Philip S Wells

Summary

Affiliation: Ottawa Health Research Institute
Country: Canada

Publications

  1. ncbi Practical application of the 10-mg warfarin initiation nomogram
    Philip S Wells
    Thrombosis Program, Division of Hematology, Department of Medicine, University of Ottawa, Ontario, Canada
    Blood Coagul Fibrinolysis 20:403-8. 2009
  2. ncbi Effectiveness of compression stockings to prevent the post-thrombotic syndrome (the SOX Trial and Bio-SOX biomarker substudy): a randomized controlled trial
    Susan R Kahn
    Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, Quebec, Canada
    BMC Cardiovasc Disord 7:21. 2007
  3. ncbi The outpatient bleeding risk index: validation of a tool for predicting bleeding rates in patients treated for deep venous thrombosis and pulmonary embolism
    Philip S Wells
    Department of Medicine, University of Ottawa, Ottawa Health Research Institute, Ontario, Canada
    Arch Intern Med 163:917-20. 2003
  4. ncbi Advances in the diagnosis of venous thromboembolism
    Philip S Wells
    Department of Medicine, Ottawa Hospital and the University of Ottawa, Suite F6 49, 1053 Carling Avenue, Ottawa Hospital Civic Campus, Ottawa, Ontario, K1Y 4E9 Canada
    J Thromb Thrombolysis 21:31-40. 2006
  5. ncbi Elevated factor VIII is a risk factor for idiopathic venous thromboembolism in Canada - is it necessary to define a new upper reference range for factor VIII?
    Philip S Wells
    Department of Medicine, University of Ottawa, Ontario, Canada
    Thromb Haemost 93:842-6. 2005
  6. ncbi A randomized trial comparing 2 low-molecular-weight heparins for the outpatient treatment of deep vein thrombosis and pulmonary embolism
    Philip S Wells
    Departments of Medicine, University of Ottawa, Ottawa Health Research Institute, Ottawa, Ontario
    Arch Intern Med 165:733-8. 2005
  7. ncbi Safety and efficacy of methods for reducing perioperative allogeneic transfusion: a critical review of the literature
    Philip S Wells
    Department of Medicine, Ottawa Health Research Institute, University of Ottawa, Ottawa, Ontario, Canada
    Am J Ther 9:377-88. 2002
  8. ncbi The ACE D/D genotype is protective against the development of idiopathic deep vein thrombosis and pulmonary embolism
    Philip S Wells
    Department of Medicine, University of Ottawa, Canada
    Thromb Haemost 90:829-34. 2003
  9. ncbi Diagnosis of pulmonary embolism: when is imaging needed?
    Philip S Wells
    Department of Medicine, Ottawa Hospital, University of Ottawa, Suite F6 47, 1053 Carling Avenue, Ottawa, Ontario, Canada K1Y 4E9
    Clin Chest Med 24:13-28. 2003
  10. ncbi Pulmonary embolism: a clinician's perspective
    Philip S Wells
    Department of Medicine, Ottawa Hospital, Ottawa Health Research Institute and the University of Ottawa, Ottawa, Ontario, Canada
    Semin Nucl Med 38:404-11. 2008

Detail Information

Publications97

  1. ncbi Practical application of the 10-mg warfarin initiation nomogram
    Philip S Wells
    Thrombosis Program, Division of Hematology, Department of Medicine, University of Ottawa, Ontario, Canada
    Blood Coagul Fibrinolysis 20:403-8. 2009
    ..0 in the first 4 weeks of treatment. The 10-mg nomogram effectively results in an early therapeutic international normalized ratio with a good safety profile in 'real-life' daily practice...
  2. ncbi Effectiveness of compression stockings to prevent the post-thrombotic syndrome (the SOX Trial and Bio-SOX biomarker substudy): a randomized controlled trial
    Susan R Kahn
    Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, Quebec, Canada
    BMC Cardiovasc Disord 7:21. 2007
    ..Elastic compression stockings (ECS) could be helpful in preventing PTS; however, data on their effectiveness are scarce and conflicting...
  3. ncbi The outpatient bleeding risk index: validation of a tool for predicting bleeding rates in patients treated for deep venous thrombosis and pulmonary embolism
    Philip S Wells
    Department of Medicine, University of Ottawa, Ottawa Health Research Institute, Ontario, Canada
    Arch Intern Med 163:917-20. 2003
    ..We sought to determine the accuracy of the index in our population of patients...
