Evidence map›Paper›PMID 32542391›Full record

SynthesisBlood advances2020

Risk models for VTE and bleeding in medical inpatients: systematic identification and expert assessment.

Andrea J Darzi, Samer G Karam, Frederick A Spencer, Alex C Spyropoulos, Lawrence Mbuagbaw, Scott C Woller, Neil A Zakai, Michael B Streiff, Michael K Gould, Mary Cushman and 9 more

Open access · goldAbstract readSystematic Review
In one paragraph

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 22 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 2 pooled it
1.9field-weighted citation impact, top 9% 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

22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.

  1. Pooled it
  2. Thrombotic and Hemorrhagic Incidences in Patients After Discharge from COVID-19 Infection: A Systematic Review and Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Pooled it
  3. Article
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  7. Article
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  9. Observational
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  11. Review
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  15. Prediction of bleeding in patients being considered for venous thromboembolism prophylaxis.Journal of vascular surgery. Venous and lymphatic disorders · 2023
    Article
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  18. Review
  19. Article
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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

19 authors at 12 institutions in 5 countries.

Andrea J DarziMichael G. DeGroote Cochrane Canada Centre.
Samer G KaramMichael G. DeGroote Cochrane Canada Centre.
Frederick A SpencerDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Alex C SpyropoulosThe Donald and Barbara Zucker School of Medicine, Hofstra/Northwell, Hempstead, NY.
Lawrence MbuagbawMichael G. DeGroote Cochrane Canada Centre.
Scott C WollerDepartment of Medicine, Intermountain Medical Center, University of Utah School of Medicine, Salt Lake City, UT.
Neil A ZakaiDepartment of Medicine and.
Michael B StreiffDivision of Hematology, Departments of Medicine and Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD.
Michael K GouldDepartment of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA.
Mary CushmanDepartment of Medicine and.
Rana CharideAmerican University of Beirut (AUB) GRADE Center, Clinical Research Institute, AUB, Beirut, Lebanon.
Itziar Etxeandia-IkobaltzetaMichael G. DeGroote Cochrane Canada Centre.
Federico GerminiMichael G. DeGroote Cochrane Canada Centre.
Marta RigoniHealthcare Research and Innovation Program, Heath Technology Assessment Unit, Fondazione Bruno Kessler, Trento, Italy.
Arnav AgarwalMichael G. DeGroote Cochrane Canada Centre.
Rami Z MorsiAmerican University of Beirut (AUB) GRADE Center, Clinical Research Institute, AUB, Beirut, Lebanon.
Elie A AklMichael G. DeGroote Cochrane Canada Centre.
Alfonso IorioMichael G. DeGroote Cochrane Canada Centre.
Holger J SchünemannMichael G. DeGroote Cochrane Canada Centre.
Cochrane · CAAmerican University of Beirut · LBUniversity of Vermont · USCentral Hospital of Yaoundé · CMFondazione Bruno Kessler · ITJohns Hopkins University · USKaiser Permanente · USMcMaster University · CANorthwell Health · USUniversity of Milan · ITUniversity of Toronto · CAUniversity of Utah · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Risk assessment models (RAMs) for venous thromboembolism (VTE) and bleeding in hospitalized medical patients inform appropriate use of thromboprophylaxis. Our aim was to use a novel approach for selecting risk factors for VTE and bleeding to be included in RAMs. First, we used the results of a systematic review of all candidate factors. Second, we used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to assess the certainty of the evidence for the identified factors. Third, we using a structured approach to select factors to develop the RAMs, by building on clinical and methodological expertise. The expert panel made judgments on whether to include, potentially include, or exclude risk factors, according to domains of the GRADE approach and the Delphi method. The VTE RAM included age >60 years, previous VTE, acute infections, immobility, acute paresis, active malignancy, critical illness, and known thrombophilia. The bleeding RAM included age ≥65 years, renal failure, thrombocytopenia, active gastroduodenal ulcers, hepatic disease, recent bleeding, and critical illness. We identified acute infection as a factor that was not considered in widely used RAMs. Also, we identified factors that require further research to confirm or refute their importance in a VTE RAM (eg, D-dimer). We excluded autoimmune disease which is included in the IMPROVE (International Medical Prevention Registry on Venous Thromboembolism) bleeding RAM. Our results also suggest that sex, malignancy, and use of central venous catheters (factors in the IMPROVE bleeding RAM) require further research. In conclusion, our study presents a novel approach to systematically identifying and assessing risk factors to be included or further explored during RAM development.

Indexed as

Venous ThromboembolismAgedAnticoagulantsHemorrhageHumansInpatientsMiddle AgedRisk AssessmentAnticoagulants

Identifiers

PMID32542391
PMCPMC7322970
OpenAlexW3035235169

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.