Background: Hospitalization is an important opportunity for applying prevention efforts. International clinical practice guidelines are for individual healthcare practitioners, who should use them in their work in conjunction with their own judgment and discussion. That’s why in 2019, a committee with physicians from Internal Medicine at Hospital Italiano de Buenos Aires, initiated an effort to develop evidence-based recommendations related to Venous Thromboembolism prophylaxis during clinical hospitalization, that meet the highest standards of development, rigor, and trustworthiness.
Aims: To develop our own recommendation/s based on the best available evidence, and to describe the process (search, update and check the quality).
Methods: A project-manager provided administrative support, planning and scheduling the work, and arranging meetings. The specialist team identified relevant questions and only one was selected due to feasibility, by using the Hanlon Method. The committee made a literature search to answer it, created databases to manage the search results and kept a log of search results and strategies (using Pubmed and Rayyan). The evidence review team identified, reviewed and summarised the evidence.
Results: The selected PICO question was: what is the efficacy and safety of thromboprophylaxis with low molecular weight heparin versus unfractionated heparin in patients hospitalized for non-surgical reasons?
The original search found 498 articles, reviewed by title/abstract, leaving 30 for review by text. Quality tools (PRISMA and AMSTAR2) were applied to a total of 18 papers, with 7 systematic reviews and meta-analyses finally selected.
The reviewers critically appraised this evidence, distilled it into a Summary of Findings Table, and wrote brief summaries.
Conclusions: The consolidation of a working group, the construction of an academic space -in order to learn, disseminate the GRADE methodology and critical reading of evidence-, the training and participation of the potential users of the final recommendations, could improve health care outcomes. It is pending to measure post-implementation adherence.
To cite this abstract in AMA style:Vázquez FJ, Grande Ratti MF, Vallone MG, Paula Guadalupe Gutierrez PG, Bonella MB, Andresik D, Freixas A, Peroni ML, Thomas DS, Ungaro CMU, Burgos M, Giunta DH, Recchioni HM, Serra MM, Martinez B, Michelangelo H, Pollán JA, Boietti BR, Peuchot VA. Venous Thromboembolism Prophylaxis during Hospitalization: Evidence-based Recommendation (by an Internal Medicine Team) [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/venous-thromboembolism-prophylaxis-during-hospitalization-evidence-based-recommendation-by-an-internal-medicine-team/. Accessed December 5, 2021.
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