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Mandeep R. Mehra - One of the best experts on this subject based on the ideXlab platform.

  • Forest plot for cumulative meta-analysis of EDT versus standard-duration thromboprophylaxis in hospitalized Medically Ill Patients for major or fatal bleeding.
    2019
    Co-Authors: Navkaranbir S. Bajaj, Muthiah Vaduganathan, Arman Qamar, Kartik Gupta, Ankur Gupta, Harsh Golwala, Javed Butler, Samuel Z. Goldhaber, Mandeep R. Mehra
    Abstract:

    Black solid square markers and associated solid lines represent cumulative summary RR and 95% CI after addition of each trial as listed in left column. The size of black markers is proportional to total accrued size. The numerical estimates in the right columns are cumulative RRs and 95% CI after sequentially adding each trial and cumulative sample size after addition of each trial listed in left column. ADOPT, Apixaban Dosing to Optimize Protection from Thrombosis; APEX, Acute Medically Ill Venous Prevention with Extended Duration Betrixaban; CI, confidence interval; EDT, extended-duration thromboprophylaxis; EXCLAIM, Extended Prophylaxis for Venous ThromboEmbolism in Acutely Ill Medical Patients With Prolonged Immobilization; MAGELLAN, Multicenter, Randomized, Parallel Group Efficacy and Safety Study for the Prevention of Venous Thromboembolism in Hospitalized Acutely Ill Medical Patients Comparing Rivaroxaban with Enoxaparin; MARINER, Medically Ill Patient Assessment of Rivaroxaban versus Placebo in Reducing Post-Discharge Venous Thrombo-Embolism Risk; RR, risk ratio.

  • NNT to prevent one symptomatic VTE or VTE-related death and NNH to cause one major or fatal bleeding event for individual trials and overall pooled estimates.
    2019
    Co-Authors: Navkaranbir S. Bajaj, Muthiah Vaduganathan, Arman Qamar, Kartik Gupta, Ankur Gupta, Harsh Golwala, Javed Butler, Samuel Z. Goldhaber, Mandeep R. Mehra
    Abstract:

    The size of red bubbles is proportional to number of Patients in the trial, and the size of the black bubble is proportional to accrued information size. The overall pooled estimates for NNH and NNT were calculated by conducting random effects meta-analyses for risk difference for primary efficacy and safety events. Safer implies higher NNH for causing one major or fatal bleeding event. Efficacious implies lower NNT to prevent one symptomatic VTE or VTE-related death. ADOPT, Apixaban Dosing to Optimize Protection from Thrombosis; APEX, Acute Medically Ill Venous Prevention with Extended Duration Betrixaban; EXCLAIM, Extended Prophylaxis for Venous ThromboEmbolism in Acutely Ill Medical Patients With Prolonged Immobilization; MAGELLAN, Multicenter, Randomized, Parallel Group Efficacy and Safety Study for the Prevention of Venous Thromboembolism in Hospitalized Acutely Ill Medical Patients Comparing Rivaroxaban with Enoxaparin; MARINER, Medically Ill Patient Assessment of Rivaroxaban versus Placebo in Reducing Post-Discharge Venous Thrombo-Embolism Risk; NNH, number need to harm; NNT, number needed to treat; VTE, venous thromboembolism.

  • Forest plot for cumulative meta-analysis of EDT versus standard-duration thromboprophylaxis in hospitalized Medically Ill Patients for primary efficacy events.
    2019
    Co-Authors: Navkaranbir S. Bajaj, Muthiah Vaduganathan, Arman Qamar, Kartik Gupta, Ankur Gupta, Harsh Golwala, Javed Butler, Samuel Z. Goldhaber, Mandeep R. Mehra
    Abstract:

    Black solid square markers and associated solid lines represent cumulative summary RR and 95% CI after addition of each trial as listed in the left column. The size of black markers is proportional to total accrued size. The numerical estimates in the right columns are cumulative RRs and 95% CI after sequentially adding each trial and cumulative sample size after addition of each trial listed in left column. ADOPT, Apixaban Dosing to Optimize Protection from Thrombosis; APEX, Acute Medically Ill Venous Prevention with Extended Duration Betrixaban; CI, confidence interval; EDT, extended-duration thromboprophylaxis; EXCLAIM, Extended Prophylaxis for Venous ThromboEmbolism in Acutely Ill Medical Patients With Prolonged Immobilization; MAGELLAN, Multicenter, Randomized, Parallel Group Efficacy and Safety Study for the Prevention of Venous Thromboembolism in Hospitalized Acutely Ill Medical Patients Comparing Rivaroxaban with Enoxaparin; MARINER, Medically Ill Patient Assessment of Rivaroxaban versus Placebo in Reducing Post-Discharge Venous Thrombo-Embolism Risk; RR, risk ratio.

