This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page. |
Archive 1 |
I think the merge should have been done the other way. The term "deep vein thrombosis" is more common than "deep venous thrombosis"
google results:
633,000 for deep vein thrombosis
358,000 for deep venous thrombosis
Nephron
01:08, 21 July 2005 (UTC)
Since an important audience is the less-technical, the common usage is more helpful. Technical readers, if they wish to consult Wikipedia, will be familiar with the more common term. —Preceding unsigned comment added by 67.101.66.55 ( talk) 04:22, 30 November 2007 (UTC)
"A careful history has to be taken considering risk factors (see below), " There's no subsection entitled 'Risk factors'. Could this be clarified or corrected?
Of thrombophlebitis and deep vein thrombosis, the latter is the more serious and clinically relevant ones. Perhaps thrombophlebitis could be mentioned within deep vein thrombosis. Furthermore the content on thrombophlebitis is quite similar to the DVT article. Andrew73 12:33, 15 March 2006 (UTC)
Prophylaxis? Pathogenesis? This article is hard to follow for the average lay person such as myself. Can someone rewrite with sections named "Causes" and "Treatment"? -- Barrylb 19:51, 6 May 2006 (UTC)
A complications section could be useful.
"In up to 25% of all hospitalized patients, there may be some form of DVT, which often remains clinically inapparent." This presumably refers to all patients hospitalized for whatever reason, not all patients hospitalized for suspected DVT - the sentence logic suggests it must be the the former, but it's such a large statistic that it took me a couple of rereads to understand. Moonlander69 23:17, 1 June 2007 (UTC)
Can someone please explain the risks of using the prescibed medications for DVT and pregnancy. And if I have DVT due to an previous pregnancy what should I do when pregnant again whilst having DVT.
I think the article is way too complex and written in the lingo that doctors use, probably BY a doctor or someone with a lot of medical training. That's OK if they have that training, but the thing is that most of us regular every-day people can't understand it because we don't have that training.
Besides the grammar being incorrect in the following sentence, it also seems to reference research that claims the opposite of what it says here.
Other risk factors include advanced age, obesity, infection, immobilization, female sex, use of combined (estrogen-containing) forms of hormonal contraception, tobacco usage and air travel ("economy class syndrome", a combination of immobility and relative dehydration) are some of the better-known causes.and references Tsai A et a (2002). "Cardiovascular risk factors and venous thromboembolism incidence etc." [1].
In the abstract states: RESULTS: Cigarette smoking, hypertension, dyslipidemia, physical inactivity, and alcohol consumption were not associated with risk of VTE.
So although these are the "better-known" causes, that particular research found that it was not associated? Deadstar 13:30, 20 September 2007 (UTC)
--The "physical inactivity" relates to, e.g., how much exercise a person does per week. But "immobilization" refers to a person on a plane, etc. I suppose the two would overlap in the case of a sickly, bed-bound person. Kenmcl2 ( talk) 05:44, 12 February 2009 (UTC)
This is again supported by a systematic review: doi: 10.1111/j.1538-7836.2007.02847.x JFW | T@lk 22:07, 22 November 2007 (UTC)
Tim Russert from MSNBC Meet The Press just passed because of DVT. He collapsed on his job just after returning from Italy. AugustinMa ( talk) 21:35, 13 June 2008 (UTC)
Apparently, DVT is common after long flights (see Tim Russert above). Can the article add a section about prevention measure before, during and just after a long flight. Thanks AugustinMa ( talk) 21:35, 13 June 2008 (UTC)
The article says: "DVTs occur in about 1 per 1000 persons per year. About 1-5% will die from the complications".
