Agreement of four competing guidelines on prevention of venous thromboembolism and comparison with observed physician practices: a cross-sectional study of 1,032 medical inpatients

Journal of General Internal Medicine
Jose LabarereNathalie Thilly

Abstract

To assess the degree of agreement between four competing guidelines regarding the recommendation for prophylactic heparin therapy and to report to what extent actual practice agreed with or differed from the recommendations made before these guidelines were disseminated. Four French guidelines were applied to data from a cross-sectional study conducted before their dissemination. Twenty-six medical units of a teaching and a nonteaching hospital. One thousand thirty-two medical inpatients. Interguideline agreement rated by the kappa coefficient and percentage of patients receiving prophylactic heparin treatment. The percentage of patients requiring prophylactic treatment ranged from 35.4% to 54.6% (overall kappa coefficient, 0.65 [0.63 to 0.68]), depending on the guideline. The four guidelines agreed in recommending prophylactic heparin treatment in 330 patients (32.0%). The corresponding rate of prophylactic treatment use was 57.0% (188/330). None of the guidelines recommended prophylactic heparin treatment in 385 patients (37.3%). The physicians did not order prophylactic treatment in 80.3% of these patients (309/385). The guidelines disagreed in recommending prophylactic treatment in 317 patients (30.7%). The corresponding ra...Continue Reading

References

Aug 11, 1992·Archives of Internal Medicine·F A AndersonA Forcier
May 27, 1988·JAMA : the Journal of the American Medical Association·J LomasB MacKinnon
Dec 13, 1993·Archives of Internal Medicine·S H Woolf
Aug 11, 1993·JAMA : the Journal of the American Medical Association·J E Fielding, P J Lancry
Jul 20, 1996·Lancet·J F Bergmann, C Caulin
Jul 13, 1996·BMJ : British Medical Journal·T P Fahey, T J Peters
Dec 16, 1998·Annals of Internal Medicine·F A Lederle
Oct 27, 1999·JAMA : the Journal of the American Medical Association·M D CabanaH R Rubin
Feb 7, 2001·Chest·W H GeertsH B Wheeler
Mar 29, 2002·The New England Journal of Medicine·David BergqvistUNKNOWN ENOXACAN II Investigators
Aug 9, 2002·The European Respiratory Journal·M Woodhead
Oct 23, 2002·Journal of General Internal Medicine·Drahomir AujeskyJacques Cornuz

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Citations

Jan 19, 2011·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Pedro J SaturnoUNKNOWN ISEP GROUP
Nov 23, 2007·International Journal of Health Care Quality Assurance·J Labarere, J-L Bosson
Dec 22, 2011·Thrombosis and Haemostasis·David BergqvistUNKNOWN ETHOS investigators
Feb 13, 2010·British Journal of Haematology·Peter ClarkGordon D O Lowe
May 1, 2007·The American Journal of Medicine·Jose Labarere, Jean-Luc Bosson
Feb 24, 2006·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Jean-Luc Bosson, Jose Labarere
Jul 2, 2009·Journal of Thrombosis and Haemostasis : JTH·S L Cohn
May 2, 2012·Journal of Clinical Periodontology·Bjarni E PjeturssonNiklaus P Lang
Nov 7, 2012·Clinical Oral Implants Research·Bart A J A van OirschotRüdiger Junker

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