Copyright 4S Dawn 2002
Dawn AC BenchmarkingDawn AC Benchmarking
Mark AinsworthMark Ainsworth
4S Dawn Clinical Software4S Dawn Clinical SoftwareMark AinsworthMark Ainsworth
4S Dawn Clinical Software4S Dawn Clinical Software
Copyright 4S Dawn 2002
Dawn AC Benchmarking
Current Position
Future Plans
INR Control
Copyright 4S Dawn 2002
Current Position
9th Benchmarking Run 96,000 Patients 690,000 INRs 62 Subscribers
1315
26
31
40
44 45
53
62
0
10
20
30
40
50
60
70
Oct-98 Apr-99 Oct-99 Apr-00 Oct-00 Apr-01 Oct-01 Apr-02 Oct-02
Copyright 4S Dawn 2002
Current Position
For every target INR range 3 statistical profiles 3 charts
Summary chart Sample reports on website
www.4s-dawn.com/dawnac
Copyright 4S Dawn 2002
Future Plans
Grouping patients Statistical methods of identifying
groups Performance measures by group
Adjustments for Patient Mix age sex time on treatment
Copyright 4S Dawn 2002
Standardising Measures
% Time in Range
54
72
88
11
196
35
100
38
115
179
9 210
139
177
191
212
283
97
175
10
34
106
216
16
81
22
233
154
311
266
207
171
94
111
91
13
11
0.00
10.00
20.00
30.00
40.00
50.00
60.00
70.00
80.00
90.00
100.00
% T
ime
In R
an
ge
Copyright 4S Dawn 2002
Standardising Measures
Standardised % Time in Range
Copyright 4S Dawn 2002
INR Control
Better INR Control = Reduced Events Include events in Benchmarking results
What factors influence INR variation? Prof. Palareti, Bologna, Italy Italian Federation of Anticoagulation
Clinics AC Therapy Education is strong factor
Copyright 4S Dawn 2002
INR Control
Copyright 4S Dawn 2002
INR Control
BMJ 2002;325:1073-5 INR control has effect on events
(QC ?)
0
100
200
300
400
500
0 1 2 3 4 5 6 7
Worth having good INR control
Copyright 4S Dawn 2002
INR Control
Identify poorly performing patients Improve their INR control
0
20
40
60
80
100
0 20 40 60 80 100
% Time in Range
% o
f Pati
ents
Copyright 4S Dawn 2002
Summary
Third of Dawn AC sites now subscribe
Next improvements Grouping patients Adjusting statistics for patient mix
Copyright 4S Dawn 2002
Dawn AC BenchmarkingDawn AC Benchmarking
Copyright 4S Dawn 2002