Advertisement
Advertisement
http://2015.eurothrombosis.eu

Contact Person

Dr. Elinor Switzer

Managing Editor

Phone: +49 (0)711 - 2 29 87 63
Fax: +49 (0)711 - 2 29 87 65
send an Email


Archive

The use of weighted and scored risk assessment models for venous thromboembolism

Journal: Thrombosis and Haemostasis
ISSN: 0340-6245
Topic:

Theme Issue
Scoring in thrombotic cardiovascular disease

DOI: http://dx.doi.org/10.1160/TH12-07-0508
Issue: 2012: 108/6 (Dec) pp. 1009–1248
Pages: 1072-1076

The use of weighted and scored risk assessment models for venous thromboembolism

A. C. Spyropoulos (1), T. McGinn (2), A. Khorana (3)

(1) Division of Hematology and Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, New York, USA; (2) North Shore/LIJ Health System, Department of Medicine, New York, New York, USA; (3) James P. Wilmot Cancer Center and Department of Medicine, University of Rochester Medical Center, Rochester, New York, USA

Keywords

Risk Factors, epidemiological studies, Venous thrombosis

Summary

Formalised risk assessment models (RAMs) for venous thromboembolism (VTE) using weighted and scored variables have only recently been widely incorporated into international antithrombotic guidelines. Scored and weighted VTE RAMs have advantages over a simplified group-specific VTE risk approach, with the potential to allow more tailored strategies for thromboprophylaxis and an improved estimation of the risk/benefit profile for a particular patient. The derivation of VTE RAMs should be based on variables that are a priori defined or identified in a univariate analysis and the predictive capability of each variable should be rigorously assessed for both clinical and statistical significance and internal consistency and completeness. The assessment of the RAM should include the goodness of fit of the model and construction of a prognostic index score. Any VTE RAM which has been derived must undergo validation of that model before it can be used in clinical practice. Validation of the model should be performed in a “deliberate” prospective fashion across several diverse clinical sites using pre-defined criteria using basic standards for performing model validation. We discuss the basic concepts in the derivation of recent scored and weighted VTE RAMs in hospitalised surgical and medical patients and cancer outpatients, the mechanisms for accurate external validation of the models, and implications for their use in clinical practice.

You may also be interested in...

1.

J.-P. Galanaud (1), A. C. Arnoult (2, 3), M.-A. Sevestre (4), C. Genty (3), M. Bonaldi (5), A. Guyard (3), P. Giordana (6), O. Pichot (7), M. Colonna (8), I. Quéré (1), J.-L. Bosson (3), for the OPTIMEV-SFMV Investigators

Thromb Haemost 2014 112 6: 1129-1136

http://dx.doi.org/10.1160/TH14-04-0351

2.
Elisabeth R. Pomp1, Frits R. Rosendaal1–3, Carine J. M. Doggen1

Thromb Haemost 2008 99 1: 59-63

http://dx.doi.org/10.1160/TH07-07-0470

3.
Willem M. Lijfering1, Michiel Coppens2, Marlène H. W. van de Poel1, Saskia Middeldorp2, Karly Hamulyák3, Ivan Bank2, Nic J. G. M. Veeger1, Martin H. Prins4, Harry R. Büller2, Jan van der Meer1

Thromb Haemost 2007 98 2: 457-563

http://dx.doi.org/10.1160/TH07-02-0138