A comparison of international clinical practice guidelines for postpartum venous thromboembolism prophylaxis
Bibliographic record
Abstract
BACKGROUND: Venous thromboembolism is a leading cause of maternal death worldwide. The postpartum period is a time of particularly increased risk. International guidelines provide recommendations for when a woman should be offered thromboembolism prophylaxis, however they differ greatly in their criteria as to which women qualify for low molecular weight heparin (LMWH). The aim of this study was to determine the most common risk factors for women being recommended LMWH and compare the proportion of women who would qualify for postpartum LMWH according to four international guidelines. MATERIALS AND METHODS: This cross-sectional study evaluated rates of postpartum LMWH prophylaxis by applying guideline recommendations from the American College of Chest Physicians (ACCP), the Royal College of Obstetricians and Gynaecologists (RCOG), the Society of Obstetricians and Gynaecologists of Canada (SOGC) and the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ). Demographic, medical and obstetric risk factors for venous thromboembolism were identified for individual women from one regional and two tertiary maternity hospitals in New South Wales, Australia between February and October 2022. RESULTS: and instrumental birth. CONCLUSIONS: There are considerable differences in the rates of women receiving postpartum pharmacological venous thromboembolism prophylaxis when recommendations from different international guidelines are applied. These differences reflect the wide variation in guideline recommendations for the use of LMWH following birth.
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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 | 0.017 | 0.120 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.006 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 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".