Evidence map›Paper›PMID 26033397›Full record

Trial reportThrombosis research2015

Women's values and preferences for thromboprophylaxis during pregnancy: a comparison of direct-choice and decision analysis using patient specific utilities.

Mark H Eckman, Pablo Alonso-Coello, Gordon H Guyatt, Shanil Ebrahim, Kari A O Tikkinen, Luciane Cruz Lopes, Ignacio Neumann, Sarah D McDonald, Yuqing Zhang, Qi Zhou and 7 more

Abstract readClinical TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Thrombosis research, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 2 pooled it
1.1field-weighted citation impact, top 23% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 36 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Comparison of open fetal, fetoscopic and postnatal surgical repair for open spina bifida: decision analysis.Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2025
    Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. The Risk of Thrombosis Around Pregnancy: Where Do We Stand?Frontiers in cardiovascular medicine · 2022
    Article
  11. Article
  12. Article
  13. Review
  14. Preventing venous thromboembolism during pregnancy and postpartum: crossing the threshold.Hematology. American Society of Hematology. Education Program · 2017
    Review
  15. Article
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

17 authors at 14 institutions in 7 countries.

Mark H EckmanDivision of General Internal Medicine and Center for Clinical Effectiveness, University of Cincinnati, USA. Electronic address: mark.eckman@uc.edu.
Pablo Alonso-CoelloDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada; Iberoamerican Cochrane Centre, CIBERESP-IIB Sant Pau, Barcelona, Spain.
Gordon H GuyattDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada.
Shanil EbrahimDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada; Department of Anaesthesia, McMaster University, Hamilton, ON; Department of Medicine, Stanford University, Stanford; Department of Anaesthesia and Pain Medicine, Hospital for Sick Children, Toronto, ON, Canada.
Kari A O TikkinenDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada; Departments of Urology and Public Health, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland.
Luciane Cruz LopesPharmaceutical Sciences, University of Sorocaba, UNISO, Sorocaba, Sao Paolo, Brazil.
Ignacio NeumannDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada; Department of Internal Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Sarah D McDonaldDepartments of Obstetrics & Gynecology, Radiology, and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
Yuqing ZhangDivision of General Internal Medicine and Center for Clinical Effectiveness, University of Cincinnati, USA.
Qi ZhouDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
Elie A AklDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada; Department of Medicine, American University of Beirut, Beirut, Lebanon; Department of Medicine, State University of New York at Buffalo, New York, NY, USA.
Ann Flem JacobsenDepartment of Obstetrics & Gynecology, Oslo University Hospital and University of Oslo, Oslo, Norway.
Amparo SantamaríaUnidad de Hemostasia y Trombosis, Hospital de la Vall d'hebron Sant Pau, Barcelona, Spain.
Joyce Maria Annichino-BizzacchiHematology and Hemotherapy Center, Faculty of Medical Sciences, State University of Campinas, Campinas, SP, Brazil.
Wael BitarBrooks Memorial Hospital, Dunkirk, NY, USA.
Per Morten SandsetDepartment of Haematology, Oslo University Hospital and University of Oslo, Oslo, Norway.
Shannon M BatesDepartment of Medicine, McMaster University, Hamilton, ON, Canada; Thrombosis and Atherosclerosis Research Institute, Hamilton, ON, Canada.
McMaster University · CAOslo University Hospital · NOAmerican University of Beirut New York Office · USHelsinki University Hospital · FIIberoamerican Cochrane Centre · ESMcMaster Children's Hospital · CAMemorial Hospital · USPontificia Universidad Católica de Chile · CLSociedad Española de Trombosis y Hemostasia · ESThrombosis and Atherosclerosis Research Institute · CAUCLA Medical Center · USUniversidade de Sorocaba · BRUniversidade Estadual de Campinas (UNICAMP) · BRUniversity of Cincinnati · US

Funding

LCenter for Clinical and Translational Science and TrainingUL1TR001425 · NCATS · UNIVERSITY OF CINCINNATI · PI HEUBI, JAMES E., KISSELA, BRETT M · 2015 to 2024
$37.5M
Cincinnati Center for Clinical and Translational Sciences and TrainingUL1TR000077 · NCATS · UNIVERSITY OF CINCINNATI · PI HEUBI, JAMES E., TSEVAT, JOEL · 2012 to 2014
$9.9M
NCATS NIH HHS 8UL1TR000077-05NCATS NIH HHS UL1 TR000077NCATS NIH HHS UL1 TR001425
6 · The paper itself

Abstract

backgroundWomen with a history of venous thromboembolism (VTE) have an increased recurrence risk during pregnancy. Low molecular weight heparin (LMWH) reduces this risk, but is costly, burdensome, and may increase risk of bleeding. The decision to start thromboprophylaxis during pregnancy is sensitive to women's values and preferences. Our objective was to compare women's choices using a holistic approach in which they were presented all of the relevant information (direct-choice) versus a personalized decision analysis in which a mathematical model incorporated their preferences and VTE risk to make a treatment recommendation.

methodsMulticenter, international study. Structured interviews were on women with a history of VTE who were pregnant, planning, or considering pregnancy. Women indicated their willingness to receive thromboprophylaxis based on scenarios using personalized estimates of VTE recurrence and bleeding risks. We also obtained women's values for health outcomes using a visual analog scale. We performed individualized decision analyses for each participant and compared model recommendations to decisions made when presented with the direct-choice exercise.

resultsOf the 123 women in the study, the decision model recommended LMWH for 51 women and recommended against LMWH for 72 women. 12% (6/51) of women for whom the decision model recommended thromboprophylaxis chose not to take LMWH; 72% (52/72) of women for whom the decision model recommended against thromboprophylaxis chose LMWH.

conclusionsWe observed a high degree of discordance between decisions in the direct-choice exercise and decision model recommendations. Although which approach best captures individuals' true values remains uncertain, personalized decision support tools presenting results based on personalized risks and values may improve decision making.

Indexed as

AdolescentAdultDecision Support Systems, ClinicalFemaleFibrinolytic AgentsHumansInternationalityMiddle AgedPatient ParticipationPatient PreferencePregnancyPregnancy Complications, CardiovascularPrevalenceQuality of LifeSocial ValuesUtilization ReviewFibrinolytic AgentsDecision makingDecision support techniquesHeparinPregnancyVenous thromboembolism

Identifiers

PMID26033397
PMCPMC4880369
OpenAlexW1804423020

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.