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Article
February 5, 1988

Prophylaxis Against Deep-Vein Thrombosis-Reply

Author Affiliations

Policy Analysis Inc Brookline, Mass
Harvard Medical School and Brigham and Women's Hospital Harvard School of Public Health Boston

Policy Analysis Inc Brookline, Mass
Harvard Medical School and Brigham and Women's Hospital Harvard School of Public Health Boston

JAMA. 1988;259(5):688. doi:10.1001/jama.1988.03720050023015
Abstract

In Reply.  —We are sorry to learn of Lotke and Day's distress about our recent study of the cost-effectiveness of prophylaxis against DVT in orthopedic surgery, in which we reported that such measures can save both lives and health care dollars. They raise a number of issues that we address in turn below.Was our analysis based only on information concerning the effectiveness of prophylaxis against calf-vein thrombi? As reported, we based our analysis on all reports of randomized, controlled trials of DVT prophylaxis in orthopedic surgery that were published between January 1976 and June 1984. We are unaware of any data that should have been included in our analysis but were not. In these trials, separate rates for proximal- and distal-vein thrombi usually are not reported. Trials that do report both rates, however, indicate comparable reductions in both calf and femoral DVT among patients receiving prophylaxis.1Are calf-vein

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