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. 2016 Mar 30;2016(3):CD004179. doi: 10.1002/14651858.CD004179.pub2
Anticoagulants (chosen at investigators' discretion) compared to placebo for prevention of venous thromboembolism following total hip or knee replacement or hip fracture repair
Patient or population: people requiring prevention of venous thromboembolism following total hip or knee replacement or hip fracture repair
 Setting: hospital and outpatient setting
 Intervention: anticoagulant (chosen at investigators' discretion)
 Comparison: placebo
Outcomes Anticipated absolute effects* (95% CI) Relative effect
 (95% CI) Number of participants
 (studies) Quality of the evidence
 (GRADE) Comments
Risk with placebo Risk with anticoagulant (chosen at investigators' discretion)
Total VTE (symptomatic and asymptomatic)
Treatment duration 28 ‐ 42 days
Study population OR 0.26
 (0.14 to 0.50) 557
 (1 RCT) ⊕⊕⊕⊝
 MODERATE 1
158 per 1000 46 per 1000
 (26 to 86)
Asymptomatic DVT
Treatment duration 28 ‐ 42 days
Study population OR 0.26
 (0.13 to 0.54) 557
 (1 RCT) ⊕⊕⊕⊝
 MODERATE 1
125 per 1000 36 per 1000
 (18 to 72)
Asymptomatic proximal DVT
Treatment duration 28 ‐ 42 days
see comment not reported in single included study in this comparison
Asymptomatic distal DVT
Treatment duration 28 ‐ 42 days
Study population OR 0.26
 (0.13 to 0.54) 557
 (1 RCT) ⊕⊕⊕⊝
 MODERATE 1
125 per 1000 36 per 1000
 (18 to 72)
All‐cause mortality
Treatment duration 28 ‐ 42 days
see comment 842
 (1 RCT) the single included study reported no deaths in either study arm
Adverse events
Treatment duration 28 ‐ 42 days
see comment not reported in single included study in this comparison
Reoperation
 Treatment duration 28 ‐ 42 days see comment outcome reported as part of the definition of the outcome major bleeding but data not reported separately
Wound infection
Treatment duration 28 ‐ 42 days
see comment not reported in single included study in this comparison
Wound healing
Treatment duration 28 ‐ 42 days
see comment not reported in single included study in this comparison
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
 CI: Ccnfidence interval; DVT: deep vein thrombosis; OR: odds ratio; PE: pulmonary embolism; RCT: randomised controlled trial; VTE: venous thromboembolism
GRADE Working Group grades of evidenceHigh quality: We are very confident that the true effect lies close to that of the estimate of the effect
 Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
 Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
 Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect