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  1. Article ; Online: In medical inpatients, the IMPROVE risk score had moderate predictive power for 14-d in-hospital bleeding.

    Tafur, Alfonso J / Douketis, James D

    Annals of internal medicine

    2024  Volume 177, Issue 1, Page(s) JC11

    Abstract: Source citation: Villiger R, Juillard P, Darbellay Farhoumand P, et al. ...

    Abstract Source citation: Villiger R, Juillard P, Darbellay Farhoumand P, et al.
    MeSH term(s) Humans ; Inpatients ; Risk Factors ; Hemorrhage ; Hospitals
    Language English
    Publishing date 2024-01-02
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 336-0
    ISSN 1539-3704 ; 0003-4819
    ISSN (online) 1539-3704
    ISSN 0003-4819
    DOI 10.7326/J23-0104
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Perioperative Management of Anticoagulant and Antiplatelet Therapy.

    Douketis, James D / Spyropoulos, Alex C

    NEJM evidence

    2023  Volume 2, Issue 6, Page(s) EVIDra2200322

    Abstract: ... antiplatelet drug who require surgery or an invasive procedure is a common clinical problem. Douketis and ...

    Abstract Anticoagulant and Antiplatelet Drug ManagementManagement of patients on an anticoagulant or antiplatelet drug who require surgery or an invasive procedure is a common clinical problem. Douketis and Spyropoulos provide an evidence-based but practical approach to managing anticoagulants and antiplatelet drugs in the perioperative setting.
    MeSH term(s) Humans ; Anticoagulants ; Platelet Aggregation Inhibitors ; Perioperative Care/methods ; Health Services
    Chemical Substances Anticoagulants ; Platelet Aggregation Inhibitors
    Language English
    Publishing date 2023-05-23
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2766-5526
    ISSN (online) 2766-5526
    DOI 10.1056/EVIDra2200322
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  3. Article ; Online: Uncomplicated outpatient deep venous thrombosis management with a novel care pathway: Is it ready for prime time?

    Godoy, Alejandro / Carlin, Stephanie / Douketis, James D

    European journal of internal medicine

    2024  Volume 122, Page(s) 40–41

    MeSH term(s) Humans ; Outpatients ; Critical Pathways ; Anticoagulants/therapeutic use ; Heparin, Low-Molecular-Weight ; Venous Thrombosis/therapy ; Ambulatory Care
    Chemical Substances Anticoagulants ; Heparin, Low-Molecular-Weight
    Language English
    Publishing date 2024-01-30
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1038679-8
    ISSN 1879-0828 ; 0953-6205
    ISSN (online) 1879-0828
    ISSN 0953-6205
    DOI 10.1016/j.ejim.2024.01.032
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    Zs.A 2608: Show issues Location:
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  4. Article ; Online: Prevention of venous thromboembolism in medical cancer patients: Guidance or guideline?

    Douketis, James D

    Journal of thrombosis and haemostasis : JTH

    2020  Volume 18, Issue 2, Page(s) 520–521

    MeSH term(s) Anticoagulants ; Humans ; Neoplasms ; Risk Factors ; Venous Thromboembolism
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2020-02-26
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 2112661-6
    ISSN 1538-7836 ; 1538-7933
    ISSN (online) 1538-7836
    ISSN 1538-7933
    DOI 10.1111/jth.14693
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    Zs.MO 295: Show issues

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  5. Article ; Online: Anticoagulation Stewardship to Bridge the Implementation Gap in Perioperative Anticoagulation Management.

    Tafur, Alfonso J / Barnes, Geoffrey D / Bhagirath, Vinai C / Douketis, James

    TH open : companion journal to thrombosis and haemostasis

    2024  Volume 8, Issue 1, Page(s) e114–e120

    Abstract: Lack of alignment of care protocols among providers in health care is a driver of increased costs and suboptimal patient outcomes. Perioperative anticoagulation management is a good example of a complex area where protocol creation is a clinical ... ...

    Abstract Lack of alignment of care protocols among providers in health care is a driver of increased costs and suboptimal patient outcomes. Perioperative anticoagulation management is a good example of a complex area where protocol creation is a clinical challenge that demands input from multiple experts. Questions regarding the need for anticoagulation interruptions are frequent. Yet, due to layers of complexity involving analysis of anticoagulation indication, surgical risk, and anesthesia-associated bleeding risk as well as institutional practices, there is heterogeneity in how these interruptions are approached. The recent perioperative anticoagulation guidelines from the American College of Chest Physicians summarize extensive evidence for the management of anticoagulant and antiplatelet medications in patients who undergo elective interventions. However, implementation of these guidelines by individual clinicians is highly varied and often does not follow the best available clinical evidence. Against this background, anticoagulation stewardship units, which exist to improve safety and quality monitoring for the anticoagulated patient, are of growing interest. These units provide a bridge for the implementation of value-based, high-quality guidelines for patients who need perioperative anticoagulation interruption. We use a case to pragmatically illustrate the problem and tactics for change management and implementation science that may facilitate the adoption of perioperative anticoagulation guidelines.
    Language English
    Publishing date 2024-03-11
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 2901738-5
    ISSN 2512-9465 ; 2567-3459
    ISSN (online) 2512-9465
    ISSN 2567-3459
    DOI 10.1055/a-2259-0911
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    Zs.A 7138: Show issues Location:
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  6. Article ; Online: Routine measurement of DOAC concentrations for prognostication and clinical management in acute ischemic stroke: Is it ready for prime time?

