Hormonal Contraceptive Use After Venous Thrombosis: Practice From 1999 to 2004
Bibliographic record
Abstract
Background: Current guidelines state that women using combined hormonal contraceptives should stop using these preparations after a venous thrombosis. The aim of this study was to assess to what extent these guidelines are followed in daily practice. Methods: Women younger than 50 years with a hormonal contraceptive-associated venous thrombosis were selected from the Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis (MEGA) study. Data on hormonal contraceptive use after the event and advice from a physician were collected at venepuncture and through a follow-up study, respectively. Risk differences (RDs) with 95% confidence interval (95% CI) were calculated. Results: Seven hundred three women were included with a mean follow-up at venepuncture of 10.8 months (range: 2.1 to 35.4 months). Five hundred twenty-one (74%) women stopped hormonal contraceptive use, 63 (9%) changed to a different preparation and 119 (17%) continued to use their preparation. One hundred forty-three (21%) of 682 women using a combined oral contraceptive at the thrombotic event were still using a combined preparation after the event. Women who continued their contraceptive use had less often a positive family history of venous thrombosis and more often surgery (RD 19% (95% CI: 9 to 30%)) or a plaster cast (RD 17% (95% CI: 3 to 34%)) at the thrombotic event than women who stopped. Out of 332 women using a combined preparation and who received advice from a physician to stop, 39 (12%) continued to use their current contraceptive. Conclusions: The finding that women continue their combined oral contraceptive use after receiving advice to stop is a real concern, in particular because this use could increase the risk of a recurrence. J Endocrinol Metab. 2014;4(3):56-63 doi: http://dx.doi.org/10.14740/jem221w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".