Yet this link http://ap.google.com/article/ALeqM5jLUJgboI9vrUtwrpyeOXkWNLOFOQD937BUI80 gives much higher death number: "the new surgeon general's campaign estimates that every year, between 350,000 and 600,000 Americans get one of these clots — and at least 100,000 of them die". It implies 15-30% death rate. —Preceding unsigned comment added by 97.116.53.139 ( talk) 03:14, 16 September 2008 (UTC)
This is going to get interesting: LMWH therapy instead of warfarin was well tolerated but improved outcomes for postthrombotic syndrome and leg ulcers. doi: 10.1016/j.amjmed.2008.12.023 JFW | T@lk 20:39, 28 July 2009 (UTC)
Br J Haem doi: 10.1111/j.1365-2141.2009.07732.x JFW | T@lk 21:03, 28 July 2009 (UTC)
I'm not medical or nursing, so I have not corrected the wording at Wells criterion 8, which currently reads as "major surgery requiring regional or general anesthetic in past 4 weeks". Surely that is a typo for "12 weeks". Patrick Hamilton ( talk)
The last sentence is a fragment and it is unclear to me what exactly is not being disputed: "Despite the fact that no one disputes this, based on a meta analysis done by the Cochrane Collaboration where they found only one randomized trial of anti coagulation vs placebo in the treatment of VTE in which there was no significant difference between the two." —Preceding unsigned comment added by 64.149.52.154 ( talk) 21:29, 18 May 2010 (UTC)
Traveller's thrombosis should be merged her as it is basically a DVT due to flight. It is the same disease just has some social significance. Doc James ( talk · contribs · email) 00:59, 29 May 2011 (UTC)
I think the image used in the info box is confusing, mostly because of the arrow which appears to point to the thrombus on the leg rather than in it. Is there a similar image without the arrow, under which it could be written something along the lines of "DVTs typically present with a swollen painful calf, and comparing the calf diameters is an integral part of the diagnosing of the syndrome (see right calf)."-- Mofs ( talk) 21:15, 30 July 2011 (UTC)
Please, please, please, someone knowledgeable on the mainstream medical approaches find references to my paragraph about raising legs. Raising legs does work and is often advised by medical practitioners. Anonywiki ( talk) 21:54, 1 August 2011 (UTC)
I removed them, [2] as medical conditions which may lead to DVT because they aren't mentioned/sourced in the article. Instead, I added things that were sourced. Biosthmors ( talk) 20:28, 27 February 2012 (UTC)
Phlegmasia alba dolens and phlegmasia cerulea dolens are currently discussed in the signs and symptoms section. May-Thurner syndrome and Paget-Schrötter disease are just mentioned in the pathophysiology section. And perhaps we're omitting another worthy manifestation. But I'm wondering if we should discuss all these four entities together, perhaps in the classification section. I'm thinking phlegmasia might be too infrequently mentioned/experienced to justify the word count it is currently given in the signs and symptoms section, although it does give characteristic signs. Biosthmors ( talk) 17:43, 5 May 2012 (UTC)
GA toolbox |
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Reviewing |
Reviewer: Cwmhiraeth ( talk · contribs) 09:48, 6 June 2012 (UTC) I have taken on the GA review of this article. On first inspection it looks impressive and I will be studying it in much greater detail shortly. Cwmhiraeth ( talk) 09:48, 6 June 2012 (UTC)
"Deep vein thrombosis" is a noun phrase so the abbreviation DVT should be used grammatically in the same way as the phrase. This means that such a sentence as "... most of those suspected of DVT do not have it after evaluation" is unsatisfactory. If you used "blood clot" instead of DVT in the sentence you would get "... most of those suspected of blood clot do not have it after evaluation." So I would prefer "... most of those suspected of having a DVT do not have it after evaluation". This point is rather fundamental to the article. Maybe DVT is widely used in the way you have used it and I am being pedantic. I would welcome some input from others on this point. Cwmhiraeth ( talk) 10:25, 6 June 2012 (UTC)
I have read through the article carefully. In general the prose, grammar, spelling etc. are fine. Here are the small number of points that struck me when considering criterion 1a. I shall consider the other criteria later. There is no rush - I understand that Biosthmors is away for the time being and the review can continue on his return. Cwmhiraeth ( talk) 14:06, 7 June 2012 (UTC)
Classification
Causes
Pathophysiology
Surgery patients
Pregnancy
Prognosis
History
No one seems to have made any comments here for about two weeks. Do you need help? WhatamIdoing ( talk) 20:26, 23 June 2012 (UTC)
Rate | Attribute | Review Comment |
---|---|---|
1. Well-written: | ||
1a. the prose is clear, concise, and understandable to an appropriately broad audience; spelling and grammar are correct. | The chief problem that I see is the repeated use of the words "suggested" and "recommended" without an indication of who is making these suggestions/recommendations. I suspect that this is referring to the position in the US and the ACCP guidelines but this should be clarified as other organisations, in other parts of the world, may provide different guidance.
