Please note that this is app an abridged version of the complete guidelines, the electronic version of which is available on the following website: www.haematology.org.my
These guidelines are meant to be a guide for clinical practice, based on the best available evidence at the time of development. Adherence to these guidelines may not necessarily ensure the best outcome in every case. Every health care provider is responsible for the management options available locally.
These guidelines were issued in 2013 and will be reviewed in 2017 or sooner if new evidence becomes available.
DISCLOSURE STATEMENT
The panel members had completed disclosure forms. None held shares in pharmaceutical firms or acted as consultants to such firms (details are available upon request from the CPG Secretariat).
SOURCES OF FUNDING
The development of the CPG on Prevention and Treatment of Venous Thromboembolism was supported via unrestricted educational grant from Bayer Healthcare Pharmaceuticals. The funding body has not influenced the development of the guidelines.
GUIDELINES DEVELOPMENT
The development group for these guidelines consists of Haematologist, Cardiologist, Neurologist, Obstetrician & Gynaecologist, Vascular Surgeon, Orthopaedic Surgeon, Anaesthesiologist, Pharmacologist and Pharmacist from the Ministry of Health Malaysia, Ministry of Higher Education Malaysia and the Private sector.
Literature search was carried out at the following electronic databases: International Health Technology Assessment website, PUBMED, MEDLINE, Cochrane Database of Systemic Reviews (CDSR), Journal full text via OVID search engine and Science Direct. In addition, the reference lists of studies selected for inclusion were scanned for relevant studies.
The clinical questions were divided into 18 subgroups and members of the development workgroup were assigned individual topics. Literature searched were appraised by workgroup members using Critical Appraisal Skills Programme (CASP) checklist, presented in the form of evidence table and discussed during group meetings. All statements and recommendations formulated were agreed by both the development group and review committee. Where the evidence was insufficient, the recommendations were derived by consensus of the development group and review committee.
The articles were graded by using the National Guidelines Clearinghouse (www.guidelines.gov), Agency for Healthcare Research and Quality, U.S. Department of Health & Human Services, USA, level of evidence while the grading of recommendations in these guidelines was modified from the Scottish Intercollegiate Guidelines Network (SIGN). Refer to Appendix 12 for further details.
These guidelines have been presented to the Technical Advisory Committee for Clinical Practice Guidelines and the Health Technology Assessment and Clinical Practice Guidelines Council, Ministry of Health Malaysia for review and approval.
OBJECTIVES
GENERAL OBJECTIVES
To provide evidence-based guidance in the management of venous thromboembolism.
SPECIFIC OBJECTIVES
It is not the objective of these guidelines to cover:
o Management of arterial thrombosis
TARGET POPULATION
All patients with VTE or at risk for VTE
CLINICAL QUESTIONS
Refer to appendix 13
TARGET GROUP/ USER
All health care professionals
GUIDELINES DEVELOPMENT GROUP
Chairperson
Professor Dr Abdul Rashid Abdul Rahman
Consultant Physician and Clinical Pharmacologist
Cyberjaya Unviversity College of Medical Sciences and Hospital Pakar An Nur
Co-Chairperson
Dr Jameela Sathar
Consultant Haematologist
Ampang Hospital
Members (alphabetical order)
Chong Chia Chee
Pharmacist
Ampang Hospital
Dr Eeson Sinthamoney
Consultant Obstetrician & Gynaecologist
Pantai Hospital Kuala Lumpur
Dr Hamat Hamdi Che Hassan
Consultant Cardiologist
Hospital Universiti Kebangsaan Malaysia
Assoc Professor Dr Hanafiah Harunarashid
Consultant Vascular Surgeon
Hospital Universiti Kebangsaan Malaysia
Dr Kiren Sidhu
Consultant Obstetrician & Gynaecologist
Pantai Hospital Kuala Lumpur
Assoc Professor Dr Mohammad Hassan Shukur
Consultant Orthopaedic and Trauma Surgeon
Hospital Universiti Kebangsaan Malaysia
Dr Santhi Datuk Puvanarajah
Consultant Neurologist
Hospital Kuala Lumpur
Dr Shanti Rudra Deva
Consultant Intensivist
Hospital Kuala Lumpur
Professor Dr Woo Yin Ling
Consultant Obstetrician & Gynaecologist
University Malaya Medical Center
REVIEW COMMITTEE
The draft of these guidelines are reviewed by a panel of independent expert referees from both public and private sectors, who were asked to comment primarily on the comprehensiveness and accuracy of interpretation of the evidence supporting the recommendations in the guidelines.
Chairman
Dr Chang Kian Meng
Head of Haematology &
Consultant Haematologist
Department of Haematology
Ampang Hospital
Members (in alphabetical order)
Dr Fitzgerald Henry
Head of Surgery &
Consultant Surgeon
Department of Surgery
Selayang Hospital
Dr Jay Suriar
Consultant haematologist
Department of Haematology
Ampang Hospital
Dr Kauthaman a/l Mahendran
Head of Medicine
Consultant Physician
Department of Medicine
Malacca Hospital
Dr Liew Nyan Chin
Medical Officer
Department of Obstetrics & Gynaecology
Ampang Hospital
Dr Muralitharan Ganesalingam
Consultant Obstetrics & Gynaecology
Head of Department
Department of Obstetrics & Gynaecology
Ampang Hospital
Dr Salmiah Md Shariff
Family Medicine Specialist
Batu 9, Cheras Health Clinic
Dr Shekhar Krishnan
Consultant Paediatric Haematologist
Department of Paediatrics
University Malaya Medical Center
Dr Wan Hamilton bt Wan Hassan
Head and Consultant Obstetrician & Gynaecologist
Department of Obstetrics & Gynaecology
Serdang Hospital
Dr Wong Jun Ching
Medical Officer
Department of Obstetrics & Gynaecology
Ampang Hospital
Dr Zaharah Musa
Head of Radiology &
Consultant Radiologist
Department of Diagnostic Imaging
Hospital Selayang
Dr Zainal Ariffin Azizi
Head of Surgery &
Consultant Vascular Surgeon
Department of Surgery
Hospital Kuala Lumpur
EXTERNAL REVIEWERS
The following external reviewers provided feedback on the draft.
Professor Mike A Laffan
Professor of Haemostasis & Thrombosis
Department of Medicine
Imperial College, United Kingdom
Professor John Andrew Murie
Senior Consultant Vascular Surgeon, Royal Infirmary of Edinburgh
Honorary Senior Lecturer University of Edinburgh Medical School
Adjunct Professor, Universiti Kebangsaan Malaysia
Professor Paul Monagle
Head and Consultant Paediatric Haematologist
Department of Paediatrics
The University of Melbourne
Royal Children's Hospital
Victoria, Australia