  • Forest plot comparing EDT versus standard-duration thromboprophylaxis in hospitalized Medically Ill Patients for the primary efficacy endpoint (symptomatic VTE or VTE-related death) and the primary safety endpoint (major or fatal bleeding).
    2019
    Co-Authors: Navkaranbir S. Bajaj, Muthiah Vaduganathan, Arman Qamar, Kartik Gupta, Ankur Gupta, Harsh Golwala, Javed Butler, Samuel Z. Goldhaber, Mandeep R. Mehra
    Abstract:

    Black solid square markers and associated solid lines represent summary RR and 95% CI of each trial listed in the left column. The size of black markers is proportional to standard error of effect estimate. The numerical estimates in the right columns are RRs with 95% CI of each trial listed in the left column. The hollow blue diamond is summary RR and 95% CI for VTE or VTE-related death, whereas the hollow red diamond is summary RR for major or fatal bleeding. ADOPT, Apixaban Dosing to Optimize Protection from Thrombosis; APEX, Acute Medically Ill Venous Prevention with Extended Duration Betrixaban; BID, two times a day; CI, confidence interval; EDT, extended-duration thromboprophylaxis; EXCLAIM, Extended Prophylaxis for Venous ThromboEmbolism in Acutely Ill Medical Patients With Prolonged Immobilization; MAGELLAN, Multicenter, Randomized, Parallel Group Efficacy and Safety Study for the Prevention of Venous Thromboembolism in Hospitalized Acutely Ill Medical Patients Comparing Rivaroxaban with Enoxaparin; MARINER, Medically Ill Patient Assessment of Rivaroxaban Versus Placebo in Reducing Post-Discharge Venous Thrombo-Embolism Risk; OD, once daily; RR, risk ratio; VTE, venous thromboembolism.

  • Trial sequential analysis of EDT versus standard-duration thromboprophylaxis in hospitalized Medically Ill Patients for primary efficacy events.
    2019
    Co-Authors: Navkaranbir S. Bajaj, Muthiah Vaduganathan, Arman Qamar, Kartik Gupta, Ankur Gupta, Harsh Golwala, Javed Butler, Samuel Z. Goldhaber, Mandeep R. Mehra
    Abstract:

    The green dashed line represents Lan–DeMets trial sequential boundary for benefit and the maroon dashed line represents Lan–DeMets trial sequential boundary for harm. The blue solid line is cumulative Z-curve derived from random effects cumulative meta-analysis. The solid bright green line indicates line of no difference, and dashed black lines are upper and lower bounds for 95% CI. The total accrued information size for this analysis was 40,247 Patients. The cumulative Z-curve surpassed both the dashed black line (line of statistical significance at Z-score of +1.96) and green dashed line (Lan–DeMets trial sequential boundary for benefit), indicating true benefit EDT over standard of care in reducing postdischarge VTE. ADOPT, Apixaban Dosing to Optimize Protection from Thrombosis; APEX, Acute Medically Ill Venous Prevention with Extended Duration Betrixaban; CI, confidence interval; EDT, extended-duration thromboprophylaxis; EXCLAIM, Extended Prophylaxis for Venous ThromboEmbolism in Acutely Ill Medical Patients With Prolonged Immobilization; MAGELLAN, Multicenter, Randomized, Parallel Group Efficacy and Safety Study for the Prevention of Venous Thromboembolism in Hospitalized Acutely Ill Medical Patients Comparing Rivaroxaban with Enoxaparin; MARINER, Medically Ill Patient Assessment of Rivaroxaban versus Placebo in Reducing Post-Discharge Venous Thrombo-Embolism Risk; VTE, venous thromboembolism.

Navkaranbir S. Bajaj - One of the best experts on this subject based on the ideXlab platform.

  • Forest plot for cumulative meta-analysis of EDT versus standard-duration thromboprophylaxis in hospitalized Medically Ill Patients for major or fatal bleeding.
    2019
    Co-Authors: Navkaranbir S. Bajaj, Muthiah Vaduganathan, Arman Qamar, Kartik Gupta, Ankur Gupta, Harsh Golwala, Javed Butler, Samuel Z. Goldhaber, Mandeep R. Mehra
    Abstract:

    Black solid square markers and associated solid lines represent cumulative summary RR and 95% CI after addition of each trial as listed in left column. The size of black markers is proportional to total accrued size. The numerical estimates in the right columns are cumulative RRs and 95% CI after sequentially adding each trial and cumulative sample size after addition of each trial listed in left column. ADOPT, Apixaban Dosing to Optimize Protection from Thrombosis; APEX, Acute Medically Ill Venous Prevention with Extended Duration Betrixaban; CI, confidence interval; EDT, extended-duration thromboprophylaxis; EXCLAIM, Extended Prophylaxis for Venous ThromboEmbolism in Acutely Ill Medical Patients With Prolonged Immobilization; MAGELLAN, Multicenter, Randomized, Parallel Group Efficacy and Safety Study for the Prevention of Venous Thromboembolism in Hospitalized Acutely Ill Medical Patients Comparing Rivaroxaban with Enoxaparin; MARINER, Medically Ill Patient Assessment of Rivaroxaban versus Placebo in Reducing Post-Discharge Venous Thrombo-Embolism Risk; RR, risk ratio.

  • NNT to prevent one symptomatic VTE or VTE-related death and NNH to cause one major or fatal bleeding event for individual trials and overall pooled estimates.
    2019
    Co-Authors: Navkaranbir S. Bajaj, Muthiah Vaduganathan, Arman Qamar, Kartik Gupta, Ankur Gupta, Harsh Golwala, Javed Butler, Samuel Z. Goldhaber, Mandeep R. Mehra
    Abstract:

    The size of red bubbles is proportional to number of Patients in the trial, and the size of the black bubble is proportional to accrued information size. The overall pooled estimates for NNH and NNT were calculated by conducting random effects meta-analyses for risk difference for primary efficacy and safety events. Safer implies higher NNH for causing one major or fatal bleeding event. Efficacious implies lower NNT to prevent one symptomatic VTE or VTE-related death. ADOPT, Apixaban Dosing to Optimize Protection from Thrombosis; APEX, Acute Medically Ill Venous Prevention with Extended Duration Betrixaban; EXCLAIM, Extended Prophylaxis for Venous ThromboEmbolism in Acutely Ill Medical Patients With Prolonged Immobilization; MAGELLAN, Multicenter, Randomized, Parallel Group Efficacy and Safety Study for the Prevention of Venous Thromboembolism in Hospitalized Acutely Ill Medical Patients Comparing Rivaroxaban with Enoxaparin; MARINER, Medically Ill Patient Assessment of Rivaroxaban versus Placebo in Reducing Post-Discharge Venous Thrombo-Embolism Risk; NNH, number need to harm; NNT, number needed to treat; VTE, venous thromboembolism.

  • Forest plot for cumulative meta-analysis of EDT versus standard-duration thromboprophylaxis in hospitalized Medically Ill Patients for primary efficacy events.
    2019
    Co-Authors: Navkaranbir S. Bajaj, Muthiah Vaduganathan, Arman Qamar, Kartik Gupta, Ankur Gupta, Harsh Golwala, Javed Butler, Samuel Z. Goldhaber, Mandeep R. Mehra
    Abstract:

    Black solid square markers and associated solid lines represent cumulative summary RR and 95% CI after addition of each trial as listed in the left column. The size of black markers is proportional to total accrued size. The numerical estimates in the right columns are cumulative RRs and 95% CI after sequentially adding each trial and cumulative sample size after addition of each trial listed in left column. ADOPT, Apixaban Dosing to Optimize Protection from Thrombosis; APEX, Acute Medically Ill Venous Prevention with Extended Duration Betrixaban; CI, confidence interval; EDT, extended-duration thromboprophylaxis; EXCLAIM, Extended Prophylaxis for Venous ThromboEmbolism in Acutely Ill Medical Patients With Prolonged Immobilization; MAGELLAN, Multicenter, Randomized, Parallel Group Efficacy and Safety Study for the Prevention of Venous Thromboembolism in Hospitalized Acutely Ill Medical Patients Comparing Rivaroxaban with Enoxaparin; MARINER, Medically Ill Patient Assessment of Rivaroxaban versus Placebo in Reducing Post-Discharge Venous Thrombo-Embolism Risk; RR, risk ratio.