| |
1b. it complies with the Manual of Style guidelines for lead sections, layout, words to watch, fiction, and list incorporation. | No problem here. | |
2. Verifiable with no original research: | ||
2a. it contains a list of all references (sources of information), presented in accordance with the layout style guideline. | Article is well referenced. | |
2b. reliable sources are cited inline. All content that could reasonably be challenged, except for plot summaries and that which summarizes cited content elsewhere in the article, must be cited no later than the end of the paragraph (or line if the content is not in prose). | Article is well referenced. | |
2c. it contains no original research. | As far as I can tell. | |
3. Broad in its coverage: | ||
3a. it addresses the main aspects of the topic. | Topic is comprehensively covered. | |
3b. it stays focused on the topic without going into unnecessary detail (see summary style). | ||
4. Neutral: it represents viewpoints fairly and without editorial bias, giving due weight to each. | ||
5. Stable: it does not change significantly from day to day because of an ongoing edit war or content dispute. | This does not seem to be a problem. | |
6. Illustrated, if possible, by media such as images, video, or audio: | ||
6a. media are tagged with their copyright statuses, and valid non-free use rationales are provided for non-free content. | All images are appropriately licensed. | |
6b. media are relevant to the topic, and have suitable captions. | Images and captions are appropriate and helpful. | |
7. Overall assessment. | A good, well-written article that fulfils the GA criteria. Cwmhiraeth ( talk) 05:47, 26 June 2012 (UTC) |
I would like to suggest some modifications.
1. On the one hand: "Only pregnant women with strong risk factors for VTE are suggested to receive targeted (INR of 2.0 to 3.0) preventative measures." But on the other, by the end of the paragraph: "Warfarin, a common VKA, is known to have teratogenic effects on the fetus if administered in early pregnancy[55][56] and is not advised in pregnant women."
I think the problem is the tail end of the second sentence. It is generally true that warfarin is contraindicated (to varying degrees traditionally) throughout pregnancy. However, after week 13 (if that can be determined with reasonable assurance) it is a relative issue (in distinction to the high level contraindication earlier, especially between weeks 4 and 12 traditionally, acknowledging that we now substitute with e.g. LMWH prior to conception when possible), but warfarin may still (optionally) be used (with care) in e.g. high-risk mechanical valve situations etc.
2. On a second minor point, "Only pregnant women with strong risk factors for VTE are suggested to receive targeted (INR of 2.0 to 3.0) preventative measures." would be better phrased as "Only pregnant women with strong risk factors for VTE should receive preventative measures such as warfarin therapy with a target INR of 2.0 to 3.0." The present wording is unduly inexact.
3. Lastly, for several reasons a citation for this corrected sentence would be a reasonable expectation. FeatherPluma ( talk) 03:40, 29 July 2012 (UTC)
I find it interesting that the article does not list smoking as a causal factor. It seems to be the conventional wisdom that smoking increases the risk of DVT, but the only medical studies I've been able to find online (which are quite old, dating from the late 1970s) concluded that smoking had a PROTECTIVE effect against the formation of DVTs. It would be nice if knowledgeable medical professionals could supplement the article with peer-reviewed evidence about the effects of smoking. I emphasize 'peer-reviewed,' because most websites that list smoking as a causal factor do not cite any evidence in support of the statement. They make logical conclusions about the harmful effects of vasoconstriction and platelet aggregation, but do not validate the conclusions through empirical testing. — Preceding unsigned comment added by 202.130.114.242 ( talk) 09:34, 10 August 2012 (UTC)
doi: 10.1056/NEJMoa1114238 is the study and doi: 10.1016/j.beha.2012.06.003 might be an appropriate secondary source. Biosthmors ( talk) 05:24, 25 August 2012 (UTC)
This might be useful:
{{
cite journal}}
: Unknown parameter |month=
ignored (
help)CS1 maint: multiple names: authors list (
link)It says under Risk of recurrence after unprovoked VTE, that men have a higher risk of recurrent VTE than women, and it's gives generally good coverage of the other risk factors. Graham Colm ( talk) 14:43, 10 September 2012 (UTC)
I don't understand the value behind this edit because the version before already said that, and now (after removing the sources that appear to have no value) it appears the source that is left understates what is unnecessary, which appears to contradict the article. So I'm going to remove it. Biosthmors ( talk) 02:49, 27 September 2012 (UTC)
Thrombus or thrombosis? Biosthmors ( talk) 04:19, 6 November 2012 (UTC)
High probability or high-probability?
