American Society of Hematology 2021 guidelines for management of venous thromboembolism: prevention and treatment in patients with cancer
Overview
Paper Summary
The guidelines recommend thromboprophylaxis for hospitalized medical and surgical cancer patients at high risk for VTE and low risk for bleeding, using LMWH or DOACs in various settings. They also emphasize individualized treatment decisions based on patient-specific factors, balancing the risk of VTE recurrence with bleeding complications.
Explain Like I'm Five
Scientists found that for very sick people with cancer, doctors often give special medicine to stop their blood from getting too sticky and causing problems. They decide the best medicine for each person so they get better without new issues.
Possible Conflicts of Interest
Most members of the guideline panel were members of ASH, the funding organization. Two panelists disclosed direct financial conflicts with affected companies after recommendations were formed, but the oversight committee determined that these were unlikely to have influenced the guidelines.
Identified Limitations
Rating Explanation
This guideline provides comprehensive and evidence-based recommendations for VTE prevention and treatment in cancer patients, addressing a significant clinical problem. While many recommendations are based on low-certainty evidence, the guidelines follow a rigorous methodology (GRADE) and incorporate important considerations like patient values and cost-effectiveness. The identified COIs are acknowledged and were judged to be unlikely to have significantly biased the recommendations.
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