Evidence map›Paper›PMID 22315259›Full record

GuidelineChest2012

Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.

Anne Holbrook, Sam Schulman, Daniel M Witt, Per Olav Vandvik, Jason Fish, Michael J Kovacs, Peter J Svensson, David L Veenstra, Mark Crowther, Gordon H Guyatt

2 registry-linked trialsOpen access · bronzeAbstract readComparative StudyPractice GuidelineReview
PubMed Full text at PMC Publisher
In one paragraph

Guideline in Chest, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 454 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
454citing papers in PubMed, 14 pooled it
75.7field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT02324686 phase2completednot on this mapstarted 2014, after this paper: background citation

Vitamin K Supplementation to Improve INR Stability in Patients on Hemodialysis Taking Warfarin for Atrial Fibrillation

TypeinterventionalSponsorUniversity Health Network, TorontoRan2014 to 2017Enrolled3ConditionsEnd Stage Renal Failure on Dialysis, Atrial FibrillationArmsvitamin K1
NCT02557672 phase4completednot on this mapstarted 2016, after this paper: background citation

Prothrombin Complex Concentrate (PCC) Compared to Fresh Frozen Plasma (FFP) for Post-cardiopulmonary Bypass Coagulopathy and Bleeding, a Prospective Randomized Trial at Large US Medical Center.

TypeinterventionalSponsorMayo ClinicRan2016 to 2022Enrolled106ConditionsBleeding, Blood Loss, Surgical, Cardiovascular Surgical Procedures, Prothrombin Complex ConcentratesArmsProthrombin complex concentrate (Human), Fresh frozen plasma (FFP)
3 · Its place in the literature

Who cites it

454 citing papers in PubMed, 14 syntheses or guidelines pooled it, 1,243 citations in OpenAlex.

  1. Pooled it
  2. Guideline
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  5. SAMe-TTAmerican journal of cardiovascular drugs : drugs, devices, and other interventions · 2024
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  14. Guideline
  15. Trial
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394 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 7 institutions in 4 countries.

Anne HolbrookDivision of Clinical Pharmacology and Therapeutics, McMaster University, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada; Department of Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. Electronic address: holbrook@mcmaster.ca.
Sam SchulmanDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Daniel M WittDepartment of Pharmacy, Kaiser Permanente Colorado, Denver, CO.
Per Olav VandvikDepartment of Medicine, Innlandet Hospital Trust, Gjøvik, Norway.
Jason FishDepartment of Internal Medicine, University of California Los Angeles, Los Angeles, CA.
Michael J KovacsDepartment of Medicine, University of Western Ontario, London, ON, Canada.
Peter J SvenssonDepartment for Coagulation Disorders, University of Lund, University Hospital, Malmö, Sweden.
David L VeenstraDepartment of Pharmacy, University of Washington, Seattle, WA.
Mark CrowtherDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Gordon H GuyattDepartment of Medicine, McMaster University, Hamilton, ON, Canada; Department of Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
McMaster University · CAInnlandet Hospital Trust · NOKaiser Permanente · USLund University · SEUniversity of California, Los Angeles · USUniversity of Washington · USWestern University · CA

Funding

Antithrombotic Therapy and Prevention of Thrombosis: ACCP Evidence-Based ClinicalR13HL104758 · NHLBI · AMERICAN COLLEGE OF CHEST PHYSICIANS · PI LEWIS, SANDRA ZELMAN · 2010 to 2010
$11k
NHLBI NIH HHS R13 HL104758
6 · The paper itself

Abstract

backgroundHigh-quality anticoagulation management is required to keep these narrow therapeutic index medications as effective and safe as possible. This article focuses on the common important management questions for which, at a minimum, low-quality published evidence is available to guide best practices.

methodsThe methods of this guideline follow those described in Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines in this supplement.

resultsMost practical clinical questions regarding the management of anticoagulation, both oral and parenteral, have not been adequately addressed by randomized trials. We found sufficient evidence for summaries of recommendations for 23 questions, of which only two are strong rather than weak recommendations. Strong recommendations include targeting an international normalized ratio of 2.0 to 3.0 for patients on vitamin K antagonist therapy (Grade 1B) and not routinely using pharmacogenetic testing for guiding doses of vitamin K antagonist (Grade 1B). Weak recommendations deal with such issues as loading doses, initiation overlap, monitoring frequency, vitamin K supplementation, patient self-management, weight and renal function adjustment of doses, dosing decision support, drug interactions to avoid, and prevention and management of bleeding complications. We also address anticoagulation management services and intensive patient education.

conclusionsWe offer guidance for many common anticoagulation-related management problems. Most anticoagulation management questions have not been adequately studied.

Indexed as

Evidence-Based MedicineSocieties, MedicalAdministration, OralDecision Support Systems, ClinicalDose-Response Relationship, DrugDrug Administration ScheduleDrug InteractionsDrug-Related Side Effects and Adverse ReactionsFibrinolytic AgentsFondaparinuxHemorrhageHeparinHumansInfusions, IntravenousInternational Normalized RatioLong-Term CareFibrinolytic AgentsFondaparinuxHeparinPolysaccharidesVitamin K

Identifiers

PMID22315259
PMCPMC3278055
OpenAlexW2157822705

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.