Biosthmors (
talk)
22:19, 10 November 2012 (UTC)
In the United States (U.S.) population, about 5 to 8% of people have thrombophilia of some form.<ref name="CDC"/> Among people who develop VTE, 30 to 50% have thrombophilia. Prevalence estimates are as follows: 0.5 to 9% for antithrombin deficiency, 3 to 9% for protein C deficiency, 1 to 3% for protein S deficiency, 12 to 20% for heterozygous factor V Leiden, 6 to 8% for heterozygous prothrombin G20210A, 0.2 to 4% for the homozygous case, and 2 to 4.5% for individuals doubly heterozygous for factor V Leiden and prothrombin G20210A.<ref name="Varga"/>
Prevalence among whom? Among people who develop VTE in the U.S.? (Sorry, I don't have access to the paper.) — MistyMorn ( talk) 00:51, 7 November 2012 (UTC)
UEDVT should perhaps be split off into its own article. Biosthmors ( talk) 19:51, 7 November 2012 (UTC)
A section of the 2012 NICE guideline, Venous thromboembolic diseases: the management of venous thromboembolic diseases and the role of thrombophilia testing: worth citing here (and, perhaps, elsewhere)? Also, Righini et al, 2006 may be helpful, although as a primary study it doesn't technically meet WP:MEDRS. — MistyMorn ( talk) 09:46, 12 November 2012 (UTC)
Someone has written a history of DVT. Citeable: doi:10.1111/jth.12127 JFW | T@lk 21:38, 15 January 2013 (UTC)
The imaging images might be better presented horizontally in that section with one of these: Template:Multiple_image#See_also. Biosthmors ( talk) 22:25, 3 March 2013 (UTC)
Epidemiology of provoked DVT might be a topic to include. Biosthmors ( talk) 01:58, 12 March 2013 (UTC)
All the recent reviews I remember seeing only list genetically determined blood states as inherited risk factors. So I don't think listing May–Thurner syndrome/Cockett syndrome/Iliac vein compression syndrome is best as was done with this edit. This source, on page 15S, says "Knowledge of the underlying cause of iliac vein compression syndrome...", which to me suggests we shouldn't assume it's a purely genetic/inherited trait. Biosthmors ( talk) 17:17, 4 April 2013 (UTC)
doi:10.1111/jth.12447 - the hypothesis that thrombophilia leads to an increased risk of post-thrombotic syndrome can be rejected. Systematic review & meta-analysis. JFW | T@lk 13:26, 13 November 2013 (UTC)
doi:10.1001/jama.2014.65 JAMA JFW | T@lk 11:06, 20 February 2014 (UTC)
Mainly about NOACs - Br J Haem doi:10.1111/bjh.13431 JFW | T@lk 12:03, 23 April 2015 (UTC)
http://www.nejm.org/doi/full/10.1056/NEJMcp1407434 mentions laterality in pregnancy at the beginning of the article, which seems worthy of a mention, at least in a footnote. Biosthmors ( talk) pls notify me (i.e. {{ U}}) while signing a reply, thx 12:18, 16 September 2015 (UTC)
... are not much good doi:10.1016/j.amjmed.2015.11.031 JFW | T@lk 11:59, 11 March 2016 (UTC)
doi:10.1016/S0140-6736(16)30514-1 JFW | T@lk 08:25, 2 September 2016 (UTC)
Have removed the merge tag. For one venous thrombosis includes a wide variety of conditions (DVT, PE, cerebral venous thrombosis, etc). DVT is one specific type of venous thrombosis. Doc James ( talk · contribs · email) 05:55, 31 December 2016 (UTC)
Prevention/research directions looks like it could use updating perhaps. doi: 10.1056/NEJMoa1700518 Biosthmors ( talk) pls notify me (i.e. {{ U}}) while signing a reply, thx 13:11, 4 April 2017 (UTC)
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This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page. |
Archive 1 |
I think the merge should have been done the other way. The term "deep vein thrombosis" is more common than "deep venous thrombosis"
google results:
633,000 for deep vein thrombosis
358,000 for deep venous thrombosis
Nephron
01:08, 21 July 2005 (UTC)
Since an important audience is the less-technical, the common usage is more helpful. Technical readers, if they wish to consult Wikipedia, will be familiar with the more common term. —Preceding unsigned comment added by 67.101.66.55 ( talk) 04:22, 30 November 2007 (UTC)
"A careful history has to be taken considering risk factors (see below), " There's no subsection entitled 'Risk factors'. Could this be clarified or corrected?
