dc.contributor.author | Lewis, S | |
dc.contributor.author | Glen, J | |
dc.contributor.author | Dawoud, D | |
dc.contributor.author | Dias, S | |
dc.contributor.author | Cobb, J | |
dc.contributor.author | Griffin, X | |
dc.contributor.author | Reed, M | |
dc.contributor.author | Sharpin, C | |
dc.contributor.author | Stansby, G | |
dc.contributor.author | Barry, P | |
dc.date.accessioned | 2021-05-20T11:36:40Z | |
dc.date.available | 2019-02-19 | |
dc.date.available | 2021-05-20T11:36:40Z | |
dc.date.issued | 2019-05-17 | |
dc.identifier.citation | Lewis, S., Glen, J., Dawoud, D., Dias, S., Cobb, J., Griffin, X. L., Rossiter, N., Reed, M., Sharpin, C., Stansby, G., & Barry, P. Venous thromboembolism prophylaxis strategies for people undergoing elective total knee replacement: a systematic review and network meta-analysis. Lancet Haematology, 6(10), e530–e539. | en_US |
dc.identifier.issn | 1098-3015 | |
dc.identifier.uri | https://qmro.qmul.ac.uk/xmlui/handle/123456789/71929 | |
dc.description.abstract | Objectives: To assess the efficacy and safety of venous thromboembolism prophylaxis in people undergoing elective total hip replacement. Methods: Systematic review and Bayesian network meta-analyses of randomized controlled trials were conducted for 3 outcomes: deep vein thrombosis (DVT), pulmonary embolism (PE), and major bleeding (MB). MEDLINE, EMBASE, and Cochrane Library (CENTRAL) databases were searched. Study quality was assessed using the Cochrane risk-of-bias checklist. Fixed- and random-effects models were fitted and compared. The median relative risk (RR) and odds ratio (OR) compared with no prophylaxis, with their 95% credible intervals (CrIs), rank, and probability of being the best, were calculated. Results: Forty-two (n = 24 374, 26 interventions), 30 (n = 28 842, 23 interventions), and 24 (n = 31 792, 15 interventions) randomized controlled trials were included in the DVT, PE, and MB networks, respectively. Rivaroxaban had the highest probability of being the most effective intervention for DVT (RR 0.06 [95% CrI 0.01-0.29]). Strategy of low-molecular-weight heparin followed by aspirin had the highest probability of reducing the risk of PE and MB (RR 0.0011 [95% CrI 0.00-0.096] and OR 0.37 [95% CrI 0.00-26.96], respectively). The ranking of efficacy estimates across the 3 networks, particularly PE and MB, had very wide CrIs, indicating high degree of uncertainty. Conclusions: A strategy of low-molecular-weight heparin given for 10 days followed by aspirin for 28 days had the best benefit-risk balance, with the highest probability of being the best on the basis of the results of the PE and MB network meta-analyses. Nevertheless, there is considerable uncertainty around the median ranks of the interventions. | en_US |
dc.format.extent | 953 - 969 | |
dc.publisher | Elsevier | en_US |
dc.relation.ispartof | VALUE IN HEALTH | |
dc.subject | deep vein thrombosis | en_US |
dc.subject | direct-acting oral anticoagulants | en_US |
dc.subject | hospital-acquired thrombosis | en_US |
dc.subject | network meta-analysis | en_US |
dc.subject | orthopedics | en_US |
dc.subject | pulmonary embolism | en_US |
dc.subject | systematic review | en_US |
dc.subject | total hip replacement | en_US |
dc.subject | venous thromboembolism | en_US |
dc.title | Venous Thromboembolism Prophylaxis Strategies for People Undergoing Elective Total Hip Replacement: A Systematic Review and Network Meta-Analysis | en_US |
dc.type | Article | en_US |
dc.rights.holder | © 2019 ISPOR-The Professional Society for Health Economics and Outcomes Research. Published by Elsevier Inc. | |
dc.identifier.doi | 10.1016/j.jval.2019.02.013 | |
pubs.author-url | http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000481618000015&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=612ae0d773dcbdba3046f6df545e9f6a | en_US |
pubs.issue | 8 | en_US |
pubs.notes | Not known | en_US |
pubs.publication-status | Published | en_US |
pubs.publisher-url | https://doi.org/10.1016/j.jval.2019.02.013 | |
pubs.volume | 22 | en_US |
dcterms.dateAccepted | 2019-06-14 | |
rioxxterms.funder | Default funder | en_US |
rioxxterms.identifier.project | Default project | en_US |
qmul.funder | A programme of high priority Reviews for the management of patients with hip fracture: a collaboration which can inform future healthcare policy guidance::NIHR Evaluation Trials and Studies Coordinating Centre | en_US |