American Society of Hematology

The American Society of Hematology and McMaster University Announce Partnership to Develop Clinical Practice Guidelines on Venous Thromboembolism

Guidelines on the Treatment and Diagnosis of VTE Anticipated in 2017

(WASHINGTON, November 30, 2015) – The American Society of Hematology, the world’s largest association of clinicians and scientists dedicated to conquering blood diseases, is collaborating with McMaster University, a world leader in guideline development and an international authority on thrombosis, to develop clinical practice guidelines on the diagnosis and treatment of venous thromboembolism (VTE).

VTE is a blood clotting disorder that includes both deep-vein thrombosis (DVT) and pulmonary embolism (PE). DVT is a blood clot that typically forms in the deep veins of the leg and can develop into PE, a life-threatening condition that occurs when the clot breaks free and becomes lodged in the arteries of the lung. Through scientific research and discovery, the field of hematology has contributed to today’s advanced understanding of the biology of VTE, and clinical hematologists have unique expertise in its diagnosis and treatment. VTE is also a commonly encountered clinical concern for many other medical specialties and disciplines, including emergency medicine, internal medicine, surgery, oncology, and pharmacology. 

“VTE is a common and serious condition that is often treated by hematologists and can occur in a variety of settings,” said Adam Cuker, MD, MS, Chair of the ASH VTE Guideline Coordination Panel. “Recently, there has been a rapid proliferation of research on VTE that must be synthesized, appraised, and distilled for clinical use. As such, these guidelines are eagerly anticipated. ASH is pleased to collaborate with McMaster University on this effort, bringing together a diverse and multidisciplinary group of experts to identify best practices for the treatment of VTE and health research methodology, which will have far-reaching implications for improving quality of care for these patients on a global scale.”

The goal of this effort is to produce and maintain comprehensive and state-of-the-art guidelines on VTE. In 2015, ASH and the GRADE center at McMaster University assembled a coordination panel and 10 expert guideline development panels. The panels are made up of more than 100 individuals, including U.S.-based and international hematologists, clinicians from other specialties, and scientists with expertise in evidence synthesis and appraisal and guideline development methodology. 

In accordance with recommendations by the U.S. Institute of Medicine, the Guidelines International Network, and other influential organizations, each panel also includes two patient representatives, who are participating equally with the experts in the entire guideline development process, including formulating recommendations. 

Specific topics to be addressed in these guidelines include prevention of VTE in surgical and nonsurgical patients, diagnosis of VTE, treatment of DVT and PE, optimal management of anticoagulation therapy, thrombophilia, heparin-induced thrombocytopenia, VTE in the context of pregnancy, VTE in patients with cancer, and VTE in pediatric populations. Specific new treatments to be addressed include direct oral anticoagulants, many of which were developed and approved within the past three years and present both advantages and disadvantages compared with older medications. 

Under the methods center’s leadership at McMaster, in the first phase of this initiative, members of the expert panels will identify and prioritize clinical questions that they hope to address through the guideline development process. Criteria considered include the frequency with which a question arises in clinical practice, the degree to which there is variation in clinical practice, the extent to which the question has already been addressed by high-quality guidelines, and implications for resource utilization. Once the question formulation step is complete, McMaster University will conduct a systematic review of available evidence. Researchers with specialized training will identify, summarize, and grade the strength of the evidence. The 10 expert panels will then use the evidence to develop clinical guidelines. A public comment period will follow with publication of the guidelines anticipated in 2017.

To ensure the trustworthiness of these ASH guidelines, the majority of participating individuals have no direct financial interests in companies with products that will potentially be affected by the guidelines.  Furthermore, development of these guidelines is wholly funded by ASH. 

As part of this effort, ASH and McMaster University will create tools and resources to bring the guidelines to ASH members, clinicians, and patients across the globe and help users implement them in practice. ASH will also oversee the long-term maintenance of the guidelines. 

“The importance of the topic coupled with McMaster’s excellence in research synthesis and guideline development will create trustworthy health care recommendations that will support care providers and patients in making the best decisions for their lives,” said Holger Schünemann, MD, PhD, Vice-Chair of the VTE guideline coordination panel and Chair of the Department of Clinical Epidemiology and Biostatistics at McMaster University. He is the principal investigator of the project for McMaster University.  

The development of these VTE guidelines is the first of a larger guideline development initiative for ASH that aims to develop evidence-based guidelines on a range of hematologic conditions. 

“As the world’s leading hematology organization, ASH strives to enhance the quality of care for all patients with hematologic disorders,” said Mark Crowther, MD, Chair of the ASH Committee on Quality, which oversees the Society’s guideline development efforts. “As guideline development is important to our members and vital to upholding high quality in the treatment of patients with blood disorders, ASH has invested heavily in this area to ensure we are creating guidelines of the highest standard.”


About the American Society of Hematology
The American Society of Hematology (www.hematology.org) is the world’s largest professional society concerned with the causes and treatment of blood disorders. Its mission is to further the understanding, diagnosis, treatment, and prevention of disorders affecting blood, bone marrow, and the immunologic, hemostatic, and vascular systems by promoting research, clinical care, education, training, and advocacy in hematology. The official journal of ASH is Blood (www.bloodjournal.org), the most cited peer-reviewed publication in the field, which is available weekly in print and online.

About McMaster University
McMaster University, one of four Canadian universities listed among the Top 100 universities in the world, is renowned for its innovation in both learning and discovery. It has a student population of 23,000, and more than 160,000 alumni in 140 countries. Its Michael G. DeGroote School of Medicine is the birthplace of evidence-based medicine in Canada.  The McMaster GRADE center combines excellence for guideline development methodology and production. Its members have supported numerous guidelines for the World Health Organization, the World Allergy Organization and many other prestigious groups.

CONTACT:
Amanda Szabo, American Society of Hematology
aszabo@hematology.org; 202-552-4914

Veronica McGuire, McMaster University Faculty of Health Sciences
vmcguir@mcmaster.ca; 905-525-9140, ext. 22169

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