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Venous thromboembolism prophylaxis: applying evidence‐based guidelines

Venous thromboembolism (VTE) has been recognized for many years as an important cause of postoperative morbidity and mortality. There have been a number of consensus statements on prophylaxis for VTE and each of these involved an extensive review (by a panel of experts) of the published evidence to guide recommendations for appropriate clinical practice. An approach taken by the International Consensus Statement produced under the auspices of the International Union of Angiology first published in 1997 and updated in 2001, 1 was to grade recommendations on the available level of evidence: a Grade A recommendation was to be made from Level 1 evidence obtained from results of appropriately conducted randomized controlled trials; Grades B and C recommendations were to be formed from lower levels of evidence available from less well randomized and non-randomized studies. The widespread application of these recommendations for ‘best practice’ in VTE prophylaxis has remained a challenge. The article by Ahmad et al . 2