    Carlin, Stephanie / Chan, Noel C / Douketis, James D

    European journal of internal medicine

    2023  Volume 113, Page(s) 18–19

    MeSH term(s) Humans ; Ischemic Stroke ; Stroke/therapy ; Stroke/drug therapy ; Anticoagulants/therapeutic use ; Blood Coagulation Tests ; Administration, Oral ; Atrial Fibrillation/drug therapy
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2023-04-29
    Publishing country Netherlands
    Document type Journal Article ; Comment
    ZDB-ID 1038679-8
    ISSN 1879-0828 ; 0953-6205
    ISSN (online) 1879-0828
    ISSN 0953-6205
    DOI 10.1016/j.ejim.2023.04.024
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2608: Show issues Location:
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  7. Article ; Online: Machine learning-based predictive models for patients with venous thromboembolism: A Systematic Review.

    Danilatou, Vasiliki / Dimopoulos, Dimitris / Kostoulas, Theodoros / Douketis, James

    Thrombosis and haemostasis

    2024  

    Abstract: Background: Venous thromboembolism (VTE) is a chronic disorder with a significant health and economic burden. Several VTE-specific Clinical Prediction Models (CPMs) have been used to assist physicians in decision-making but have several limitations. ... ...

    Abstract Background: Venous thromboembolism (VTE) is a chronic disorder with a significant health and economic burden. Several VTE-specific Clinical Prediction Models (CPMs) have been used to assist physicians in decision-making but have several limitations. This systematic review explores if machine learning (ML) can enhance CPMs by analyzing extensive patient data derived from electronic health records (EHRs). We aimed to explore ML-CPMs applications in VTE for risk stratification, outcome prediction, diagnosis, and treatment.
    Methods: Three databases were searched, PubMed, Google Scholar, and IEEE electronic library. Inclusion criteria focused on studies using structured data, excluding non-English publications, studies on non-humans, and certain data types such as natural language processing and image processing. Studies involving pregnant women, cancer patients, and children were also excluded. After excluding irrelevant studies, a total of 77 studies were included.
    Results: Most studies report that ML-CPMs outperformed traditional CPMs in terms of receiver operating area under the curve in the four clinical domains that were explored. However, the majority of the studies were retrospective, monocentric, and lacked detailed model architecture description and external validation, which are essential for quality audit. This review identified research gaps and highlighted challenges related to standardized reporting, reproducibility, and model comparison.
    Conclusion: ML-CPMs show promise in improving risk assessment and individualized treatment recommendations in VTE. Apparently, there is an urgent need for standardized reporting and methodology for ML models, external validation, prospective and real-world data studies, as well as interventional studies to evaluate the impact of AI in VTE.
    Language English
    Publishing date 2024-04-04
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 518294-3
    ISSN 2567-689X ; 0340-6245
    ISSN (online) 2567-689X
    ISSN 0340-6245
    DOI 10.1055/a-2299-4758
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Uh III Zs.192: Show issues Location:
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    Zs.MO 433: Show issues

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  8. Article ; Online: Drug

    Candeloro, Matteo / Carlin, Stephanie / Shapiro, Michelle J / Douketis, James D

    Research and practice in thrombosis and haemostasis

    2023  Volume 7, Issue 3, Page(s) 100137

    Abstract: Background: Direct oral anticoagulants (DOACs) are widely used in patients with atrial fibrillation and venous thromboembolism. However, DOACs have important potential drug-drug interactions (DDIs) with several classes of drugs. In particular, ... ...