Of thrombophlebitis and deep vein thrombosis, the latter is the more serious and clinically relevant ones. Perhaps thrombophlebitis could be mentioned within deep vein thrombosis. Furthermore the content on thrombophlebitis is quite similar to the DVT article. Andrew73 12:33, 15 March 2006 (UTC)
Prophylaxis? Pathogenesis? This article is hard to follow for the average lay person such as myself. Can someone rewrite with sections named "Causes" and "Treatment"? -- Barrylb 19:51, 6 May 2006 (UTC)
A complications section could be useful.
"In up to 25% of all hospitalized patients, there may be some form of DVT, which often remains clinically inapparent." This presumably refers to all patients hospitalized for whatever reason, not all patients hospitalized for suspected DVT - the sentence logic suggests it must be the the former, but it's such a large statistic that it took me a couple of rereads to understand. Moonlander69 23:17, 1 June 2007 (UTC)
Can someone please explain the risks of using the prescibed medications for DVT and pregnancy. And if I have DVT due to an previous pregnancy what should I do when pregnant again whilst having DVT.
I think the article is way too complex and written in the lingo that doctors use, probably BY a doctor or someone with a lot of medical training. That's OK if they have that training, but the thing is that most of us regular every-day people can't understand it because we don't have that training.
Besides the grammar being incorrect in the following sentence, it also seems to reference research that claims the opposite of what it says here.
Other risk factors include advanced age, obesity, infection, immobilization, female sex, use of combined (estrogen-containing) forms of hormonal contraception, tobacco usage and air travel ("economy class syndrome", a combination of immobility and relative dehydration) are some of the better-known causes.and references Tsai A et a (2002). "Cardiovascular risk factors and venous thromboembolism incidence etc." [1].
In the abstract states: RESULTS: Cigarette smoking, hypertension, dyslipidemia, physical inactivity, and alcohol consumption were not associated with risk of VTE.
So although these are the "better-known" causes, that particular research found that it was not associated? Deadstar 13:30, 20 September 2007 (UTC)
--The "physical inactivity" relates to, e.g., how much exercise a person does per week. But "immobilization" refers to a person on a plane, etc. I suppose the two would overlap in the case of a sickly, bed-bound person. Kenmcl2 ( talk) 05:44, 12 February 2009 (UTC)
This is again supported by a systematic review: doi: 10.1111/j.1538-7836.2007.02847.x JFW | T@lk 22:07, 22 November 2007 (UTC)
Tim Russert from MSNBC Meet The Press just passed because of DVT. He collapsed on his job just after returning from Italy. AugustinMa ( talk) 21:35, 13 June 2008 (UTC)
Apparently, DVT is common after long flights (see Tim Russert above). Can the article add a section about prevention measure before, during and just after a long flight. Thanks AugustinMa ( talk) 21:35, 13 June 2008 (UTC)
The article says: "DVTs occur in about 1 per 1000 persons per year. About 1-5% will die from the complications".
