{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T06:24:04Z","timestamp":1780467844505,"version":"3.54.1"},"reference-count":47,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Viatris"},{"name":"Oliba Srl"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Prevention and treatment of venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a major clinical issue in hospitalized patients. Some aspects of VTE management lack clarity due to differing physicians\u2019 opinions and behaviors. Methods: A multidisciplinary steering committee identified two main areas of uncertainty: VTE prophylaxis and PE management in special settings. A multiple-choice questionnaire including 10 statements was circulated to 183 doctors trained in VTE management. The expected benefit-to-harm ratio was represented on a nine-point Likert scale, with consensus (\u226575% agreement) on scores of 1\u20133 indicating inappropriate and 7\u20139 indicating appropriate care measures. Results: In online voting, a consensus was reached for 9\/10 statements. Respondents considered the following to be appropriate: risk assessment of VTE (93.44%) and bleeding (91.6%) in hospitalized medical patients; low-molecular weight heparin (LMWH) prophylaxis for inpatients with pneumonia and malignancy (82.78%); therapeutic doses of LMWH\/fondaparinux in patients with intermediate\/high risk of PE with (80.9%) or without (77.97%) instability criteria; and echocardiography to manage patients with a post-PE syndrome (93.99%). Respondents considered the following to be inappropriate: use of 4000 IU LMWH in chronic renal failure (80.46%); use of 2000 IU LMWH in persons on dual antiplatelet therapy (77.01%); and use of low-dose apixaban (2.5 mg) in pregnancy (88.57%) or in subsegmental PE with hypoxemia (82.46%). No consensus was reached on the identification of PE cases eligible for outpatient treatment. Conclusions: Our findings show persistent gaps between guideline recommendations and clinical implementation despite improved awareness among physicians. Uncertainty persists regarding criteria for outpatient PE eligibility and\/or for validation of bleeding-risk models.<\/jats:p>","DOI":"10.3390\/jcm14238531","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T16:20:29Z","timestamp":1765210829000},"page":"8531","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Preferences Among Expert Physicians in Areas of Uncertainty in Venous Thromboembolism Management: Results from a Multiple-Choice Questionnaire"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8084-9976","authenticated-orcid":false,"given":"Alessandro","family":"Di Minno","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Federico II University Naples, Via D. Montesano 49, 80138 Napoli, Italy"},{"name":"CEINGE-Biotecnologie Avanzate, Via Gaetano Salvatore 486, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaia","family":"Spadarella","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Biomediche Avanzate, Federico II University Naples, 80138 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilenia Lorenza","family":"Calcaterra","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina Clinica e Chirurgia, Universit\u00e0 degli Studi di Napoli Federico II, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2398-6135","authenticated-orcid":false,"given":"Antonella","family":"Tufano","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina Clinica e Chirurgia, Universit\u00e0 degli Studi di Napoli Federico II, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Monaco","sequence":"additional","affiliation":[{"name":"Oliba Healthcare and Pharma, 00192 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco Maria Pio","family":"Mondello Malvestiti","sequence":"additional","affiliation":[{"name":"Viatris, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Tremoli","sequence":"additional","affiliation":[{"name":"Maria Cecilia Hospital, 48033 Cotignola, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7787-9610","authenticated-orcid":false,"given":"Domenico","family":"Prisco","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50121 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"4693","DOI":"10.1182\/bloodadvances.2020001830","article-title":"American Society of Hematology 2020 guidelines for management of venous thromboembolism: Treatment of deep vein thrombosis and pulmonary embolism","volume":"4","author":"Ortel","year":"2020","journal-title":"Blood Adv."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e045672","DOI":"10.1136\/bmjopen-2020-045672","article-title":"Risk assessment models for venous thromboembolism in hospitalised adult patients: A systematic review","volume":"11","author":"Pandor","year":"2021","journal-title":"BMJ Open"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Zheng, L., Xia, B., Yuan, Y., Wang, Y., and Wang, Y. 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