  • Forest plot comparing EDT versus standard-duration thromboprophylaxis in hospitalized Medically Ill Patients for the primary efficacy endpoint (symptomatic VTE or VTE-related death) and the primary safety endpoint (major or fatal bleeding).
    2019
    Co-Authors: Navkaranbir S. Bajaj, Muthiah Vaduganathan, Arman Qamar, Kartik Gupta, Ankur Gupta, Harsh Golwala, Javed Butler, Samuel Z. Goldhaber, Mandeep R. Mehra
    Abstract:

    Black solid square markers and associated solid lines represent summary RR and 95% CI of each trial listed in the left column. The size of black markers is proportional to standard error of effect estimate. The numerical estimates in the right columns are RRs with 95% CI of each trial listed in the left column. The hollow blue diamond is summary RR and 95% CI for VTE or VTE-related death, whereas the hollow red diamond is summary RR for major or fatal bleeding. ADOPT, Apixaban Dosing to Optimize Protection from Thrombosis; APEX, Acute Medically Ill Venous Prevention with Extended Duration Betrixaban; BID, two times a day; CI, confidence interval; EDT, extended-duration thromboprophylaxis; EXCLAIM, Extended Prophylaxis for Venous ThromboEmbolism in Acutely Ill Medical Patients With Prolonged Immobilization; MAGELLAN, Multicenter, Randomized, Parallel Group Efficacy and Safety Study for the Prevention of Venous Thromboembolism in Hospitalized Acutely Ill Medical Patients Comparing Rivaroxaban with Enoxaparin; MARINER, Medically Ill Patient Assessment of Rivaroxaban Versus Placebo in Reducing Post-Discharge Venous Thrombo-Embolism Risk; OD, once daily; RR, risk ratio; VTE, venous thromboembolism.

  • Trial sequential analysis of EDT versus standard-duration thromboprophylaxis in hospitalized Medically Ill Patients for primary efficacy events.
    2019
    Co-Authors: Navkaranbir S. Bajaj, Muthiah Vaduganathan, Arman Qamar, Kartik Gupta, Ankur Gupta, Harsh Golwala, Javed Butler, Samuel Z. Goldhaber, Mandeep R. Mehra
    Abstract:

    The green dashed line represents Lan–DeMets trial sequential boundary for benefit and the maroon dashed line represents Lan–DeMets trial sequential boundary for harm. The blue solid line is cumulative Z-curve derived from random effects cumulative meta-analysis. The solid bright green line indicates line of no difference, and dashed black lines are upper and lower bounds for 95% CI. The total accrued information size for this analysis was 40,247 Patients. The cumulative Z-curve surpassed both the dashed black line (line of statistical significance at Z-score of +1.96) and green dashed line (Lan–DeMets trial sequential boundary for benefit), indicating true benefit EDT over standard of care in reducing postdischarge VTE. ADOPT, Apixaban Dosing to Optimize Protection from Thrombosis; APEX, Acute Medically Ill Venous Prevention with Extended Duration Betrixaban; CI, confidence interval; EDT, extended-duration thromboprophylaxis; EXCLAIM, Extended Prophylaxis for Venous ThromboEmbolism in Acutely Ill Medical Patients With Prolonged Immobilization; MAGELLAN, Multicenter, Randomized, Parallel Group Efficacy and Safety Study for the Prevention of Venous Thromboembolism in Hospitalized Acutely Ill Medical Patients Comparing Rivaroxaban with Enoxaparin; MARINER, Medically Ill Patient Assessment of Rivaroxaban versus Placebo in Reducing Post-Discharge Venous Thrombo-Embolism Risk; VTE, venous thromboembolism.

Oyinlola Oluwagbemiga - One of the best experts on this subject based on the ideXlab platform.

  • effectiveness of social support in coping with stroke by Medically Ill Patient in ibadan
    international journal of neurorehabilitation, 2017
    Co-Authors: Mainoo Blessing, Oyinlola Oluwagbemiga
    Abstract:

    Stroke, also known as cerebrovascular accident (CVA), cerebrovascular insult (CVI) or brain attack, is when poor blood flow to the brain results in cell death, there is need for concurrent coping with stroke demand cognitive effort from the Patient. Social support intervention is best started as early (at diagnosis) and demands continuous effort. Hence, the study examines the effectiveness of social support in coping with stroke by Medically Ill Patient in Ibadan. The study is a descriptive survey research and a total of 50 stroke Patients attending the government hospital of Adeoyo, Ibadan were purposively selected for the study. The study adopted the researchers, Multidimensional Scale of Social Support and the result yielded r=0.78 while coping with stroke was measured using a scale from Journal compilation (2008) Blackwell publishing Ltd. titled stroke self-efficacy questionnaire, the result yielded 0.81. The study developed five hypotheses and pearson product moment correlation was used to analyze of the findings. The result revealed that, there was a significant effect of family support on coping with stroke by the Medically Ill Patients (r=0.352, N=50, p<0.05), there was a significant effect of financial support on coping with stroke by the Medically Ill Patients (r=0.658, N=50, p<0.05), there was a significant relationship of emotional support on coping with stroke by the Medically Ill Patients (r=0.402, N=50, p<0.05), there was a significant effect of companionship support on coping with stroke by the Medically Ill Patients (r=0.654, N=50, p<0.05), the multiple regression analysis showed that, Family Support (β=-0.391, p<0.05) had significant effect followed by Financial Support (β=0.418, p<0.05), followed by Emotional Support (β=0.165, p<0.05) and Companionship Support (β=0.7878, p<0.05)Hence, the study revealed that, living with stroke requires joint effort of family support, financial support, emotional support and companionship support to help make the necessary changes to cope and adapt to stroke.

