Enoxaparin and Thromboprophylaxis

Featured Article

Baumgartner JM, McKenzie S, Block S, Costantini TW, Lowy AM. Prophylactic enoxaparin doses may be inadequate in patients undergoing abdominal cancer surgery. Journal of Surgical Research. 2018 Jan 1;221:183-9

Expert Reviews

Methodological Reviewer: Prosanto Chaudhury MD, MSc, FRCSC, FACS, Department of Surgery, McGill University

Clinical Reviewer: Chad Ball MD, MSc, FRCSC, FACS, Department of Surgery, University of Calgary

Clinical Reviewer:  Sharon Weber MD, Department of Surgery, University of Wisconsin

Supplementary Articles

Bucher HC, Guyatt GH, Cook DJ, Holbrook A, McAlister FA, for the Evidence-Based Medicine Working Group. Users’ Guides to the Medical Literature: XIX. Applying Clinical Trial Results A. How to Use an Article Measuring the Effect of an Intervention on Surrogate End Points. JAMA.1999;282(8):771–77

Questions

Please read the above articles and be prepared to discuss the following:

1. What is the clinical question being addressed?
2. Is there a strong, independent, consistent association between the surrogate end point and the clinical end point?
3. Is there evidence from other randomized controlled trials in other drug classes that improvement in the surrogate end point has consistently led to improvement in the target outcome?
4. Is there evidence from the same randomized controlled trials in other classes that improvement in the surrogate end point has consistently led to improvement in the target outcome?
5. How large, precise and lasting was the treatment effect?
6. Are the likely treatment benefits worth the potential harms and costs?
7. State the conclusion. Have the authors addressed the clinical question posed?
8. Does the evidence support the conclusion?