Impact of the VTE-PREDICT calculator on clinicians’ decision making in fictional patients with venous thromboembolism: a randomized controlled trial

Autor: Daniël Duijzer, Maria A. de Winter, Marc Carrier, Alexander T. Cohen, John-Bjarne Hansen, Karin A.H. Kaasjager, Ajay K. Kakkar, Saskia Middeldorp, Henrik T. Sørensen, Frank L.J. Visseren, Philip S. Wells, Jannick A.N. Dorresteijn, Mathilde Nijkeuter
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Research and Practice in Thrombosis and Haemostasis, Vol 8, Iss 7, Pp 102569- (2024)
Druh dokumentu: article
ISSN: 2475-0379
DOI: 10.1016/j.rpth.2024.102569
Popis: Background: After 3 months of anticoagulation for venous thromboembolism (VTE), the decision needs to be made whether to stop anticoagulation or extend treatment indefinitely. The VTE-PREDICT calculator can be used to estimate individual risks of VTE recurrence and bleeding to guide this decision. Objectives: To evaluate the impact of predicted individual risks of recurrence and bleeding on clinicians’ decisions on anticoagulation duration and to assess usefulness of the VTE-PREDICT calculator. Methods: A randomized controlled trial and within-subject study was conducted among clinicians treating VTE patients. The clinicians were asked to complete an online survey containing 6 fictional case vignettes. Group A proposed anticoagulant duration for each case without additional information first and subsequently after seeing calculator-predicted risks (within-subject analysis). Group B was directly provided with calculator risks and proposed treatment duration for each case vignette (for comparison with group A results in a randomized controlled trial analysis). Then, group B received questions on usefulness and credibility of the calculator. Results: Forty-five clinicians were assigned to group A and 48 to B. Overall, group A did not propose different anticoagulation durations than group B. However, individual clinicians in group A changed proposed duration in 35% of the cases after seeing the calculator risks. The calculator was considered useful and credible by most clinicians. Conclusion: Overall, use of the VTE-PREDICT calculator did not affect proposed anticoagulation duration. However, individual clinicians frequently changed their proposed duration after using the calculator, especially for patients with high bleeding risk.
Databáze: Directory of Open Access Journals