Venous thromboembolism research priorities: A scientific statement from the American Heart Association and the International Society on Thrombosis and Haemostasis.
Andrea N EdgintonGeoffery D BarnesMark A CreagerJose Antonio DiazPeter K HenkeKellie R MachlusMarvin T NiemanAlisa S Wolbergnull nullPublished in: Research and practice in thrombosis and haemostasis (2020)
Venous thromboembolism (VTE) is a major cause of morbidity and mortality. The impact of the Surgeon General's Call to Action in 2008 has been lower than expected given the public health impact of this disease. This scientific statement highlights future research priorities in VTE, developed by experts and a crowdsourcing survey across 16 scientific organizations. At the fundamental research level (T0), researchers need to identify pathobiologic causative mechanisms for the 50% of patients with unprovoked VTE and better understand mechanisms that differentiate hemostasis from thrombosis. At the human level (T1), new methods for diagnosing, treating, and preventing VTE will allow tailoring of diagnostic and therapeutic approaches to individuals. At the patient level (T2), research efforts are required to understand how foundational evidence impacts care of patients (eg, biomarkers). New treatments, such as catheter-based therapies, require further testing to identify which patients are most likely to experience benefit. At the practice level (T3), translating evidence into practice remains challenging. Areas of overuse and underuse will require evidence-based tools to improve care delivery. At the community and population level (T4), public awareness campaigns need thorough impact assessment. Large population-based cohort studies can elucidate the biologic and environmental underpinings of VTE and its complications. To achieve these goals, funding agencies and training programs must support a new generation of scientists and clinicians who work in multidisciplinary teams to solve the pressing public health problem of VTE.
Keyphrases
- venous thromboembolism
- public health
- direct oral anticoagulants
- healthcare
- end stage renal disease
- quality improvement
- palliative care
- ejection fraction
- peritoneal dialysis
- chronic kidney disease
- pulmonary embolism
- newly diagnosed
- endothelial cells
- primary care
- heart failure
- prognostic factors
- mental health
- rheumatoid arthritis
- emergency department
- chronic pain
- affordable care act
- risk assessment
- atrial fibrillation
- climate change
- ultrasound guided