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.
PY  - 2015
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  - 2024/04/23
UR  - jamaevidence.mhmedical.com/content.aspx?aid=1191942883
ER  -