  4. ncbi Advances in the diagnosis of venous thromboembolism
    Philip S Wells
    Department of Medicine, Ottawa Hospital and the University of Ottawa, Suite F6 49, 1053 Carling Avenue, Ottawa Hospital Civic Campus, Ottawa, Ontario, K1Y 4E9 Canada
    J Thromb Thrombolysis 21:31-40. 2006
    ....
  5. ncbi Elevated factor VIII is a risk factor for idiopathic venous thromboembolism in Canada - is it necessary to define a new upper reference range for factor VIII?
    Philip S Wells
    Department of Medicine, University of Ottawa, Ontario, Canada
    Thromb Haemost 93:842-6. 2005
    ..We propose that the upper limit be increased to 270 IU/dl or individual labs should establish their upper limit if they wish their assays to be discriminatory in patients with VTE. Age specific cut-offs may be clinically relevant...
  6. ncbi A randomized trial comparing 2 low-molecular-weight heparins for the outpatient treatment of deep vein thrombosis and pulmonary embolism
    Philip S Wells
    Departments of Medicine, University of Ottawa, Ottawa Health Research Institute, Ottawa, Ontario
    Arch Intern Med 165:733-8. 2005
    ..No published trials have compared LMWHs, and few studies have examined outpatient therapy for PE. Only tinzaparin sodium has demonstrated superiority to unfractionated heparin in a clinical trial...
  7. ncbi Safety and efficacy of methods for reducing perioperative allogeneic transfusion: a critical review of the literature
    Philip S Wells
    Department of Medicine, Ottawa Health Research Institute, University of Ottawa, Ottawa, Ontario, Canada
    Am J Ther 9:377-88. 2002
    ..Autologous predonation probably has similar risks as homologous blood with respect to transfusion errors and bacterial infection. As with most medical interventions, we must be vigilant to prevent human error...
  8. ncbi The ACE D/D genotype is protective against the development of idiopathic deep vein thrombosis and pulmonary embolism
    Philip S Wells
    Department of Medicine, University of Ottawa, Canada
    Thromb Haemost 90:829-34. 2003
    ..33). The ACE D/D genotype was present in 25.3% of cases and 32.4% of controls for an adjusted odds ratio of 0.66 (95% CI = 0.433 to 0.997). We can conclude that the ACE D/D genotype is protective against idiopathic venous thromboembolism...
  9. ncbi Diagnosis of pulmonary embolism: when is imaging needed?
    Philip S Wells
    Department of Medicine, Ottawa Hospital, University of Ottawa, Suite F6 47, 1053 Carling Avenue, Ottawa, Ontario, Canada K1Y 4E9
    Clin Chest Med 24:13-28. 2003
    ..It is now possible to identify low-risk patients with suspected pulmonary embolism in whom imaging procedures can be avoided altogether...
  10. ncbi Pulmonary embolism: a clinician's perspective
    Philip S Wells
    Department of Medicine, Ottawa Hospital, Ottawa Health Research Institute and the University of Ottawa, Ottawa, Ontario, Canada
    Semin Nucl Med 38:404-11. 2008
    ..As with any illness, there is room for improvement in the management of PE, but it remains unknown whether preventive measures, diagnosis, treatment modalities, or physician or patient education should be the focus...
  11. ncbi Does this patient have deep vein thrombosis?
    Philip S Wells
    Department of Medicine, University of Ottawa, Ontario
    JAMA 295:199-207. 2006
    ..Missed DVT diagnosis may result in fatal pulmonary embolism. Since many patients may have DVT, a selective and efficient diagnostic process is needed...
  12. ncbi Integrated strategies for the diagnosis of venous thromboembolism
    P S Wells
    Department of Medicine, Ottawa Hospital, Ottawa Health Research Institute, and the University of Ottawa, Ottawa, ON, Canada
    J Thromb Haemost 5:41-50. 2007
    ..These integration strategies result in safer, more convenient and cost-effective care for patients...
  13. ncbi Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis
    Philip S Wells
    Department of Medicine, Ottawa Hospital, University of Ottawa, Ottawa, Ont, Canada
    N Engl J Med 349:1227-35. 2003
    ....
  14. ncbi The factor XIII Val34Leu polymorphism: is it protective against idiopathic venous thromboembolism?
