{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T22:10:40Z","timestamp":1792102240402,"version":"4.4.0"},"reference-count":48,"publisher":"American Society of Hematology","issue":"12","license":[{"start":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T00:00:00Z","timestamp":1713139200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,6,25]]},"abstract":"<jats:sec>\n                  <jats:title>Abstract<\/jats:title>\n                  <jats:p>Current hospital venous thromboembolism (VTE) prophylaxis for medical patients is characterized by both underuse and overuse. The American Society of Hematology (ASH) has endorsed the use of risk assessment models (RAMs) as an approach to individualize VTE prophylaxis by balancing overuse (excessive risk of bleeding) and underuse (risk of avoidable VTE). ASH has endorsed IMPROVE (International Medical Prevention Registry on Venous Thromboembolism) risk assessment models, the only RAMs to assess short-term bleeding and VTE risk in acutely ill medical inpatients. ASH, however, notes that no RAMs have been thoroughly analyzed for their effect on patient outcomes. We aimed to validate the IMPROVE models and adapt them into a simple, fast-and-frugal (FFT) decision tree to evaluate the impact of VTE prevention on health outcomes and costs. We used 3 methods: the \u201cbest evidence\u201d from ASH guidelines, a \u201clearning health system paradigm\u201d combining guideline and real-world data from the Medical University of South Carolina (MUSC), and a \u201creal-world data\u201d approach based solely on MUSC data retrospectively extracted from electronic records. We found that the most effective VTE prevention strategy used the FFT decision tree based on an IMPROVE VTE score of \u22652 or \u22654 and a bleeding score of &amp;lt;7. This method could prevent 45% of unnecessary treatments, saving \u223c$5 million annually for patients such as the MUSC cohort. We recommend integrating IMPROVE models into hospital electronic medical records as a point-of-care tool, thereby enhancing VTE prevention in hospitalized medical patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1182\/bloodadvances.2024013166","type":"journal-article","created":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T20:09:01Z","timestamp":1713211741000},"page":"3214-3224","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":12,"title":["Converting IMPROVE bleeding and VTE risk assessment models into a fast-and-frugal decision tree for optimal hospital VTE prophylaxis"],"prefix":"10.1182","volume":"8","author":[{"given":"Benjamin","family":"Djulbegovic","sequence":"first","affiliation":[{"name":"1Medical University of South Carolina, Charleston, SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Boylan","sequence":"additional","affiliation":[{"name":"1Medical University of South Carolina, Charleston, SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelby","family":"Kolo","sequence":"additional","affiliation":[{"name":"1Medical University of South Carolina, Charleston, SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle Bowen","family":"Scheurer","sequence":"additional","affiliation":[{"name":"1Medical University of South Carolina, Charleston, SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydney","family":"Anuskiewicz","sequence":"additional","affiliation":[{"name":"1Medical University of South Carolina, Charleston, SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flora","family":"Khaledi","sequence":"additional","affiliation":[{"name":"1Medical University of South Carolina, Charleston, SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberley","family":"Youkhana","sequence":"additional","affiliation":[{"name":"1Medical University of South Carolina, Charleston, SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Madgwick","sequence":"additional","affiliation":[{"name":"1Medical University of South Carolina, Charleston, SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neema","family":"Maharjan","sequence":"additional","affiliation":[{"name":"1Medical University of South Carolina, Charleston, SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2349-5707","authenticated-orcid":false,"given":"Iztok","family":"Hozo","sequence":"additional","affiliation":[{"name":"2Department of Mathematics, Indiana University Northwest, Gary, IN"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","published-online":{"date-parts":[[2024,6,14]]},"reference":[{"key":"2024062415062135300_bib1","volume-title":"The Surgeon General's Call to Action to Prevent Deep Vein Thrombosis and Pulmonary Embolism (Office of the Surgeon General (US)","year":"2008"},{"issue":"6","key":"2024062415062135300_bib2","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1177\/1062860610369824","article-title":"Preprinted standardized orders promote venous thromboembolism prophylaxis compared with traditional handwritten orders: an endorsement of standardized evidence-based practice","volume":"25","author":"Gaylis","year":"2010","journal-title":"Am J Med Qual"},{"key":"2024062415062135300_bib3","volume-title":"Preventing Hospital-Associated Venous Thromboembolism. 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