{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T22:26:21Z","timestamp":1791584781459,"version":"4.3.4"},"reference-count":32,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T00:00:00Z","timestamp":1766620800000},"content-version":"unspecified","delay-in-days":24,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,12,10]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Venous thromboembolism (VTE) contributes to hospitalisation-associated morbidity. Although guidelines recommend limiting VTE prophylaxis to high-risk patients, some physicians prescribe it broadly. We compared beliefs of low and high prescribing physicians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We surveyed hospitalists and medical residents who had the opportunity to prescribe prophylaxis \u226550 times. Best-worst scaling was used to assess their beliefs. Using a balanced incomplete block design, we created seven choice tasks with seven statements regarding prophylaxis beliefs each presented four times. For each task, physicians selected the statement that most and least reflected their beliefs. We used a count method to calculate best-worst scores and a conditional logistic regression choice model to compare low and high prescribers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 434 invitees, 172 (40%) completed all survey questions between June and November 2023. Low (n=86, \u226462.5% prescribing rate) and high (n=86, &gt;62.5 prescribing rate) prescribers endorsed similar beliefs with differing levels of agreement. All felt confident to prescribe prophylaxis appropriately (low: +1.13, high: +1.10, p=0.81). High prescribers expressed more concern about VTE without prophylaxis (+1.02\u2009vs +0.65, p=0.002). Low prescribers disagreed more that prophylaxis had no downside (\u22121.03 vs \u22120.73, p=0.01). High prescribers worried less about prophylaxis risks (\u22120.49 vs \u22120.22, p=0.01), and overuse (\u22120.61 vs \u22120.34, p=0.02).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compared with low prescribers, high prescribers were more concerned about VTE without prophylaxis and less about harms. These differences in beliefs may underlie physician behaviour and could be targets for interventions to reduce inappropriate prophylaxis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-107411","type":"journal-article","created":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T05:10:26Z","timestamp":1766725826000},"page":"e107411","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Physician beliefs regarding venous thromboembolism prophylaxis at a large multihospital US healthcare system: a cross-sectional survey study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2361-7073","authenticated-orcid":false,"given":"Stephanie R","family":"Moss","sequence":"first","affiliation":[{"name":"Department of Hospital Medicine, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oindrila","family":"Bhattacharyya","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin G","family":"Mittman","sequence":"additional","affiliation":[{"name":"Center for Value-Based Care Research, Department of Internal Medicine and Geriatrics, Cleveland Clinic, Cleveland, Ohio, USA"},{"name":"Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarini","family":"Gunaratne","sequence":"additional","affiliation":[{"name":"Department of Hospital Medicine, Ochsner Baptist Medical Center, New Orleans, Louisiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola B","family":"Campoamor","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John FP","family":"Bridges","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael B","family":"Rothberg","sequence":"additional","affiliation":[{"name":"Center for Value-Based Care Research, Department of Internal Medicine and Geriatrics, Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,12,25]]},"reference":[{"key":"2026010703484267000_15.12.e107411.1","doi-asserted-by":"publisher","DOI":"10.1002\/jhm.450"},{"key":"2026010703484267000_15.12.e107411.2","first-page":"e255","article-title":"Costs of venous thromboembolism associated with hospitalization for medical illness","volume":"21","author":"Cohoon","year":"2015","journal-title":"Am J Manag Care"},{"key":"2026010703484267000_15.12.e107411.3","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.167.14.1476"},{"key":"2026010703484267000_15.12.e107411.4","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-2296"},{"key":"2026010703484267000_15.12.e107411.5","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2018022954"},{"key":"2026010703484267000_15.12.e107411.6","unstructured":"NQF: National Voluntary Consensus Standards for Prevention and Care of Venous Thromboembolism: Policy, Preferred Practices, and Initial Performance Measures, Available: https:\/\/www.qualityforum.org\/Publications\/2006\/12\/National_Voluntary_Consensus_Standards_for_Prevention_and_Care_of_Venous_Thromboembolism__Policy,_Preferred_Practices,_and_Initial_Performance_Measures.aspx [Accessed 16 Jan 2025]."},{"key":"2026010703484267000_15.12.e107411.7","unstructured":"The Joint Commission on the Accreditation of Healthcare Organizations . 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