    Philip S Wells
    Department of Medicine, University of Ottawa and the Ottawa Health Research Institute, Ottawa, Ontario, Canada
    Blood Coagul Fibrinolysis 17:533-8. 2006
    ..69 (95% confidence interval, 0.46-1.02) for the dominant model. Our results do not support an independent association of the FXIII Val34Leu polymorphism with idiopathic venous thromboembolism in our Caucasian Canadian study population...
  15. ncbi Diagnosis of DVT: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines
    Shannon M Bates
    MDHSC 3W11, Department of Medicine, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada
    Chest 141:e351S-418S. 2012
    ..This guideline focuses on the identification of optimal strategies for the diagnosis of DVT in ambulatory adults...
  16. ncbi The bedside investigation of pulmonary embolism diagnosis study: a double-blind randomized controlled trial comparing combinations of 3 bedside tests vs ventilation-perfusion scan for the initial investigation of suspected pulmonary embolism
    Marc A Rodger
    University of Ottawa, Ottawa Health Research Institute, and Department of Medicine, Ottawa Hospital, Ottawa, Ontario, Canada
    Arch Intern Med 166:181-7. 2006
    ..CONCLUSION: Excluding PE with at least 2 negative results on 3 bedside tests safely eliminates the need for diagnostic imaging in 34% of patients with suspected PE...
  17. ncbi Factor XIII Val34Leu variant is protective against venous thromboembolism: a HuGE review and meta-analysis
    Philip S Wells
    Faculty of Medicine, Department of Medicine, University of Ottawa, Ontario, Canada
    Am J Epidemiol 164:101-9. 2006
    ....
  18. ncbi Early postoperative anticoagulation after mechanical valve replacement: a Canadian survey
    Alexander Kulik
    Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
    J Heart Valve Dis 15:581-7. 2006
    ..The clinical impact of these findings is unknown, and can only be assessed through a prospective trial...
  19. ncbi VIDAS D-dimer in combination with clinical pre-test probability to rule out pulmonary embolism. A systematic review of management outcome studies
    Marc Carrier
    Thrombosis Program, Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
    Thromb Haemost 101:886-92. 2009
    ..14%, 95% CI 0.05 to 0.41%). In conclusion, the combination of a negative VIDAS D-dimer result and a non-high PTP effectively and safely excludes PE in an important proportion of outpatients with suspected PE...
  20. ncbi Risk of recurrent venous thromboembolism after a first oestrogen-associated episode. Data from the REVERSE cohort study
    Gregoire Le Gal
    Thrombosis Program, Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
    Thromb Haemost 104:498-503. 2010
    ..The risk of recurrent VTE is low in women after a first otherwise unprovoked oestrogen-associated VTE. However, this risk is not significantly lower than in women whose VTE was not related to oestrogen use...
  21. ncbi Appropriateness of diagnostic strategies for evaluating suspected venous thromboembolism
    Thomas Arnason
    Ottawa Health Research Institute Clinical Epidemiology Program, Ottawa, ON, Canada
    Thromb Haemost 97:195-201. 2007
    ..In conclusion, physicians often fail to use diagnostic testing strategies for VTE correctly following a D-dimer test...
  22. ncbi Antithrombotic Therapy for VTE Disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines
    Clive Kearon
    Department of Medicine, State University of New York at Buffalo, ECMC CC 142, 462 Grider St, Buffalo, NY 14215
    Chest 141:e419S-94S. 2012
    ..This article addresses the treatment of VTE disease...
  23. ncbi Burden of potentially avoidable anticoagulant-associated hemorrhagic and thromboembolic events in the elderly
    Carl van Walraven
    Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa Hospital, Civic Campus, 1053 Carling Avenue, Ottawa, Ontario, Canada
    Chest 131:1508-15. 2007
    ..However, not all anticoagulation-associated events are attributable to poor anticoagulation control, nor do all hemorrhagic or thromboembolic events occur in anticoagulated patients...
  24. ncbi Factor XIII Val34Leu variant and the risk of myocardial infarction: a meta-analysis
    Mona Shafey
    Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
    Thromb Haemost 97:635-41. 2007
    ..These results suggest that there is an association between the factor XIII Leu allele and a modest protective effect against AMI and may provide useful information in profiling susceptibility to myocardial infarction...
  25. ncbi Computed tomographic pulmonary angiography vs ventilation-perfusion lung scanning in patients with suspected pulmonary embolism: a randomized controlled trial
    David R Anderson
    Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
    JAMA 298:2743-53. 2007
    ..Ventilation-perfusion scanning has been largely replaced by CTPA in many centers despite limited comparative formal evaluations and concerns about CTPA's low sensitivity (ie, chance of missing clinically important pulmonary embuli)...