Yet this link http://ap.google.com/article/ALeqM5jLUJgboI9vrUtwrpyeOXkWNLOFOQD937BUI80 gives much higher death number: "the new surgeon general's campaign estimates that every year, between 350,000 and 600,000 Americans get one of these clots — and at least 100,000 of them die". It implies 15-30% death rate. —Preceding unsigned comment added by 97.116.53.139 ( talk) 03:14, 16 September 2008 (UTC)
This is going to get interesting: LMWH therapy instead of warfarin was well tolerated but improved outcomes for postthrombotic syndrome and leg ulcers. doi: 10.1016/j.amjmed.2008.12.023 JFW | T@lk 20:39, 28 July 2009 (UTC)
Br J Haem doi: 10.1111/j.1365-2141.2009.07732.x JFW | T@lk 21:03, 28 July 2009 (UTC)
I'm not medical or nursing, so I have not corrected the wording at Wells criterion 8, which currently reads as "major surgery requiring regional or general anesthetic in past 4 weeks". Surely that is a typo for "12 weeks". Patrick Hamilton ( talk)
The last sentence is a fragment and it is unclear to me what exactly is not being disputed: "Despite the fact that no one disputes this, based on a meta analysis done by the Cochrane Collaboration where they found only one randomized trial of anti coagulation vs placebo in the treatment of VTE in which there was no significant difference between the two." —Preceding unsigned comment added by 64.149.52.154 ( talk) 21:29, 18 May 2010 (UTC)
Traveller's thrombosis should be merged her as it is basically a DVT due to flight. It is the same disease just has some social significance. Doc James ( talk · contribs · email) 00:59, 29 May 2011 (UTC)
I think the image used in the info box is confusing, mostly because of the arrow which appears to point to the thrombus on the leg rather than in it. Is there a similar image without the arrow, under which it could be written something along the lines of "DVTs typically present with a swollen painful calf, and comparing the calf diameters is an integral part of the diagnosing of the syndrome (see right calf)."-- Mofs ( talk) 21:15, 30 July 2011 (UTC)
Please, please, please, someone knowledgeable on the mainstream medical approaches find references to my paragraph about raising legs. Raising legs does work and is often advised by medical practitioners. Anonywiki ( talk) 21:54, 1 August 2011 (UTC)
I removed them, [2] as medical conditions which may lead to DVT because they aren't mentioned/sourced in the article. Instead, I added things that were sourced. Biosthmors ( talk) 20:28, 27 February 2012 (UTC)
Phlegmasia alba dolens and phlegmasia cerulea dolens are currently discussed in the signs and symptoms section. May-Thurner syndrome and Paget-Schrötter disease are just mentioned in the pathophysiology section. And perhaps we're omitting another worthy manifestation. But I'm wondering if we should discuss all these four entities together, perhaps in the classification section. I'm thinking phlegmasia might be too infrequently mentioned/experienced to justify the word count it is currently given in the signs and symptoms section, although it does give characteristic signs. Biosthmors ( talk) 17:43, 5 May 2012 (UTC)
GA toolbox |
---|
Reviewing |
Reviewer: Cwmhiraeth ( talk · contribs) 09:48, 6 June 2012 (UTC) I have taken on the GA review of this article. On first inspection it looks impressive and I will be studying it in much greater detail shortly. Cwmhiraeth ( talk) 09:48, 6 June 2012 (UTC)
"Deep vein thrombosis" is a noun phrase so the abbreviation DVT should be used grammatically in the same way as the phrase. This means that such a sentence as "... most of those suspected of DVT do not have it after evaluation" is unsatisfactory. If you used "blood clot" instead of DVT in the sentence you would get "... most of those suspected of blood clot do not have it after evaluation." So I would prefer "... most of those suspected of having a DVT do not have it after evaluation". This point is rather fundamental to the article. Maybe DVT is widely used in the way you have used it and I am being pedantic. I would welcome some input from others on this point. Cwmhiraeth ( talk) 10:25, 6 June 2012 (UTC)
I have read through the article carefully. In general the prose, grammar, spelling etc. are fine. Here are the small number of points that struck me when considering criterion 1a. I shall consider the other criteria later. There is no rush - I understand that Biosthmors is away for the time being and the review can continue on his return. Cwmhiraeth ( talk) 14:06, 7 June 2012 (UTC)
Classification
Causes
Pathophysiology
Surgery patients
Pregnancy
Prognosis
History
No one seems to have made any comments here for about two weeks. Do you need help? WhatamIdoing ( talk) 20:26, 23 June 2012 (UTC)
Rate | Attribute | Review Comment |
---|---|---|
1. Well-written: | ||
1a. the prose is clear, concise, and understandable to an appropriately broad audience; spelling and grammar are correct. | The chief problem that I see is the repeated use of the words "suggested" and "recommended" without an indication of who is making these suggestions/recommendations. I suspect that this is referring to the position in the US and the ACCP guidelines but this should be clarified as other organisations, in other parts of the world, may provide different guidance.
