TY - CHAP M1 - Book, Section TI - How to Use a Patient Management Recommendation: Clinical Practice Guidelines and Decision Analyses A1 - Neumann, Ignacio A1 - Akl, Elie A. A1 - Vandvik, Per Olav A1 - Agoritsas, Thomas A1 - Alonso-Coello, Pablo A1 - Rind, David M. A1 - Santesso, Nancy A1 - Alexander, Paul Elias A1 - Mustafa, Reem A. A1 - Prasad, Kameshwar A1 - Bates, Shannon M. A1 - Schunemann, Holger J. A1 - Guyatt, Gordon A2 - Guyatt, Gordon A2 - Rennie, Drummond A2 - Meade, Maureen O. A2 - Cook, Deborah J. Y1 - 2015 N1 - T2 - Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed AB - CLINICAL SCENARIOYou are an obstetrician seeing a 31-year-old pregnant woman who had an unprovoked deep venous thrombosis of the leg 5 years ago that was treated with warfarin for 6 months without complication. She is no longer using antithrombotic medication and is otherwise healthy. Given a possible increased risk of thrombosis with pregnancy, you are considering discussing the possibility of low-molecular-weight heparin (LMWH) prophylaxis for the rest of the pregnancy.To inform your discussion, you search first for an evidence-based recommendation and find the following recommendation from a practice guideline1: “For pregnant women at moderate to high risk of recurrent venous thromboembolism (VTE) (single unprovoked VTE, pregnancy- or estrogen-related VTE, or multiple prior unprovoked VTE not receiving long-term anticoagulation), we suggest antepartum prophylaxis with prophylactic- or intermediate-dose LMWH rather than clinical vigilance or routine care (weak recommendation, based on low confidence in effect estimates).”The statement “weak recommendation, based on low confidence in effect estimates” leaves you uncomfortable. You decide to read further to understand the recommendation and its rationale. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/12 UR - jamaevidence.mhmedical.com/content.aspx?aid=1191942883 ER -