  26. ncbi Hospital mortality due to pulmonary embolism and an evaluation of the usefulness of preventative interventions
    Dimitrios Scarvelis
    Medicine, University of Ottawa, Ottawa, Ontario, Canada
    Thromb Res 125:166-70. 2010
    ..Mortality rates due to pulmonary embolism (PE) are difficult to estimate often due to the presence of comorbid disease...
  27. ncbi A pilot study to assess the feasibility of a multicenter cluster randomized trial for the management of asymptomatic persons with a thrombophilia
    Philip S Wells
    University of Ottawa, ON, Canada
    J Genet Couns 18:475-82. 2009
    ..The question of the best educational approach in these patients remains unanswered. The value of testing and following asymptomatic carriers of probands with VTE and thrombophilia remains unknown...
  28. ncbi Use of spiral computed tomography contrast angiography and ultrasonography to exclude the diagnosis of pulmonary embolism in the emergency department
    David R Anderson
    Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
    J Emerg Med 29:399-404. 2005
    ..These findings suggest that the combination of a negative spiral CT contrast angiography scan and normal venous ultrasound imaging safely excludes the diagnosis of pulmonary embolism in the Emergency Department setting...
  29. ncbi Prospective evaluation of a pharmacogenetics-guided warfarin loading and maintenance dose regimen for initiation of therapy
    Inna Y Gong
    Department of Physiology and Pharmacology, University of Western Ontario, London, ON, Canada
    Blood 118:3163-71. 2011
    ..We demonstrate the clinical utility of genetics-guided warfarin initiation with the WRAPID protocol to provide safe and optimal anticoagulation therapy for patients with atrial fibrillation or venous thromboembolism...
  30. ncbi Clinical and genetic determinants of warfarin pharmacokinetics and pharmacodynamics during treatment initiation
    Inna Y Gong
    Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
    PLoS ONE 6:e27808. 2011
    ..These insights and modeling approaches have application to personalized warfarin therapy...
  31. ncbi Lessons from ximelagatran: issues for future studies evaluating new oral direct thrombin inhibitors for venous thromboembolism prophylaxis in orthopedic surgery
    Alejandro Lazo-Langner
    Department of Medicine, The University of Western Ontario, London, Ontario, Canada
    Clin Appl Thromb Hemost 15:316-26. 2009
    ..These issues should be explicitly explored in future trials evaluating new direct thrombin inhibitors...
  32. ncbi Identifying unprovoked thromboembolism patients at low risk for recurrence who can discontinue anticoagulant therapy
    Marc A Rodger
    Thrombosis Program, Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, Ont
    CMAJ 179:417-26. 2008
    ..We sought to determine clinical predictors to identify patients who are at low risk of recurrent venous thromboembolism who could safely discontinue oral anticoagulants...
  33. ncbi Systematic review: case-fatality rates of recurrent venous thromboembolism and major bleeding events among patients treated for venous thromboembolism
    Marc Carrier
    University of Ottawa, Ottawa Hospital Research Institute, Ontario, Canada
    Ann Intern Med 152:578-89. 2010
    ..Case-fatality rates are important for assessing the risks and benefits of anticoagulation in patients with venous thromboembolism (VTE)...
  34. ncbi Early postoperative anticoagulation after mechanical valve replacement: a systematic review
    Alexander Kulik
    Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa Hospital, Ottawa, Canada
    Ann Thorac Surg 81:770-81. 2006
    ....
  35. ncbi Will there be a role for genotyping in warfarin therapy?
    Esteban Gandara
    Thrombosis Program, Division of Hematology, Department of Medicine, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
    Curr Opin Hematol 17:439-43. 2010
    ..Various authors and agencies advocate the role of genetic testing to guide warfarin dosing...
  36. ncbi Risk of venous thromboembolism in relatives of symptomatic probands with thrombophilia: a systematic review
    Nicole J Langlois
    Clinical Epidemiology Unity, Ottawa Health Research Institute, Ontario, Canada
    Thromb Haemost 90:17-26. 2003
    ..38, 20.81). In conclusion, the risk of VTE events in asymptomatic relatives is low, but this may be an underestimate. Anticoagulant prophylaxis during risk periods appears to be of benefit but further research in this area is required...