| |
1b. it complies with the Manual of Style guidelines for lead sections, layout, words to watch, fiction, and list incorporation. | No problem here. | |
2. Verifiable with no original research: | ||
2a. it contains a list of all references (sources of information), presented in accordance with the layout style guideline. | Article is well referenced. | |
2b. reliable sources are cited inline. All content that could reasonably be challenged, except for plot summaries and that which summarizes cited content elsewhere in the article, must be cited no later than the end of the paragraph (or line if the content is not in prose). | Article is well referenced. | |
2c. it contains no original research. | As far as I can tell. | |
3. Broad in its coverage: | ||
3a. it addresses the main aspects of the topic. | Topic is comprehensively covered. | |
3b. it stays focused on the topic without going into unnecessary detail (see summary style). | ||
4. Neutral: it represents viewpoints fairly and without editorial bias, giving due weight to each. | ||
5. Stable: it does not change significantly from day to day because of an ongoing edit war or content dispute. | This does not seem to be a problem. | |
6. Illustrated, if possible, by media such as images, video, or audio: | ||
6a. media are tagged with their copyright statuses, and valid non-free use rationales are provided for non-free content. | All images are appropriately licensed. | |
6b. media are relevant to the topic, and have suitable captions. | Images and captions are appropriate and helpful. | |
7. Overall assessment. | A good, well-written article that fulfils the GA criteria. Cwmhiraeth ( talk) 05:47, 26 June 2012 (UTC) |
I would like to suggest some modifications.
1. On the one hand: "Only pregnant women with strong risk factors for VTE are suggested to receive targeted (INR of 2.0 to 3.0) preventative measures." But on the other, by the end of the paragraph: "Warfarin, a common VKA, is known to have teratogenic effects on the fetus if administered in early pregnancy[55][56] and is not advised in pregnant women."
I think the problem is the tail end of the second sentence. It is generally true that warfarin is contraindicated (to varying degrees traditionally) throughout pregnancy. However, after week 13 (if that can be determined with reasonable assurance) it is a relative issue (in distinction to the high level contraindication earlier, especially between weeks 4 and 12 traditionally, acknowledging that we now substitute with e.g. LMWH prior to conception when possible), but warfarin may still (optionally) be used (with care) in e.g. high-risk mechanical valve situations etc.
2. On a second minor point, "Only pregnant women with strong risk factors for VTE are suggested to receive targeted (INR of 2.0 to 3.0) preventative measures." would be better phrased as "Only pregnant women with strong risk factors for VTE should receive preventative measures such as warfarin therapy with a target INR of 2.0 to 3.0." The present wording is unduly inexact.
3. Lastly, for several reasons a citation for this corrected sentence would be a reasonable expectation. FeatherPluma ( talk) 03:40, 29 July 2012 (UTC)
I find it interesting that the article does not list smoking as a causal factor. It seems to be the conventional wisdom that smoking increases the risk of DVT, but the only medical studies I've been able to find online (which are quite old, dating from the late 1970s) concluded that smoking had a PROTECTIVE effect against the formation of DVTs. It would be nice if knowledgeable medical professionals could supplement the article with peer-reviewed evidence about the effects of smoking. I emphasize 'peer-reviewed,' because most websites that list smoking as a causal factor do not cite any evidence in support of the statement. They make logical conclusions about the harmful effects of vasoconstriction and platelet aggregation, but do not validate the conclusions through empirical testing. — Preceding unsigned comment added by 202.130.114.242 ( talk) 09:34, 10 August 2012 (UTC)
doi: 10.1056/NEJMoa1114238 is the study and doi: 10.1016/j.beha.2012.06.003 might be an appropriate secondary source. Biosthmors ( talk) 05:24, 25 August 2012 (UTC)
This might be useful:
{{
cite journal}}
: Unknown parameter |month=
ignored (
help)CS1 maint: multiple names: authors list (
link)It says under Risk of recurrence after unprovoked VTE, that men have a higher risk of recurrent VTE than women, and it's gives generally good coverage of the other risk factors. Graham Colm ( talk) 14:43, 10 September 2012 (UTC)
I don't understand the value behind this edit because the version before already said that, and now (after removing the sources that appear to have no value) it appears the source that is left understates what is unnecessary, which appears to contradict the article. So I'm going to remove it. Biosthmors ( talk) 02:49, 27 September 2012 (UTC)
Thrombus or thrombosis? Biosthmors ( talk) 04:19, 6 November 2012 (UTC)
High probability or high-probability?
