Evidence map›Paper›PMID 38058129›Full record

SynthesisThe American surgeon2024

Clinical Surveillance vs Anticoagulation Therapy for Isolated Subsegmental Pulmonary Embolism: A Systematic Review of Clinical Outcomes.

Brian Chin, Caitlin Tweedie, Hazem Nasef, Nickolas Hernandez, D-Dre Wright, Muhammad Usman Awan, Adel Elkbuli

Expression of concernAbstract readSystematic ReviewComparative Study
PubMed Publisher
In one paragraph

Synthesis in The American surgeon, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It carries an expression of concern. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.6field-weighted citation impact, top 30% 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

0 citing papers in PubMed, 2 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Brian ChinUniversity of Hawaii, John A. Burns School of Medicine, Honolulu, HI, USA.
Caitlin TweedieDepartment of Internal Medicine, Orlando Regional Medical Center, Orlando, FL, USA.
Hazem NasefNOVA Southeastern University, Kiran Patel College of Allopathic Medicine, Fort Lauderdale, FL, USA.
Nickolas HernandezCollege of Osteopathic Medicine, William Carey University, Hattiesburg, MS, USA.
D-Dre WrightUniversity of Hawaii, John A. Burns School of Medicine, Honolulu, HI, USA.
Muhammad Usman AwanKiran Patel College of Osteopathic Medicine, NOVA Southeastern University, Fort Lauderdale, FL, USA.
Adel ElkbuliDepartment of Surgery, Division of Trauma and Surgical Critical Care, Orlando Regional Medical Center, Orlando, FL, USA.
Nova Southeastern University · USOrlando Regional Medical Center · USUniversity of Hawaiʻi at Mānoa · USWilliam Carey University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis systematic review aims to evaluate and compare differences in clinical outcomes for adult patients diagnosed with ISSPE who were managed with anticoagulation vs clinical surveillance.

methodsPubMed, Embase, ProQuest, Cochrane, and Google Scholar were searched to identify studies evaluating the use of anticoagulation and/or clinical surveillance in patients diagnosed with ISSPE. The search included studies published up to August 3, 2023. Outcomes of interest included 90-day recurrent venous thromboembolism (VTE), major bleeding, and all-cause mortality rates.

resultsTen studies were included with a total of 1224 patients. Of these patients, 791 were treated with anticoagulation and 433 underwent surveillance. Studies found no difference in recurrent VTE rates, with the majority of studies reporting no recurrence. Of the studies that reported VTE recurrence, rates were .5% to 1.4% for the anticoagulation groups and 3.1% to 3.2% for the surveillance groups. Major bleeding rates were also similar. In anticoagulated patients, major bleeding rates ranged from 1% to 10%. In clinical surveillance patients, the majority found no rate of major bleeding, with 2 studies reporting rates of .8% to 3.2%. Mortality rates ranged widely with no significant differences reported.

conclusionClinical surveillance appears to be a safe and effective alternative to anticoagulation in patients with ISSPE. Ninety-day rates of recurrent VTE, major bleeding, and mortality were comparable between groups. These findings highlight the need for updated practice management guidelines to improve patient outcomes.

Indexed as

AnticoagulantsPulmonary EmbolismHemorrhageHumansRecurrenceTreatment OutcomeVenous ThromboembolismWatchful WaitingAnticoagulantsanticoagulationdeep vein thrombosismajor bleedingmortalitypulmonary embolismsubsegmentalsurveillancevenous thromboembolism

Identifiers

PMID38058129
OpenAlexW4389448036

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.