Currently taking warfarin
Prior warfarin therapy with known required stable dose
Clinician opinion that warfarin dosing needs to be adjusted for reasons not accounted for by dosing algorithm
Abnormal baseline INR (off warfarin), eg, due to liver disease, antiphospholipid antibody
Contraindication to warfarin treatment for at least 3 months
Life expectancy <1 y
Pregnant women or childbearing women not using medically approved method of birth control
Inability to follow-up on a regular basis with anticoagulation practitioners participating in trial
Any factors likely to limit adherence to warfarin (eg, dementia, alcohol or substance abuse, plans to move in the next 6 m, history of unreliability in medication taking or appointment keeping, significant concerns about participation in the study from spouse, significant other, or family members, lack of support from primary health care provider)
Cognitive or other causes of inability to provide informed consent or follow study procedures
Participating in another trial that prohibits participation in the COAG trial or planned enrollment in such a trial within the first 6 m of warfarin therapy
Estimated blood loss of >1000 mL requiring blood transfusions within 48 h before randomization
Genotype (CYP2C9 or VKORC1) known to participant from prior testing