SynthesisBlood advances2020
DOACs vs LMWHs in hospitalized medical patients: a systematic review and meta-analysis that informed 2018 ASH guidelines.
Synthesis in Blood advances, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 3 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Extended thromboprophylaxis for medically ill patients with cancer: a systemic review and meta-analysis.Blood advances · 2021Pooled it
- Prophylaxis of thromboembolism during therapy with asparaginase in adults with acute lymphoblastic leukaemia.The Cochrane database of systematic reviews · 2020Pooled it
- Guideline
- A Cross-Sectional Study on Oral Anticoagulant Utilization and Adverse Drug Reactions at Teaching Hospital, Iran.Chonnam medical journal · 2026Article
- Hypercoagulability in Cushing's syndrome: past, present, future.Archives of endocrinology and metabolism · 2025Review
- Exploring the Emerging Association Between Immune Checkpoint Inhibitors and Thrombosis.Journal of clinical medicine · 2025Review
- Healthcare resource utilization and costs after initiating direct-acting oral anticoagulants or low molecular weight heparins in patients with venous thromboembolism.Vascular medicine (London, England) · 2025Article
- Incidence and Management of Splanchnic Vein Thrombosis in Pancreatic Diseases.United European gastroenterology journal · 2025Review
- Bleeding Complications of Anticoagulation Therapy in Clinical Practice-Epidemiology and Management: Review of the Literature.Biomedicines · 2024Review
- Is It Safe to Resume Direct Oral Anticoagulants upon Discharge after Hip Fracture Surgery? A Retrospective Study.Journal of clinical medicine · 2023Article
- Risk factors for patients with acute hospital-acquired symptomatic pulmonary thromboembolism.Scientific reports · 2023Article
- Smart thrombosis inhibitors without bleeding side effects via charge tunable ligand design.Nature communications · 2023Article
- Anticoagulation Prescribing Patterns in Intensive Care Unit Patients Admitted with Prehospital Direct Oral Anticoagulant Therapy: A Single Academic Center Experience.Hospital pharmacy · 2023Article
- Indian Society of Critical Care Medicine Consensus Statement for Prevention of Venous Thromboembolism in the Critical Care Unit.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2022Article
- COVID-19 and coagulopathy.The clinical respiratory journal · 2021Review
- COVID-19 Infection and High Intracoronary Thrombus Burden.Cardiovascular revascularization medicine : including molecular interventions · 2021Review
- Rectus sheath hematoma in patients receiving subcutaneous enoxaparin: A case series of five patients.Clinical case reports · 2020Article
- Hormones and thrombosis: risk across the reproductive years and beyond.Translational research : the journal of laboratory and clinical medicine · 2020Review
- Standard and Extended Thromboprophylaxis in Patients with Inflammatory Bowel Disease: A Literature Review.Euroasian journal of hepato-gastroenterologyReview
- Methodological Issues and Controversies in COVID-19 Coagulopathy: A Tale of Two Storms.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 10 institutions in 7 countries.
Funding
Abstract
Venous thromboembolism (VTE) is a relatively frequent complication in hospitalized patients, especially in those with risk factors. The benefit of using direct oral anticoagulants (DOACs) for prevention is controversial. This systematic review was performed as part of the American Society of Hematology (ASH) guidelines on VTE, developed in partnership with McMaster University. MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Epistemonikos were used as data sources from date of inception to November 2019. We included randomized trials in patients hospitalized for an acute medical disease, evaluating any DOACs vs other pharmacological prophylaxis, and included 3 trials with low risk of bias. We analyzed the effects of DOACs vs low-molecular-weight heparins (LMWHs) at 2 different time points: at the end of the short-term treatment phase (both drugs given for the same period of time) and at the end of the extended prophylaxis period (extended DOACs vs a shorter course of LMWHs). We observed that the use of DOACs did not reduce the risk of pulmonary embolism or symptomatic deep venous thrombosis (DVT) in comparison with LMWHs. However, the risk of major bleeding was slightly increased. Additionally, we observed that the benefit of DOACs previously reported was largely based on the reduction of asymptomatic DVT and was not apparent when only symptomatic events were considered. The use of DOACs in hospitalized medical patients slightly increases the risk of major bleeding with no appreciable benefit over LMWHs.
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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.