  • Effectiveness of Social Support in Coping with Stroke by Medically Ill Patient in Ibadan
    international journal of neurorehabilitation, 2017
    Co-Authors: Mainoo Blessing, Oyinlola Oluwagbemiga
    Abstract:

    Stroke, also known as cerebrovascular accident (CVA), cerebrovascular insult (CVI) or brain attack, is when poor blood flow to the brain results in cell death, there is need for concurrent coping with stroke demand cognitive effort from the Patient. Social support intervention is best started as early (at diagnosis) and demands continuous effort. Hence, the study examines the effectiveness of social support in coping with stroke by Medically Ill Patient in Ibadan. The study is a descriptive survey research and a total of 50 stroke Patients attending the government hospital of Adeoyo, Ibadan were purposively selected for the study. The study adopted the researchers, Multidimensional Scale of Social Support and the result yielded r=0.78 while coping with stroke was measured using a scale from Journal compilation (2008) Blackwell publishing Ltd. titled stroke self-efficacy questionnaire, the result yielded 0.81. The study developed five hypotheses and pearson product moment correlation was used to analyze of the findings. The result revealed that, there was a significant effect of family support on coping with stroke by the Medically Ill Patients (r=0.352, N=50, p

Ankur Gupta - One of the best experts on this subject based on the ideXlab platform.

  • Forest plot for cumulative meta-analysis of EDT versus standard-duration thromboprophylaxis in hospitalized Medically Ill Patients for major or fatal bleeding.
    2019
    Co-Authors: Navkaranbir S. Bajaj, Muthiah Vaduganathan, Arman Qamar, Kartik Gupta, Ankur Gupta, Harsh Golwala, Javed Butler, Samuel Z. Goldhaber, Mandeep R. Mehra
    Abstract:

    Black solid square markers and associated solid lines represent cumulative summary RR and 95% CI after addition of each trial as listed in left column. The size of black markers is proportional to total accrued size. The numerical estimates in the right columns are cumulative RRs and 95% CI after sequentially adding each trial and cumulative sample size after addition of each trial listed in left column. ADOPT, Apixaban Dosing to Optimize Protection from Thrombosis; APEX, Acute Medically Ill Venous Prevention with Extended Duration Betrixaban; CI, confidence interval; EDT, extended-duration thromboprophylaxis; EXCLAIM, Extended Prophylaxis for Venous ThromboEmbolism in Acutely Ill Medical Patients With Prolonged Immobilization; MAGELLAN, Multicenter, Randomized, Parallel Group Efficacy and Safety Study for the Prevention of Venous Thromboembolism in Hospitalized Acutely Ill Medical Patients Comparing Rivaroxaban with Enoxaparin; MARINER, Medically Ill Patient Assessment of Rivaroxaban versus Placebo in Reducing Post-Discharge Venous Thrombo-Embolism Risk; RR, risk ratio.

  • NNT to prevent one symptomatic VTE or VTE-related death and NNH to cause one major or fatal bleeding event for individual trials and overall pooled estimates.
    2019
    Co-Authors: Navkaranbir S. Bajaj, Muthiah Vaduganathan, Arman Qamar, Kartik Gupta, Ankur Gupta, Harsh Golwala, Javed Butler, Samuel Z. Goldhaber, Mandeep R. Mehra
    Abstract:

    The size of red bubbles is proportional to number of Patients in the trial, and the size of the black bubble is proportional to accrued information size. The overall pooled estimates for NNH and NNT were calculated by conducting random effects meta-analyses for risk difference for primary efficacy and safety events. Safer implies higher NNH for causing one major or fatal bleeding event. Efficacious implies lower NNT to prevent one symptomatic VTE or VTE-related death. ADOPT, Apixaban Dosing to Optimize Protection from Thrombosis; APEX, Acute Medically Ill Venous Prevention with Extended Duration Betrixaban; EXCLAIM, Extended Prophylaxis for Venous ThromboEmbolism in Acutely Ill Medical Patients With Prolonged Immobilization; MAGELLAN, Multicenter, Randomized, Parallel Group Efficacy and Safety Study for the Prevention of Venous Thromboembolism in Hospitalized Acutely Ill Medical Patients Comparing Rivaroxaban with Enoxaparin; MARINER, Medically Ill Patient Assessment of Rivaroxaban versus Placebo in Reducing Post-Discharge Venous Thrombo-Embolism Risk; NNH, number need to harm; NNT, number needed to treat; VTE, venous thromboembolism.

