TY - JOUR
T1 - Impact of the VTE-PREDICT calculator on clinicians’ decision making in fictional patients with venous thromboembolism
T2 - a randomized controlled trial
AU - Duijzer, Daniël
AU - de Winter, Maria A.
AU - Carrier, Marc
AU - Cohen, Alexander T.
AU - Hansen, John Bjarne
AU - Kaasjager, Karin A.H.
AU - Kakkar, Ajay K.
AU - Middeldorp, Saskia
AU - Sørensen, Henrik T.
AU - Visseren, Frank L.J.
AU - Wells, Philip S.
AU - Dorresteijn, Jannick A.N.
AU - Nijkeuter, Mathilde
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/10
Y1 - 2024/10
N2 - 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.
AB - 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.
KW - clinical decision-making
KW - hemorrhage
KW - personalized medicine
KW - randomized controlled trial
KW - venous thromboembolism
UR - http://www.scopus.com/inward/record.url?scp=85205921829&partnerID=8YFLogxK
U2 - 10.1016/j.rpth.2024.102569
DO - 10.1016/j.rpth.2024.102569
M3 - Article
C2 - 39434959
AN - SCOPUS:85205921829
SN - 2475-0379
VL - 8
JO - Research and practice in thrombosis and haemostasis
JF - Research and practice in thrombosis and haemostasis
IS - 7
M1 - 102569
ER -