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  • Effect of Genotype-Guided Warfarin Dosing on Clinical Events and Anticoagulation Control Among Patients Undergoing Hip or Knee Arthroplasty: The GIFT Randomized Clinical Trial

    Abstract Full Text
    JAMA. 2017; 318(12):1115-1124. doi: 10.1001/jama.2017.11469

    This randomized clinical trial compares clinically guided vs genotype-guided dosing to assess whether it improves the safety of warfarin initiation in patients undergoing elective hip or knee arthroplasty.

  • JAMA September 12, 2017

    Figure 2: Mortality Outcomes in the Women’s Health Initiative Hormone Therapy Trials During the 18-Year Cumulative Follow-up

    The 18-year follow-up is cumulative, indicating the intervention plus extended postintervention phases of the 2 trials (median, 17.7 [interquartile range {IQR}, 16.6-18.6] years in the conjugated equine estrogens [CEE] plus medroxyprogesterone acetate [MPA] trial; median, 17.7 [IQR, 16.5-18.7] years in the CEE-alone trial; and median,17.7 [IQR,16.6-18.6] years in the pooled analysis).aCardiovascular disease (CVD) mortality includes deaths due to myocardial infarction, coronary heart disease, stroke, heart failure, peripheral vascular disease, venous thromboembolism, and other major causes of CVD death.bThe P value corresponding with a test of heterogeneity between trial-specific hazard ratios (HRs) was .05 or less; therefore, the pooled estimate and HR (95% CI) are not reported.cIndicates other mortality outcomes that were known but were not due to Alzheimer disease or other dementia, chronic obstructive pulmonary disease (COPD), or accident or injury.
  • JAMA September 12, 2017

    Figure 3: Mortality Outcomes During the Intervention Phase According to 10-Year Age Groups at Randomization

    Reported values indicate the duration of follow-up for the intervention phase (median, 5.6 [interquartile range {IQR}, 4.9-6.5] years in the conjugated equine estrogens [CEE] plus medroxyprogesterone acetate [MPA] trial; median, 7.2 [IQR, 6.5-8.2] years in the CEE-alone trial; and median, 6.3 [IQR, 5.3-7.3] years in the pooled analysis). Age groups indicate participant ages at randomization. HR indicates hazard ratio.aP values based on a test for trend of interaction between the randomization group and the age group.bCardiovascular disease (CVD) mortality includes deaths due to myocardial infarction, coronary heart disease, stroke, heart failure, peripheral vascular disease, venous thromboembolism, and other major causes of CVD death.cIndicates mortality outcomes not due to CVD or cancer.
  • JAMA September 12, 2017

    Figure 4: Mortality Outcomes During the 18-Year Cumulative Follow-Up According to 10-Year Age Groups at Randomization

    The 18-year follow-up is cumulative, indicating the intervention plus extended postintervention phases of the 2 trials (median, 17.7 [interquartile range {IQR}, 16.6-18.6] years in the conjugated equine estrogens [CEE] plus medroxyprogesterone acetate [MPA] trial; median, 17.7 [IQR, 16.5-18.7] years in the CEE-alone trial; and median,17.7 [IQR,16.6-18.6] years in the pooled analysis). HR indicates hazard ratio.aP values based on a test for trend of interaction between the randomization group and the age group.bCardiovascular disease (CVD) mortality includes deaths due to myocardial infarction, coronary heart disease (CHD), stroke, heart failure, peripheral vascular disease, venous thromboembolism, and other major causes of CVD death.cIndicates mortality outcomes not due to CVD or cancer.
  • Antithrombotic Therapy for Venous Thromboembolic Disease

    Abstract Full Text
    JAMA. 2017; 317(19):2008-2009. doi: 10.1001/jama.2017.1928

    This JAMA Clinical Guidelines Synopsis summarizes the American College of Chest Physicians’ 2016 recommendations on antithrombotic therapy for venous thromboembolism (VTE).

  • Preventing Venous Thromboembolism After Surgery

    Abstract Full Text
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    JAMA. 2016; 315(19):2136-2136. doi: 10.1001/jama.2016.1457
  • Accurately Measuring Hospital Venous Thromboembolism Prevention Efforts

    Abstract Full Text
    JAMA. 2016; 315(19):2113-2114. doi: 10.1001/jama.2016.5422

    This commentary discusses a cohort study published in JAMA Surgery that investigated the association between inpatient surveillance for venous thromboembolism and risk of postdischarge venous thromboembolism.

  • Prevention, Diagnosis, and Treatment of Postthrombotic Syndrome

    Abstract Full Text
    JAMA. 2016; 315(10):1048-1049. doi: 10.1001/jama.2016.0225

    This JAMA Clinical Guidelines Synopsis summarizes the American Heart Association’s 2014 scientific statement on prevention, diagnosis, and treatment of postthrombotic syndrome.

  • Improving Awareness and Outcomes Related to Venous Thromboembolism

    Abstract Full Text
    JAMA. 2015; 314(18):1913-1914. doi: 10.1001/jama.2015.15107

    This Viewpoint discusses low public awareness about risk factors for and symptoms of venous thromboembolism and proposes quality initiatives that might improve recognition of venous thromboembolism and outcomes for patients.

