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Dabigatran at a dose of 150 mg twice a day met the criteria for superiority over warfarin in preventing stroke and systemic embolism while reducing the rate of hemorrhagic stroke with a similar risk of major bleeding.

Can I change the above sentence as "Dabigatran at a dose of 150 mg twice a day met the criteria for superiority over warfarin in preventing stroke and systemic embolism while reducing the rate of hemorrhagic stroke with a similar risk in warfarin of major bleeding." as I'm not quite happy with the use of the word "similar" in the original sentence (as it is somewhat unclear)?

Suggestions please.

JohnParis · Accepted Answer

KathirkamanCan I change the above sentence.... - I would not recommend it unless you reword the entire sentence to express that these results were from a comparison of the two molecules. It's somewhat understood that the similar risk of major bleeding applies to warfarin (not "in" warfarin) but the sentence should be rewritten.

KathirkamanI'm not quite happy with the use of the word "similar" in the original sentence (as it is somewhat unclear)? If the sentence is to appear in the abstract, then I can accept the use of "similar". If the sentence were to appear in the results section of your manuscript, you would be required to provide ORs with 95% Confidence Internals and let the reader judge for himself just what "similar" means.

Hope this helps,

John

Anonymous · Answer

The whole sentence "reducing rate of hemorrhagic stroke etc, is unclear in it's meaning to the "layperson"

How about writing in this way;

At a dose of 150mg (BID) twice a day, Dabigatran met the criteria for superiority over Warfarin in preventing stroke and systemic embolism, as well as reducing rate of hemorrhagic stroke with similar risk of bleeding.

Hope that helped.

L.Lynch

JohnParis · Answer

Dear L.Lynch

Thanks for bumping this post back to the top.

I wanted to ask Kathirkaman if the sentences were part of a manuscript destined for publication in a peer-reviewed journal, or not. The thought slipped my mind and the thread too.

Kathirkaman, if you see this would you mind letting me know?

The results of two seminal comparisons of dabigatran versus warfarin were both published in the New England Journal of Medicine (Connolly, Ezekowitz, et al. Dabigatran versus Warfarin in Patients with Atrial Fibrillation, N Engl J Med 2009;361:1139-51 and Schulman, Kearon et al. Dabigatran versus Warfarin in the Treatment of Acute Venous Thromboembolism, N Engl J Med 2009;361:2342-52.)

The language used in both articles concerning similar rates of major hemorrhage is much the same, and I could not help but think that this was for a specific reason. Is it possible that the journal editors requested this during rewrites? In any event, the following sentence is a new proposal that follows the wording of the above mentioned articles and, hopefully, in a much more direct manner.

Dabigatran 150 mg administered twice daily, compared with warfarin, was associated with lower rates of stroke, hemorrhagic stroke and systemic embolism but similar rates of major hemorrhage.

Once you say that “lower rates” were achieved, the use of “meeting the criteria for superiority” sounds a bit verbose. Also, I am not certain that the average layperson would understand that the Latin phrase bis in die means twice daily, so I didn't use it.

Regards,

John

Anonymous · Answer

I think your sentence is too complex Kathirkaman. i go along more with anonymous above and would just say dabigatran bd (ie twice a day) as an anti-coagulant has advantages as it is less likely to cause cerebral haemorrhage than warfarin. Warfarin however prevents any new clots forming, though no ant-coagulant drug can dissolve an existing one.

Medical english does need to be kept as simple as possible as itsstudents are still L2 (ie second language) learners. Communication with other health professional and ordinary everyday patients is what we are trying to do.

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