  • Forest plot for cumulative meta-analysis of EDT versus standard-duration thromboprophylaxis in hospitalized Medically Ill Patients for primary efficacy events.
    2019
    Co-Authors: Navkaranbir S. Bajaj, Muthiah Vaduganathan, Arman Qamar, Kartik Gupta, Ankur Gupta, Harsh Golwala, Javed Butler, Samuel Z. Goldhaber, Mandeep R. Mehra
    Abstract:

    Black solid square markers and associated solid lines represent cumulative summary RR and 95% CI after addition of each trial as listed in the left column. The size of black markers is proportional to total accrued size. The numerical estimates in the right columns are cumulative RRs and 95% CI after sequentially adding each trial and cumulative sample size after addition of each trial listed in left column. ADOPT, Apixaban Dosing to Optimize Protection from Thrombosis; APEX, Acute Medically Ill Venous Prevention with Extended Duration Betrixaban; CI, confidence interval; EDT, extended-duration thromboprophylaxis; EXCLAIM, Extended Prophylaxis for Venous ThromboEmbolism in Acutely Ill Medical Patients With Prolonged Immobilization; MAGELLAN, Multicenter, Randomized, Parallel Group Efficacy and Safety Study for the Prevention of Venous Thromboembolism in Hospitalized Acutely Ill Medical Patients Comparing Rivaroxaban with Enoxaparin; MARINER, Medically Ill Patient Assessment of Rivaroxaban versus Placebo in Reducing Post-Discharge Venous Thrombo-Embolism Risk; RR, risk ratio.

  • Forest plot comparing EDT versus standard-duration thromboprophylaxis in hospitalized Medically Ill Patients for the primary efficacy endpoint (symptomatic VTE or VTE-related death) and the primary safety endpoint (major or fatal bleeding).
    2019
    Co-Authors: Navkaranbir S. Bajaj, Muthiah Vaduganathan, Arman Qamar, Kartik Gupta, Ankur Gupta, Harsh Golwala, Javed Butler, Samuel Z. Goldhaber, Mandeep R. Mehra
    Abstract:

    Black solid square markers and associated solid lines represent summary RR and 95% CI of each trial listed in the left column. The size of black markers is proportional to standard error of effect estimate. The numerical estimates in the right columns are RRs with 95% CI of each trial listed in the left column. The hollow blue diamond is summary RR and 95% CI for VTE or VTE-related death, whereas the hollow red diamond is summary RR for major or fatal bleeding. ADOPT, Apixaban Dosing to Optimize Protection from Thrombosis; APEX, Acute Medically Ill Venous Prevention with Extended Duration Betrixaban; BID, two times a day; CI, confidence interval; EDT, extended-duration thromboprophylaxis; EXCLAIM, Extended Prophylaxis for Venous ThromboEmbolism in Acutely Ill Medical Patients With Prolonged Immobilization; MAGELLAN, Multicenter, Randomized, Parallel Group Efficacy and Safety Study for the Prevention of Venous Thromboembolism in Hospitalized Acutely Ill Medical Patients Comparing Rivaroxaban with Enoxaparin; MARINER, Medically Ill Patient Assessment of Rivaroxaban Versus Placebo in Reducing Post-Discharge Venous Thrombo-Embolism Risk; OD, once daily; RR, risk ratio; VTE, venous thromboembolism.

  • Trial sequential analysis of EDT versus standard-duration thromboprophylaxis in hospitalized Medically Ill Patients for primary efficacy events.
    2019
    Co-Authors: Navkaranbir S. Bajaj, Muthiah Vaduganathan, Arman Qamar, Kartik Gupta, Ankur Gupta, Harsh Golwala, Javed Butler, Samuel Z. Goldhaber, Mandeep R. Mehra
    Abstract:

