Spyropoulos raises 2 questions in response to my Editorial advocating outpatient treatment as the first consideration for patients with acute VTE. His argument maintains that patients need to be identified as appropriate candidates for outpatient therapy, which is certainly true. However, he describes an Episodes of Care disease management program that clearly identifies exclusionary rather than inclusionary criteria. This would imply that all patients are at first considered for outpatient therapy. Our difference in opinion may be nothing more than semantics.
Liebowitz RS. Outpatient Protocols for Treatment of Venous Thromboembolism Using Low-Molecular-Weight Heparin: To Treat or Not to Treat at Home. Arch Intern Med. 1999;159(10):1140. doi: