Evidence map›Paper›PMID 30482768›Full record

GuidelineBlood advances2018

American Society of Hematology 2018 guidelines for management of venous thromboembolism: heparin-induced thrombocytopenia.

Adam Cuker, Gowthami M Arepally, Beng H Chong, Douglas B Cines, Andreas Greinacher, Yves Gruel, Lori A Linkins, Stephen B Rodner, Sixten Selleng, Theodore E Warkentin and 4 more

Open access · goldAbstract readPractice Guideline
In one paragraph

Guideline in Blood advances, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 312 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
312citing papers in PubMed, 4 pooled it
63.9field-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.

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

312 citing papers in PubMed, 4 syntheses or guidelines pooled it, 684 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Pooled it
  4. Pooled it
  5. Review
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article

252 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

14 authors at 8 institutions in 5 countries.

Adam CukerDepartment of Medicine and.
Gowthami M ArepallyDepartment of Medicine, Duke University Medical Center, Durham, NC.
Beng H ChongDepartment of Haematology, University of New South Wales, Sydney, NSW, Australia.
Douglas B CinesDepartment of Medicine and.
Andreas GreinacherInstitute of Immunology and Transfusion Medicine, University of Greifswald, Greifswald, Germany.
Yves GruelDepartment of Haematology-Haemostasis, Trousseau Hospital, Tours, France.
Lori A LinkinsDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Stephen B RodnerNew York, NY.
Sixten SellengDepartment of Anaesthesiology, University of Greifswald, Greifswald, Germany.
Theodore E WarkentinDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Ashleigh WexColumbus, OH.
Reem A MustafaDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; and.
Rebecca L MorganDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; and.
Nancy SantessoDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada; and.
McMaster University · CAUniversität Greifswald · DEUniversity of Pennsylvania · USBretonneau Hospital · FRDuke Medical Center · USImpact · CAUniversity of Missouri–Kansas City · USUNSW Sydney · AU

Funding

Structure-based Design of Rational PF4 Inhibitors in HITR01HL142122 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI CINES, DOUGLAS BROCK, PONCZ, MORTIMER · 2018 to 2021
$2.3M
NHLBI NIH HHS R01 HL142122
6 · The paper itself

Abstract

backgroundHeparin-induced thrombocytopenia (HIT) is an adverse drug reaction mediated by platelet-activating antibodies that target complexes of platelet factor 4 and heparin. Patients are at markedly increased risk of thromboembolism.

objectiveThese evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in their decisions about diagnosis and management of HIT.

methodsASH formed a multidisciplinary guideline panel balanced to minimize potential bias from conflicts of interest. The McMaster University GRADE Centre supported the guideline development process, including updating or performing systematic evidence reviews. The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess evidence and make recommendations, which were subject to public comment.

resultsThe panel agreed on 33 recommendations. The recommendations address screening of asymptomatic patients for HIT, diagnosis and initial management of patients with suspected HIT, treatment of acute HIT, and special situations in patients with acute HIT or a history of HIT, including cardiovascular surgery, percutaneous cardiovascular intervention, renal replacement therapy, and venous thromboembolism prophylaxis.

conclusionsStrong recommendations include use of the 4Ts score rather than a gestalt approach for estimating the pretest probability of HIT and avoidance of HIT laboratory testing and empiric treatment of HIT in patients with a low-probability 4Ts score. Conditional recommendations include the choice among non-heparin anticoagulants (argatroban, bivalirudin, danaparoid, fondaparinux, direct oral anticoagulants) for treatment of acute HIT.

Indexed as

Administration, OralAnticoagulantsArginineCardiovascular Surgical ProceduresChondroitin SulfatesDermatan SulfateEvidence-Based MedicineFondaparinuxHeparan SulfateHeparinHirudinsHumansPeptide FragmentsPipecolic AcidsPlatelet CountRecombinant ProteinsAnticoagulantsargatrobanArgininebivalirudinChondroitin SulfatesdanaparoidDermatan SulfateFondaparinuxHeparan SulfateHeparinHirudinsPeptide FragmentsPipecolic AcidsRecombinant ProteinsSulfonamides

Identifiers

PMID30482768
PMCPMC6258919
OpenAlexW2902914300

What OpenQuestion holds

Textmetadata
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.