Guidelines for PE?

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Chris co2012

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Hey guys, can somebody tell me where I can find the updated guidelines to DVT and PE?
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Have you done a search for them on Medline? Remember to use limits to search for only the practice guidelines. Also, did you check the National Guideline Clearing House at guidelines.gov.
 
Pharmgrlnxdor said:
Have you done a search for them on Medline? Remember to use limits to search for only the practice guidelines. Also, did you check the National Guideline Clearing House at guidelines.gov.
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Yes, I mean I found guidelines. It's just that I'm never sure of whether the guidelines that I pull are the CORRECT guidelines. So I just didn't know if there were any anticoag specialists around here who could verify.
 
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under what circumstance? If it is an ontology pt you use nccn. Thrombormobolic disease is circumstance specific
 
This reminds me. While I was a resident, I was reading a trial publish about 1/2 dose TPA (50 instead of 100) for PE. If I remember correctly, the author's conclusion was that it was as efficacious and safer. But the trial was done in a chinese population.

Anyone else has seen this in use in their institution or heard anything more that came out from that study?
 
Quiksilver said:
on the contrary I love em. Why the hate
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I really don't find them user-friendly, at least for printing a copy to read and take notes on. I know they provide the nice pocket versions, but I like to write all over things. It might be different when I'm using them more as a quick reference and not as a resident.
 
ucrx said:
I really don't find them user-friendly, at least for printing a copy to read and take notes on. I know they provide the nice pocket versions, but I like to write all over things. It might be different when I'm using them more as a quick reference and not as a resident.
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They have versions available for smart phones and other handheld devices.

They are organized very well and the explanations and information at the end is useful if you are not entirely familiar with the disease states. They are updated every year or even less meaning they are very good resources.


I do understand about printing them out but which guidelines can you print out? CHEST guidelines are the same way.... long. Come to think of it, there aren't many guidelines that I would ever feel comfortable printing ever.
 
Quiksilver said:
(discussing NCCN guidelines) They are organized very well and the explanations and information at the end is useful if you are not entirely familiar with the disease states. They are updated every year or even less meaning they are very good resources.


I do understand about printing them out but which guidelines can you print out? CHEST guidelines are the same way.... long. Come to think of it, there aren't many guidelines that I would ever feel comfortable printing ever.
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Reviving an old topic because my opinion has changed with more oncology experience. I'm still not a huge fan of the discussion section format. Many of the guidelines' discussions are short enough to print and take notes on and I wish I could do that more easily (for learning purposes, not for when I use the guidelines in practice). Despite that, quiksilver is right. The explanations at the end provide a nice overview and discuss the literature used to make the recommendations.

The major downside (but also a benefit in some ways) of NCCN guidelines is that they are practice based and not 100% evidence based. ASCO guidelines are evidence based. Of course, oncology practice is rarely cookie cutter, and the NCCN guidelines provide some good discussion that can be beneficial in determining how to apply the literature to specific situations. (This is probably a reflection of the issues we come across in oncology practice- there just isn't a nice simple algorithm we can use because we don't know regimen A is better than B which is better than C, and if you fail those, try regimen X, Y, or Z).

I do wish I could use the versions for smartphones, but I really don't care for reading guidelines on such a tiny screen. I would love to have a laptop/tablet/whatever for use during rounds, but unfortunately do not.
 
ucrx said:
Reviving an old topic because my opinion has changed with more oncology experience. I'm still not a huge fan of the discussion section format. Many of the guidelines' discussions are short enough to print and take notes on and I wish I could do that more easily (for learning purposes, not for when I use the guidelines in practice). Despite that, quiksilver is right. The explanations at the end provide a nice overview and discuss the literature used to make the recommendations.

The major downside (but also a benefit in some ways) of NCCN guidelines is that they are practice based and not 100% evidence based. ASCO guidelines are evidence based. Of course, oncology practice is rarely cookie cutter, and the NCCN guidelines provide some good discussion that can be beneficial in determining how to apply the literature to specific situations. (This is probably a reflection of the issues we come across in oncology practice- there just isn't a nice simple algorithm we can use because we don't know regimen A is better than B which is better than C, and if you fail those, try regimen X, Y, or Z).

I do wish I could use the versions for smartphones, but I really don't care for reading guidelines on such a tiny screen. I would love to have a laptop/tablet/whatever for use during rounds, but unfortunately do not.
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Wow. I clearly should not use the internet when sleep deprived.
 
ucrx said:
Reviving an old topic because my opinion has changed with more oncology experience. I'm still not a huge fan of the discussion section format. Many of the guidelines' discussions are short enough to print and take notes on and I wish I could do that more easily (for learning purposes, not for when I use the guidelines in practice). Despite that, quiksilver is right. The explanations at the end provide a nice overview and discuss the literature used to make the recommendations.

The major downside (but also a benefit in some ways) of NCCN guidelines is that they are practice based and not 100% evidence based. ASCO guidelines are evidence based. Of course, oncology practice is rarely cookie cutter, and the NCCN guidelines provide some good discussion that can be beneficial in determining how to apply the literature to specific situations. (This is probably a reflection of the issues we come across in oncology practice- there just isn't a nice simple algorithm we can use because we don't know regimen A is better than B which is better than C, and if you fail those, try regimen X, Y, or Z).

I do wish I could use the versions for smartphones, but I really don't care for reading guidelines on such a tiny screen. I would love to have a laptop/tablet/whatever for use during rounds, but unfortunately do not.
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Holy old thread. The nice thing about NCCN over ASCO is that the guidelines are more current; they update sometimes twice yearly. I do get what you are saying about experience vs evidence based literature but it becomes fairly difficult in an oncology setting to control for so many variables and in some cases very small n's. Just like NCCN, ASCO has a panel of crotchity doctors analyzing each detail. You just have to balence the data.

If you know you many promising drugs fail to come to market after very promising Phase II trials you will understand why you can't rely on evidence alone. I have found that in oncology more then anything else, moves you as fast as advances allow and sometimes you have to go off protocol because you just don't have the data to go along with it. Its like you have to weigh theory, benchtop research, clinical judgement, and experiences from different yet similar circumstances to come up with a decision. It certainly is an interesting subject.
 
Quiksilver said:
I have found that in oncology more then anything else, moves you as fast as advances allow and sometimes you have to go off protocol because you just don't have the data to go along with it. Its like you have to weigh theory, benchtop research, clinical judgement, and experiences from different yet similar circumstances to come up with a decision. It certainly is an interesting subject.
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Completely agree. One of the things I love about oncology is the mix of established, guideline based practice and everything else you listed. I do reach for NCCN & ASCO frequently, but there's only so much guidelines can provide especially in oncology.
 
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