Evidence map›Paper›PMID 29018538›Full record

ArticleBMJ open gastroenterology2017

Replacement of warfarin with a novel oral anticoagulant in endoscopic mucosal resection: a multicentre, open-label, randomised controlled trial.

Takuya Yamada, Akiko Kada, Toshio Uraoka, Toshio Kuwai, Noriko Watanabe, Yoshihiro Sasaki, Katsuhiro Mabe, Yasuo Takahashi, Takashi Kagaya, Toshihisa Kimura and 3 more

Open access · goldAbstract read
In one paragraph

Article in BMJ open gastroenterology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 81% 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

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. 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

13 authors at 9 institutions in 1 country.

Takuya YamadaDepartment of Gastroenterology, National Hospital Organization Osaka National Hospital, Osaka, Osaka, Japan.
Akiko KadaClinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Aichi, Japan.
Toshio UraokaDepartment of Gastroenterology, National Hospital Organization Tokyo Medical Center, Meguro-ku, Tokyo, Japan.
Toshio KuwaiDepartment of Gastroenterology, National Hospital Organization Kure Medical Center, Kure, Hiroshima, Japan.
Noriko WatanabeDepartment of Gastroenterology, National Hospital Organization Mie Chuo Medical Center, Tsu, Mie, Japan.
Yoshihiro SasakiDepartment of Gastroenterology, National Hospital Organization Disaster Medical Center, Tachikawa, Tokyo, Japan.
Katsuhiro MabeDepartment of Gastroenterology, National Hospital Organization Hakodate National Hospital, Hakodate, Hokkaido, Japan.
Yasuo TakahashiDepartment of Gastroenterology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Hokkaido, Japan.
Takashi KagayaDepartment of Gastroenterology, National Hospital Organization Kanazawa Medical Center, Kanazawa, Ishikawa, Japan.
Toshihisa KimuraDepartment of Surgery, National Hospital Organization Tsuruga Medical Center, Tsuruga, Fukui, Japan.
Hiroshige HamadaDepartment of Gastroenterology, National Hospital Organization Higashihiroshima Medical Center, Higashihiroshima, Hiroshima, Japan.
Akiko M SaitoClinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Aichi, Japan.
Naohiko HaradaDepartment of Gastroenterology, National Hospital Organization Kyushu Medical Center, Fukuoka, Fukuoka, Japan.
National Hospital Organization · JPNagoya Medical Center · JPHakodate National Hospital · JPHigashihiroshima Medical Center · JPMie Chuo Medical Center · JPMunicipal Tsuruga Hospital · JPNational Disaster Medical Center · JPNational Kyushu Medical Center · JPSapporo National Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis randomised controlled trial aims to compare the efficacy of warfarin replacement with apixaban without postoperative resumption of heparin with that of conventional heparin bridging in patients taking warfarin and scheduled to undergo endoscopic mucosal resection (EMR): specifically, by checking for reduction in proportion of postoperative bleeding following EMR. METHODS AND ANALYSIS: The multicentre, open-label randomised parallel-group, controlled intervention study regards patients taking warfarin who are scheduled to undergo colon EMR. Enrolled patients have been taking oral warfarin for non-valvular atrial fibrillation or venous thrombosis on an outpatient basis, and have been found to have a colorectal polyp (including adenoma or early-stage cancer) for which EMR was indicated. They are assigned to one of two groups. The primary endpoint is proportion of postoperative bleeding. The secondary endpoints are hospital stay length, therapeutic endoscopy outcomes such as proportion of en bloc resection, proportion of perforation, proportion of intraoperative bleeding, incidence of cerebral infarction/systemic embolism events, incidence of adverse events and serious adverse events, and proportion of postoperative therapeutic endoscopy. ETHICS AND DISSEMINATION: This trial was approved by the National Hospital Organization Central Review Board for Clinical Trials (19 April 2016). DISCUSSION: The paucity of reports with high evidence levels was considered problematic when the Japan Gastroenterological Endoscopy Society's gastroenterological endoscopy guidelines were revised in 2012. The results of this trial will have high medical significance, as its data could serve as the basis for revisions in the next edition of the guidelines. TRIAL REGISTRATION NUMBER: This trial was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) accepted from the International Committee of Medical Journal Editors (ICMJE). UMIN000021947; Pre-results.

Indexed as

apixabandirect oral anticoagulantendoscopic mucosal resectionheparinwarfarin

Identifiers

PMID29018538
PMCPMC5623266
OpenAlexW2754430723

What OpenQuestion holds

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LicenceCC BY-NC
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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.