    Abstract Background: Direct oral anticoagulants (DOACs) are widely used in patients with atrial fibrillation and venous thromboembolism. However, DOACs have important potential drug-drug interactions (DDIs) with several classes of drugs. In particular, antiepileptic (AE) drugs may induce cytochrome P450 3A4 or P-glycoprotein. Co-administration of DOACs and AE drugs may result in lower DOAC drug levels and reduced DOAC efficacy. However, the clinical significance of such DDIs is uncertain.
    Objectives: The aim of this systematic review was to generate an updated review of these DDIs and their clinical relevance, given the rapidly evolving knowledge relating to DOAC and AE DDIs.
    Methods: We searched the MEDLINE and Embase databases for studies reporting clinical adverse outcomes (thrombotic events, bleeding events, and all-cause mortality) in patients concomitantly taking DOACs and AE drugs.
    Results: We retrieved 874 studies of which 15 were deemed eligible for this review, including 4 congress abstracts, 3 case reports, 2 letters to the editor, 5 retrospective cohorts, and 1 prospective cohort study. No randomized clinical trials were found. Most of the included studies reported thrombotic events, 3 studies reported major bleeding, and one study reported all-cause mortality associated with DOAC and AE drug administration. Substantial differences in the study designs did not allow for a meta-analysis to be performed.
    Conclusion: The current literature assessing these adverse clinical outcomes from DOAC and AE drug co-administration is limited. Although the available data point to a possible increased risk of thrombotic events, they are insufficient to draw definitive conclusions. Well-designed clinical studies are of utmost importance.
    Language English
    Publishing date 2023-03-28
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2475-0379
    ISSN (online) 2475-0379
    DOI 10.1016/j.rpth.2023.100137
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  9. Article ; Online: Navigating the anticoagulant landscape in 2017.

    Douketis, James D

    Cleveland Clinic journal of medicine

    2017  Volume 84, Issue 10, Page(s) 768–778

    Abstract: Several questions remain regarding anticoagulant management: What is the best strategy for managing acute venous thromboembolism? How should patients on a direct oral anticoagulant or on warfarin be managed when they need elective surgery? When is ... ...

    Abstract Several questions remain regarding anticoagulant management: What is the best strategy for managing acute venous thromboembolism? How should patients on a direct oral anticoagulant or on warfarin be managed when they need elective surgery? When is heparin bridging necessary?
    MeSH term(s) Anticoagulants/adverse effects ; Anticoagulants/therapeutic use ; Heparin/therapeutic use ; Humans ; Perioperative Care ; Surgical Procedures, Operative/adverse effects ; Surgical Procedures, Operative/methods ; Venous Thromboembolism/drug therapy ; Warfarin/adverse effects ; Warfarin/therapeutic use
    Chemical Substances Anticoagulants ; Warfarin (5Q7ZVV76EI) ; Heparin (9005-49-6)
    Language English
    Publishing date 2017-10-25
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 639116-3
    ISSN 1939-2869 ; 0891-1150
    ISSN (online) 1939-2869
    ISSN 0891-1150
    DOI 10.3949/ccjm.84gr.17005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Ua VI Zs.212: Show issues Location:
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  10. Article: Anticoagulation Stewardship to Bridge the Implementation Gap in Perioperative Anticoagulation Management

    Tafur, Alfonso J. / Barnes, Geoffrey D. / Bhagirath, Vinai C. / Douketis, James

    TH Open

    2024  Volume 08, Issue 01, Page(s) e114–e120

    Abstract: Lack of alignment of care protocols among providers in health care is a driver of increased costs and suboptimal patient outcomes. Perioperative anticoagulation management is a good example of a complex area where protocol creation is a clinical ... ...

    Abstract Lack of alignment of care protocols among providers in health care is a driver of increased costs and suboptimal patient outcomes. Perioperative anticoagulation management is a good example of a complex area where protocol creation is a clinical challenge that demands input from multiple experts. Questions regarding the need for anticoagulation interruptions are frequent. Yet, due to layers of complexity involving analysis of anticoagulation indication, surgical risk, and anesthesia-associated bleeding risk as well as institutional practices, there is heterogeneity in how these interruptions are approached. The recent perioperative anticoagulation guidelines from the American College of Chest Physicians summarize extensive evidence for the management of anticoagulant and antiplatelet medications in patients who undergo elective interventions. However, implementation of these guidelines by individual clinicians is highly varied and often does not follow the best available clinical evidence. Against this background, anticoagulation stewardship units, which exist to improve safety and quality monitoring for the anticoagulated patient, are of growing interest. These units provide a bridge for the implementation of value-based, high-quality guidelines for patients who need perioperative anticoagulation interruption. We use a case to pragmatically illustrate the problem and tactics for change management and implementation science that may facilitate the adoption of perioperative anticoagulation guidelines.
    Keywords perioperative ; anticoagulation ; implementation ; six sigma ; nudge ; guidelines
    Language English
    Publishing date 2024-01-01
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 2901738-5
    ISSN 2512-9465 ; 2567-3459
    ISSN (online) 2512-9465
    ISSN 2567-3459
    DOI 10.1055/a-2259-0911
    Database Thieme publisher's database

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