  • Tinzaparin vs Warfarin for Treatment of Acute Venous Thromboembolism in Patients With Active Cancer: A Randomized Clinical Trial

    Abstract Full Text
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    JAMA. 2015; 314(7):677-686. doi: 10.1001/jama.2015.9243

    This randomized trial compares the efficacy and safety of tinzaparin vs warfarin for treatment of acute, symptomatic venous thromboembolism in patients with active cancer.

  • JAMA August 18, 2015

    Figure 2: Cumulative Incidence Among Patients With Active Cancer According to Treatment With Tinzaparin vs Warfarin

    VTE indicates venous thromboembolism. Source: The left panel of Figure 2 was reproduced with permission from the American Society of Hematology.
  • Long-term vs Short-term Therapy With Vitamin K Antagonists for Symptomatic Venous Thromboembolism

    Abstract Full Text
    JAMA. 2015; 314(1):72-73. doi: 10.1001/jama.2015.2693

    This JAMA Clinical Evidence Synopsis describes the association of long-term duration vs short-term duration of vitamin K antagonist therapy among patients with venous thromboembolism.

  • JAMA July 7, 2015

    Figure: The Incidence of Recurrent Venous Thromboembolism During Long-term and Short-term Therapy With Vitamin K Antagonists

    Source: Data have been adapted with permission from Wiley. RecVTE indicates recurrent venous thromboembolism; VKA, vitamin K antagonist. Ten of the 11 included studies reported on the outcome of VTE recurrence. Randomization was stratified for type of first VTE. The size of the data marker indicates the weight of the study. aShort-term and long-term durations of therapy.
  • JAMA July 7, 2015

    Figure 2: Probability of the Composite Outcome of Recurrent Venous Thromboembolism and Major Bleeding Throughout the Study Period

    The unadjusted hazard ratios for warfarin-placebo were 0.23 (95% CI, 0.09-0.55) during the treatment period and 0.74 (95% CI, 0.47-1.17) for the entire study period. The y axis that is shown in blue indicates the range of estimated cumulative risk from 0% to 10%.
  • JAMA July 7, 2015

    Figure 3: Probability of Recurrent Venous Thromboembolism and Major Bleeding Throughout the Study Period

    The unadjusted hazard ratios for warfarin-placebo for recurrent venous thromboembolism were 0.11 (95% CI, 0.03-0.37) during the treatment period and 0.67 (95% CI, 0.41-1.08) during the entire study period. The unadjusted hazard ratios warfarin-placebo for major bleeding were 4.07 (95% CI, 0.45-36.38) during the treatment period and 1.25 (95% CI, 0.384.10) during the entire study period. The y axis that is shown in blue indicates the range of estimated cumulative risk from 0% to 10%.
  • Six Months vs Extended Oral Anticoagulation After a First Episode of Pulmonary Embolism: The PADIS-PE Randomized Clinical Trial

    Abstract Full Text
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    JAMA. 2015; 314(1):31-40. doi: 10.1001/jama.2015.7046

    This randomized trial compared the efficacy and safety of 6 vs 24 months of warfarin treatment for preventing recurrent thromboembolism in patients with a first episode of symptomatic unprovoked pulmonary embolism.

  • Effect of a Retrievable Inferior Vena Cava Filter Plus Anticoagulation vs Anticoagulation Alone on Risk of Recurrent Pulmonary Embolism: A Randomized Clinical Trial

    Abstract Full Text
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    JAMA. 2015; 313(16):1627-1635. doi: 10.1001/jama.2015.3780

    This randomized trial compares the effects of a retrievable inferior vena cava filter plus anticoagulation with anticoagulation alone for prevention of recurrent pulmonary embolism in patients hospitalized with venous thromboembolism.

  • Association Between Perioperative Low-Molecular-Weight Heparin vs Unfractionated Heparin and Clinical Outcomes in Patients With Cancer Undergoing Surgery

    Abstract Full Text
    JAMA. 2015; 313(13):1364-1365. doi: 10.1001/jama.2015.498
  • Concerns About Using the Patient Safety Indicator-90 Composite in Pay-for-Performance Programs

    Abstract Full Text
    JAMA. 2015; 313(9):897-898. doi: 10.1001/jama.2015.52

    This Viewpoint discusses how the Center for Medicare and Medicaid’s use of Patient Safety Indicator-90 in pay-for-performance programs falls short in its attempt to accurately and fairly measure patient harm.

  • Cost-effectiveness of Dalteparin vs Unfractionated Heparin for the Prevention of Venous Thromboembolism in Critically Ill Patients

    Abstract Full Text
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    JAMA. 2014; 312(20):2135-2145. doi: 10.1001/jama.2014.15101

    This prospective economic evaluation reports that use of LMW heparin for venous thromboembolism prophylaxis in critically ill patients was more effective than unfractionated heparin, with similar or lower costs.