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Research quality in the study of mechanical methods of deep vein thrombosis prophylaxis

There is a lack of good-quality recent clinical data to support the use of mechanical methods to prevent deep vein thrombosis. Recommendations and meta-analyses have to rely on old data from evaluations of devices that are no longer available, with diagnostic methods that are obsolete. The aim of this narrative review is to examine the reasons why better recent evidence is not available, and how this will affect innovation in mechanical deep vein thrombosis prophylaxis. Analysis of recent published trials shows great variability in techniques and technologies, which complicates evaluation of the effectiveness of properties of intermittent pneumatic compression, graduated compression stockings, and electrical stimulation devices. Negative controlled trials have become difficult to conduct, and low rates of deep vein thrombosis have left many comparative trials of devices underpowered. There is a risk that if new approaches to enable clinical research are not developed that technological advancement of mechanical prophylaxis will be inhibited.