Professor Daniel Horner

NCA clinicians lead NIHR blood clot prevention study evaluating risk assessment tools

A £500k NIHR-funded study to determine the cost-effectiveness of different ways to prevent blood clots in hospitalised inpatients has been published as an NIHR HTA monograph.

Salford Royal academics Professor Dan Horner (Chief Investigator, pictured) and Professor Mark Holland (Co-Investigator) worked with colleagues from the University of Sheffield, Canada and London to conduct a systematic review, prospective observational cohort study and build a health economic model. The work concluded that current evidence shows only weak accuracy for risk assessment models and offering thromboprophylaxis to all eligible patients appears to be generally more cost-effective than use of any model-based strategies, for both medical and surgical inpatients.

Publication of this monograph brings a two-year work package to conclusion, which has included prior publications in BMJ Open, the Journal of Thrombosis and Haemostasis and BMJ medicine. The work has been previously selected for presentation at several international scientific conferences, including those hosted by the International Society for Thrombosis and Haemostasis and the Society of Acute Medicine. Prof Horner has also recently been invited to showcase the key findings this month at a national patient safety specialists conference, chaired by the NHSE head of patient safety policy and strategy.

The team have proposed further research should evaluate national changes in the approach to risk assessment. This could include study of inverted ‘opt out’ prophylaxis strategies for all eligible hospitalised inpatients and the use of models to accurately identify individuals at very low risk of blood clots, who could discontinue prophylaxis.

The team have also built on this work in thrombosis prevention to secure NIHR funding for two further randomised controlled trials on prevention of blood clots after lower limb immobilisation, and after traumatic brain injury.

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