Evidence map›Paper›PMID 33004396›Full record

ArticleBMJ open2020

Study protocol for a multicentre implementation trial of monotherapy anticoagulation to expedite home treatment of patients diagnosed with venous thromboembolism in the emergency department.

Jeffrey Kline, David Adler, Naomi Alanis, Joseph Bledsoe, Daniel Courtney, James D'Etienne, Deborah B Diercks, John Garrett, Alan E Jones, David MacKenzie and 8 more

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 22% 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

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Trial
  2. Article
  3. 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

18 authors at 17 institutions in 1 country.

Jeffrey KlineEmergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA jefkline@iu.edu.ORCID 0000-0001-7190-3109
David AdlerEmergency Medicine, University of Rochester Medical Center, Rochester, New York, USA.
Naomi AlanisEmergency Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA.ORCID 0000-0003-2200-315X
Joseph BledsoeEmergency Medicine, Intermountain Health Care Inc, Salt Lake City, Utah, USA.
Daniel CourtneyEmergency Medicine, University of Texas Southwestern Medical School, Dallas, Texas, USA.
James D'EtienneEmergency Medicine, John Peter Smith Hospital, Fort Worth, Texas, USA.
Deborah B DiercksEmergency Medicine, University of Texas Southwestern Medical School, Dallas, Texas, USA.
John GarrettEmergency Medicine, Baylor University Medical Center at Dallas, Dallas, Texas, USA.
Alan E JonesEmergency Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA.
David MacKenzieEmergency Medicine, Maine Medical Center, Portland, Maine, USA.
Troy MadsenEmergency Medicine, University of Utah, Salt Lake City, Utah, USA.
Andrew MatuskowitzEmergency Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
Bryn MummaEmergency Medicine, University of California Davis, Davis, California, USA.
Kristen NordenholzEmergency Medicine, University of Colorado Denver, Denver, Colorado, USA.
Justine PagenhardtEmergency Medicine, West Virginia University - Health Sciences Campus, Morgantown, West Virginia, USA.
Michael RunyonEmergency Medicine, Atrium Health, Charlotte, North Carolina, USA.
William StubblefieldEmergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Christopher WilloughbyInternal Medicine, Louisiana State University, New Orleans, Louisiana, USA.
The University of Texas Southwestern Medical Center · USAtrium Medical Cente · USBaylor University Medical Center · USEmerge · USIndiana University School of MedicineIntermountain Healthcare · USJohn Peter Smith Hospital · USLouisiana State University · USMaine Medical Center · USMedical University of South Carolina · USUniversity of California, Davis · USUniversity of Mississippi Medical Center · USUniversity of North Texas · USUniversity of Rochester Medical Center · USUniversity of Utah · USVanderbilt University Medical Center · USWest Virginia University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionIn the USA, many emergency departments (EDs) have established protocols to treat patients with newly diagnosed deep vein thrombosis (DVT) as outpatients. Similar treatment of patients with pulmonary embolism (PE) has been proposed, but no large-scale study has been published to evaluate a comprehensive, integrated protocol that employs monotherapy anticoagulation to treat patients diagnosed with DVT and PE in the ED. METHODS AND ANALYSIS: This protocol describes the implementation of the Monotherapy Anticoagulation To expedite Home treatment of Venous ThromboEmbolism (MATH-VTE) study at 33 hospitals in the USA. The study was designed and executed to meet the requirements for the Standards for Reporting Implementation Studies guideline. The study was funded by investigator-initiated awards from industry, with Indiana University as the sponsor. The study principal investigator and study associates travelled to each site to provide on-site training. The protocol identically screens patients with both DVT or PE to determine low risk of death using either the modified Hestia criteria or physician judgement plus a negative result from the simplified PE severity index. Patients must be discharged from the ED within 24 hours of triage and treated with either apixaban or rivaroxaban. Overall effectiveness is based upon the primary efficacy and safety outcomes of recurrent VTE and bleeding requiring hospitalisation respectively. Target enrolment of 1300 patients was estimated with efficacy success defined as the upper limit of the 95% CI for the 30-day frequency of VTE recurrence below 2.0%. Thirty-three hospitals in 17 states were initiated in 2016-2017. ETHICS AND DISSEMINATION: All sites had Institutional Review Board approval. We anticipate completion of enrolment in June 2020; study data will be available after peer-reviewed publication. MATH-VTE will provide information from a large multicentre sample of US patients about the efficacy and safety of home treatment of VTE with monotherapy anticoagulation.

Indexed as

Pulmonary EmbolismVenous ThromboembolismAnticoagulantsEmergency Service, HospitalHumansIndianaMulticenter Studies as TopicRisk FactorsAnticoagulantsaccident & emergency medicineclinical pharmacologythromboembolism

Identifiers

PMID33004396
PMCPMC7534683
OpenAlexW3089749000

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.