could explore this with office . . . [Full Text PDF of this Article]

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