Biosthmors (
talk)
22:19, 10 November 2012 (UTC)
In the United States (U.S.) population, about 5 to 8% of people have thrombophilia of some form.<ref name="CDC"/> Among people who develop VTE, 30 to 50% have thrombophilia. Prevalence estimates are as follows: 0.5 to 9% for antithrombin deficiency, 3 to 9% for protein C deficiency, 1 to 3% for protein S deficiency, 12 to 20% for heterozygous factor V Leiden, 6 to 8% for heterozygous prothrombin G20210A, 0.2 to 4% for the homozygous case, and 2 to 4.5% for individuals doubly heterozygous for factor V Leiden and prothrombin G20210A.<ref name="Varga"/>
Prevalence among whom? Among people who develop VTE in the U.S.? (Sorry, I don't have access to the paper.) — MistyMorn ( talk) 00:51, 7 November 2012 (UTC)
UEDVT should perhaps be split off into its own article. Biosthmors ( talk) 19:51, 7 November 2012 (UTC)
A section of the 2012 NICE guideline, Venous thromboembolic diseases: the management of venous thromboembolic diseases and the role of thrombophilia testing: worth citing here (and, perhaps, elsewhere)? Also, Righini et al, 2006 may be helpful, although as a primary study it doesn't technically meet WP:MEDRS. — MistyMorn ( talk) 09:46, 12 November 2012 (UTC)
Someone has written a history of DVT. Citeable: doi:10.1111/jth.12127 JFW | T@lk 21:38, 15 January 2013 (UTC)
The imaging images might be better presented horizontally in that section with one of these: Template:Multiple_image#See_also. Biosthmors ( talk) 22:25, 3 March 2013 (UTC)
Epidemiology of provoked DVT might be a topic to include. Biosthmors ( talk) 01:58, 12 March 2013 (UTC)
All the recent reviews I remember seeing only list genetically determined blood states as inherited risk factors. So I don't think listing May–Thurner syndrome/Cockett syndrome/Iliac vein compression syndrome is best as was done with this edit. This source, on page 15S, says "Knowledge of the underlying cause of iliac vein compression syndrome...", which to me suggests we shouldn't assume it's a purely genetic/inherited trait. Biosthmors ( talk) 17:17, 4 April 2013 (UTC)
doi:10.1111/jth.12447 - the hypothesis that thrombophilia leads to an increased risk of post-thrombotic syndrome can be rejected. Systematic review & meta-analysis. JFW | T@lk 13:26, 13 November 2013 (UTC)
doi:10.1001/jama.2014.65 JAMA JFW | T@lk 11:06, 20 February 2014 (UTC)
Mainly about NOACs - Br J Haem doi:10.1111/bjh.13431 JFW | T@lk 12:03, 23 April 2015 (UTC)
http://www.nejm.org/doi/full/10.1056/NEJMcp1407434 mentions laterality in pregnancy at the beginning of the article, which seems worthy of a mention, at least in a footnote. Biosthmors ( talk) pls notify me (i.e. {{ U}}) while signing a reply, thx 12:18, 16 September 2015 (UTC)
... are not much good doi:10.1016/j.amjmed.2015.11.031 JFW | T@lk 11:59, 11 March 2016 (UTC)
doi:10.1016/S0140-6736(16)30514-1 JFW | T@lk 08:25, 2 September 2016 (UTC)
Have removed the merge tag. For one venous thrombosis includes a wide variety of conditions (DVT, PE, cerebral venous thrombosis, etc). DVT is one specific type of venous thrombosis. Doc James ( talk · contribs · email) 05:55, 31 December 2016 (UTC)
Prevention/research directions looks like it could use updating perhaps. doi: 10.1056/NEJMoa1700518 Biosthmors ( talk) pls notify me (i.e. {{ U}}) while signing a reply, thx 13:11, 4 April 2017 (UTC)
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