    The green dashed line represents Lan–DeMets trial sequential boundary for benefit and the maroon dashed line represents Lan–DeMets trial sequential boundary for harm. The blue solid line is cumulative Z-curve derived from random effects cumulative meta-analysis. The solid bright green line indicates line of no difference, and dashed black lines are upper and lower bounds for 95% CI. The total accrued information size for this analysis was 40,247 Patients. The cumulative Z-curve surpassed both the dashed black line (line of statistical significance at Z-score of +1.96) and green dashed line (Lan–DeMets trial sequential boundary for benefit), indicating true benefit EDT over standard of care in reducing postdischarge VTE. ADOPT, Apixaban Dosing to Optimize Protection from Thrombosis; APEX, Acute Medically Ill Venous Prevention with Extended Duration Betrixaban; CI, confidence interval; EDT, extended-duration thromboprophylaxis; EXCLAIM, Extended Prophylaxis for Venous ThromboEmbolism in Acutely Ill Medical Patients With Prolonged Immobilization; MAGELLAN, Multicenter, Randomized, Parallel Group Efficacy and Safety Study for the Prevention of Venous Thromboembolism in Hospitalized Acutely Ill Medical Patients Comparing Rivaroxaban with Enoxaparin; MARINER, Medically Ill Patient Assessment of Rivaroxaban versus Placebo in Reducing Post-Discharge Venous Thrombo-Embolism Risk; VTE, venous thromboembolism.

Samuel Z. Goldhaber - One of the best experts on this subject based on the ideXlab platform.

  • Forest plot for cumulative meta-analysis of EDT versus standard-duration thromboprophylaxis in hospitalized Medically Ill Patients for major or fatal bleeding.
    2019
    Co-Authors: Navkaranbir S. Bajaj, Muthiah Vaduganathan, Arman Qamar, Kartik Gupta, Ankur Gupta, Harsh Golwala, Javed Butler, Samuel Z. Goldhaber, Mandeep R. Mehra
    Abstract:

    Black solid square markers and associated solid lines represent cumulative summary RR and 95% CI after addition of each trial as listed in left column. The size of black markers is proportional to total accrued size. The numerical estimates in the right columns are cumulative RRs and 95% CI after sequentially adding each trial and cumulative sample size after addition of each trial listed in left column. ADOPT, Apixaban Dosing to Optimize Protection from Thrombosis; APEX, Acute Medically Ill Venous Prevention with Extended Duration Betrixaban; CI, confidence interval; EDT, extended-duration thromboprophylaxis; EXCLAIM, Extended Prophylaxis for Venous ThromboEmbolism in Acutely Ill Medical Patients With Prolonged Immobilization; MAGELLAN, Multicenter, Randomized, Parallel Group Efficacy and Safety Study for the Prevention of Venous Thromboembolism in Hospitalized Acutely Ill Medical Patients Comparing Rivaroxaban with Enoxaparin; MARINER, Medically Ill Patient Assessment of Rivaroxaban versus Placebo in Reducing Post-Discharge Venous Thrombo-Embolism Risk; RR, risk ratio.

  • NNT to prevent one symptomatic VTE or VTE-related death and NNH to cause one major or fatal bleeding event for individual trials and overall pooled estimates.
    2019
    Co-Authors: Navkaranbir S. Bajaj, Muthiah Vaduganathan, Arman Qamar, Kartik Gupta, Ankur Gupta, Harsh Golwala, Javed Butler, Samuel Z. Goldhaber, Mandeep R. Mehra
    Abstract:

    The size of red bubbles is proportional to number of Patients in the trial, and the size of the black bubble is proportional to accrued information size. The overall pooled estimates for NNH and NNT were calculated by conducting random effects meta-analyses for risk difference for primary efficacy and safety events. Safer implies higher NNH for causing one major or fatal bleeding event. Efficacious implies lower NNT to prevent one symptomatic VTE or VTE-related death. ADOPT, Apixaban Dosing to Optimize Protection from Thrombosis; APEX, Acute Medically Ill Venous Prevention with Extended Duration Betrixaban; EXCLAIM, Extended Prophylaxis for Venous ThromboEmbolism in Acutely Ill Medical Patients With Prolonged Immobilization; MAGELLAN, Multicenter, Randomized, Parallel Group Efficacy and Safety Study for the Prevention of Venous Thromboembolism in Hospitalized Acutely Ill Medical Patients Comparing Rivaroxaban with Enoxaparin; MARINER, Medically Ill Patient Assessment of Rivaroxaban versus Placebo in Reducing Post-Discharge Venous Thrombo-Embolism Risk; NNH, number need to harm; NNT, number needed to treat; VTE, venous thromboembolism.

