Trial reportCirculation2009
Physician alerts to prevent symptomatic venous thromboembolism in hospitalized patients.
Trial report in Circulation, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT04211181 (Effect on Thromboprophylaxis Among Hospitalized Patients Using a System-wide Multifaceted Quality Improvement Intervention), which is not on this map. Cited by 30 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effect on Thromboprophylaxis Among Hospitalized Patients Using a System-wide Multifaceted Quality Improvement Intervention: Rationale and Design for a Multicenter Cluster Randomized Clinical Trial in China
Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it, 101 citations in OpenAlex.
- Pooled it
- Interventions for implementation of thromboprophylaxis in hospitalized patients at risk for venous thromboembolism.The Cochrane database of systematic reviews · 2018Pooled it
- Guideline
- Implementing an evidence-based computerized decision support system to improve patient care in a general hospital: the CODES study protocol for a randomized controlled trial.Implementation science : IS · 2016Trial
- Trial
- Impact of electronic reminders on venous thromboprophylaxis after admissions and transfers.Journal of the American Medical Informatics Association : JAMIA · 2014Trial
- Strategies to enhance venous thromboprophylaxis in hospitalized medical patients (SENTRY): a pilot cluster randomized trial.Implementation science : IS · 2013Trial
- Use of a Risk Assessment Model for Venous Thromboembolism Is Associated with Decreased Prophylaxis.Journal of general internal medicine · 2025Article
- Evolution of an Electronic Health Record-Based Alert to Optimize Venous Thromboembolism Prophylaxis.Applied clinical informatics · 2025Article
- A dynamic customized electronic health record rule based clinical decision support tool for standardized adult intensive care metrics.JAMIA open · 2024Article
- System-Wide Thromboprophylaxis Interventions for Hospitalized Patients at Risk of Venous Thromboembolism: Focus on Cross-Platform Clinical Decision Support.Journal of clinical medicine · 2024Review
- The Use of Risk Scores for Thromboprophylaxis in Medically Ill Patients-Rationale and Design of the RICO trial.TH open : companion journal to thrombosis and haemostasis · 2024Article
- Universal EHRs Clinical Decision Support for Thromboprophylaxis in Medical Inpatients: A Cluster Randomized Trial.JACC. Advances · 2023Article
- Electronic alerts to initiate anticoagulation dialogue in patients with atrial fibrillation.American heart journal · 2022Article
- Modified IMPROVE VTE Risk Score and Elevated D-Dimer Identify a High Venous Thromboembolism Risk in Acutely Ill Medical Population for Extended Thromboprophylaxis.TH open : companion journal to thrombosis and haemostasis · 2020Article
- Role network measures to assess healthcare team adaptation to complex situations: the case of venous thromboembolism prophylaxis.Ergonomics · 2019Article
- Electronic alerts, comparative practitioner metrics, and education improve thromboprophylaxis and reduce venous thrombosis in community hospitals.Research and practice in thrombosis and haemostasis · 2018Article
- Practices to prevent venous thromboembolism: a brief review.BMJ quality & safety · 2014Review
- Delivery of optimized inpatient anticoagulation therapy: consensus statement from the anticoagulation forum.The Annals of pharmacotherapy · 2013Article
- Prevention of venous thromboembolism in hospitalized acutely ill medical patients: focus on the clinical utility of (low-dose) fondaparinux.Drug design, development and therapy · 2013Review
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
14 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundVenous thromboembolism (VTE) prophylaxis remains underused among hospitalized patients. We designed and carried out a large, multicenter, randomized controlled trial to test the hypothesis that an alert from a hospital staff member to the attending physician will reduce the rate of symptomatic VTE among high-risk patients not receiving prophylaxis. METHODS AND
resultsWe enrolled patients using a validated point score system to detect hospitalized patients at high risk for symptomatic VTE who were not receiving prophylaxis. We randomized 2493 patients (82% on Medical Services) from 25 study sites to the intervention group (n=1238), in which the responsible physician was alerted by another hospital staff member, or the control group (n=1255), in which no alert was issued. The primary end point was symptomatic, objectively confirmed VTE within 90 days. Patients whose physicians were alerted were more than twice as likely to receive VTE prophylaxis as control subjects (46.0% versus 20.6%; P<0.0001). The symptomatic VTE rate was lower in the intervention group (2.7% versus 3.4%; hazard ratio, 0.79; 95% CI, 0.50 to 1.25), but the difference did not achieve statistical significance. The rate of major bleeding at 30 days in the alert group was similar to that in the control group (2.1% versus 2.3%; P=0.68).
conclusionsA strategy of direct notification of the physician by a staff member increases prophylaxis use and leads to a reduction in the rate of symptomatic VTE in hospitalized patients. However, VTE prophylaxis continues to be underused even after physician notification, especially among Medical Service patients.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.