Publications by authors named "N Kraaijpoel"
Background: Guidelines suggest indefinite anticoagulation after unprovoked venous thromboembolism (VTE) unless the bleeding risk is high, yet there is no consistent guidance on assessing bleeding risk.
Objectives: This study aimed to evaluate the performance of 5 bleeding risk tools (RIETE, VTE-BLEED, CHAP, VTE-PREDICT, and ABC-Bleeding).
Methods: PLATO-VTE, a prospective cohort study, included patients aged ≥40 years with a first unprovoked VTE.
The risk of recurrent venous thromboembolism after discontinuation of anticoagulant therapy in patients with cancer-associated thrombosis: a systematic review and meta-analysis.
EClinicalMedicine
October 2023
Article Synopsis
- This study examines the uncertainty surrounding the ideal duration of anticoagulation therapy in cancer patients with venous thromboembolism (VTE), noting current guidelines typically suggest 3-6 months.
- A systematic review and meta-analysis were conducted, analyzing studies on VTE recurrence after stopping anticoagulation in cancer patients who had completed at least 3 months of treatment.
- Out of 3856 studies reviewed, 14 studies with 1922 patients were included, leading to the pooled rate of recurrent VTE being estimated, although specific results were not detailed in the provided text.
Article Synopsis
- The study assessed the accuracy of the ISTH definition of pulmonary embolism (PE)-related death using autopsy confirmations among physician trainees, aiming to involve them in the adjudication process.
- Out of 126 death events reviewed, 29 were confirmed as PE-related deaths, with the ISTH definition showing a sensitivity of 48% and a specificity of 100%.
- There was a strong agreement among the adjudicators, with a percentage agreement of 93% and a Cohen's Kappa value of 0.67, indicating reliable assessment regardless of experience level.
Article Synopsis
- * Researchers conducted a detailed meta-analysis involving 28,305 adult patients across various healthcare settings and developed a logistic regression model incorporating ten key predictors like age, sex, and previous medical history.
- * The final model demonstrated high accuracy with a c-statistic of 0.87, showing it was more effective than existing algorithms (like the Wells score), although it slightly overestimated low probability cases.
Background: In patients clinically suspected of having pulmonary embolism (PE), physicians often rely on intuitive estimation ("gestalt") of PE presence. Although shown to be predictive, gestalt is criticized for its assumed variation across physicians and lack of standardization.
Objectives: To assess the diagnostic accuracy of gestalt in the diagnosis of PE and gain insight into its possible variation.