  • Forest plot for cumulative meta-analysis of EDT versus standard-duration thromboprophylaxis in hospitalized Medically Ill Patients for primary efficacy events.
    2019
    Co-Authors: Navkaranbir S. Bajaj, Muthiah Vaduganathan, Arman Qamar, Kartik Gupta, Ankur Gupta, Harsh Golwala, Javed Butler, Samuel Z. Goldhaber, Mandeep R. Mehra
    Abstract:

    Black solid square markers and associated solid lines represent cumulative summary RR and 95% CI after addition of each trial as listed in the left column. The size of black markers is proportional to total accrued size. The numerical estimates in the right columns are cumulative RRs and 95% CI after sequentially adding each trial and cumulative sample size after addition of each trial listed in left column. ADOPT, Apixaban Dosing to Optimize Protection from Thrombosis; APEX, Acute Medically Ill Venous Prevention with Extended Duration Betrixaban; CI, confidence interval; EDT, extended-duration thromboprophylaxis; EXCLAIM, Extended Prophylaxis for Venous ThromboEmbolism in Acutely Ill Medical Patients With Prolonged Immobilization; MAGELLAN, Multicenter, Randomized, Parallel Group Efficacy and Safety Study for the Prevention of Venous Thromboembolism in Hospitalized Acutely Ill Medical Patients Comparing Rivaroxaban with Enoxaparin; MARINER, Medically Ill Patient Assessment of Rivaroxaban versus Placebo in Reducing Post-Discharge Venous Thrombo-Embolism Risk; RR, risk ratio.

  • Forest plot comparing EDT versus standard-duration thromboprophylaxis in hospitalized Medically Ill Patients for the primary efficacy endpoint (symptomatic VTE or VTE-related death) and the primary safety endpoint (major or fatal bleeding).
    2019
    Co-Authors: Navkaranbir S. Bajaj, Muthiah Vaduganathan, Arman Qamar, Kartik Gupta, Ankur Gupta, Harsh Golwala, Javed Butler, Samuel Z. Goldhaber, Mandeep R. Mehra
    Abstract:

    Black solid square markers and associated solid lines represent summary RR and 95% CI of each trial listed in the left column. The size of black markers is proportional to standard error of effect estimate. The numerical estimates in the right columns are RRs with 95% CI of each trial listed in the left column. The hollow blue diamond is summary RR and 95% CI for VTE or VTE-related death, whereas the hollow red diamond is summary RR for major or fatal bleeding. ADOPT, Apixaban Dosing to Optimize Protection from Thrombosis; APEX, Acute Medically Ill Venous Prevention with Extended Duration Betrixaban; BID, two times a day; CI, confidence interval; EDT, extended-duration thromboprophylaxis; EXCLAIM, Extended Prophylaxis for Venous ThromboEmbolism in Acutely Ill Medical Patients With Prolonged Immobilization; MAGELLAN, Multicenter, Randomized, Parallel Group Efficacy and Safety Study for the Prevention of Venous Thromboembolism in Hospitalized Acutely Ill Medical Patients Comparing Rivaroxaban with Enoxaparin; MARINER, Medically Ill Patient Assessment of Rivaroxaban Versus Placebo in Reducing Post-Discharge Venous Thrombo-Embolism Risk; OD, once daily; RR, risk ratio; VTE, venous thromboembolism.

  • Trial sequential analysis of EDT versus standard-duration thromboprophylaxis in hospitalized Medically Ill Patients for primary efficacy events.
    2019
    Co-Authors: Navkaranbir S. Bajaj, Muthiah Vaduganathan, Arman Qamar, Kartik Gupta, Ankur Gupta, Harsh Golwala, Javed Butler, Samuel Z. Goldhaber, Mandeep R. Mehra
    Abstract:

    The green dashed line represents Lan–DeMets trial sequential boundary for benefit and the maroon dashed line represents Lan–DeMets trial sequential boundary for harm. The blue solid line is cumulative Z-curve derived from random effects cumulative meta-analysis. The solid bright green line indicates line of no difference, and dashed black lines are upper and lower bounds for 95% CI. The total accrued information size for this analysis was 40,247 Patients. The cumulative Z-curve surpassed both the dashed black line (line of statistical significance at Z-score of +1.96) and green dashed line (Lan–DeMets trial sequential boundary for benefit), indicating true benefit EDT over standard of care in reducing postdischarge VTE. ADOPT, Apixaban Dosing to Optimize Protection from Thrombosis; APEX, Acute Medically Ill Venous Prevention with Extended Duration Betrixaban; CI, confidence interval; EDT, extended-duration thromboprophylaxis; EXCLAIM, Extended Prophylaxis for Venous ThromboEmbolism in Acutely Ill Medical Patients With Prolonged Immobilization; MAGELLAN, Multicenter, Randomized, Parallel Group Efficacy and Safety Study for the Prevention of Venous Thromboembolism in Hospitalized Acutely Ill Medical Patients Comparing Rivaroxaban with Enoxaparin; MARINER, Medically Ill Patient Assessment of Rivaroxaban versus Placebo in Reducing Post-Discharge Venous Thrombo-Embolism Risk; VTE, venous thromboembolism.