  37. ncbi Psychological impact of thrombophilia testing in asymptomatic family members
    Martha L Louzada
    University of Western Ontario, London, Ontario, Canada
    Thromb Res 128:530-5. 2011
    ....
  38. ncbi The risk of dialysis access thrombosis is related to the transforming growth factor-beta1 production haplotype and is modified by polymorphisms in the plasminogen activator inhibitor-type 1 gene
    Alejandro Lazo-Langner
    Division of Hematology, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario Canada
    Blood 108:4052-8. 2006
    ..We concluded that low TGF-beta1 production haplotype is a risk factor for hemodialysis access thrombosis and that in the presence of the 4G/4G PAI-1 genotype there is an additional increase in risk...
  39. ncbi The outpatient treatment of deep vein thrombosis delivers cost savings to patients and their families, compared to inpatient therapy
    Marc A Rodger
    University of Ottawa, Ottawa, ON, Canada
    Thromb Res 112:13-8. 2003
    ..The aim of this study is to determine if some or all of these cost savings to third party payers are shifted to patients and their families...
  40. ncbi Diagnosis and treatment of venous thromboembolism in pregnancy
    Marc A Rodger
    Department of Medicine, Ottawa Health Research Institute, University of Ottawa, Ottawa, Ontario, Canada
    Best Pract Res Clin Haematol 16:279-96. 2003
    ..It highlights the poverty of research upon which to base clinical recommendations for this common problem yet offers practical but conservative approaches to patients with suspected and confirmed pregnancy-associated VTE...
  41. ncbi Accuracy and usefulness of a clinical prediction rule and D-dimer testing in excluding deep vein thrombosis in cancer patients
    Marc Carrier
    Thrombosis Program, Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
    Thromb Res 123:177-83. 2008
    ....
  42. ncbi Influence of warfarin on symptoms of fatigue: findings of a randomized trial
    Michael J Kovacs
    Department of Medicine, University of Western Ontario, London, Ontario, Canada
    Ann Pharmacother 39:840-2. 2005
    ..Some patients develop fatigue while taking warfarin, but causality is uncertain...
  43. ncbi Six-month exercise training program to treat post-thrombotic syndrome: a randomized controlled two-centre trial
    Susan R Kahn
    Department of Medicine, McGill University, Ottawa, Ont, Canada
    CMAJ 183:37-44. 2011
    ....
  44. ncbi The management of thrombophilia during pregnancy: a Canadian survey
    Marc A Rodger
    Department of Medicine, University of Ottawa, Ottawa, ON
    J Obstet Gynaecol Can 24:946-52. 2002
    ....
  45. ncbi Efficacy of low- molecular- weight- heparin versus vitamin K antagonists for long term treatment of cancer-associated venous thromboembolism in adults: a systematic review of randomized controlled trials
    Martha L Louzada
    University of Ottawa, Ottawa, Ontario, Canada
    Thromb Res 123:837-44. 2009
    ..Both low-molecular-weight-heparin (LMWH) and vitamin K antagonists (VKA) have been used for treatment of cancer-associated thrombosis. However, the best anticoagulation approach remains a matter of debate...
  46. ncbi Participation of pregnant women in clinical trials: will they participate and why?
    Marc A Rodger
    Thrombosis and Hemostasis Program, Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
    Am J Perinatol 20:69-76. 2003
    ..Pregnant women appear to be willing to accept risks to themselves, if there is a chance that participation in a clinical trial would help their pregnancy and improve their baby's health...
  47. ncbi Diagnosis and treatment of deep-vein thrombosis
    Dimitrios Scarvelis
    Department of Medicine, Division of Hematology, and the Ottawa Health Research Institute, University of Ottawa, Ottawa, Ont
    CMAJ 175:1087-92. 2006
    ..More research is required to optimally define the factors that predict an increased risk of recurrent DVT to determine which patients can benefit from extended anticoagulant therapy...
  48. ncbi Systematic review: the Trousseau syndrome revisited: should we screen extensively for cancer in patients with venous thromboembolism?
    Marc Carrier
    University of Ottawa and Ottawa Health Research Institute, Ottawa, Ontario, Canada
    Ann Intern Med 149:323-33. 2008
    ..Screening for malignant conditions can potentially diagnose more cases of cancer and at earlier stages, thereby preventing cancer-associated morbidity and perhaps mortality...
  49. ncbi Excluding pulmonary embolism at the bedside with low pre-test probability and D-dimer: safety and clinical utility of 4 methods to assign pre-test probability
    Marc Carrier
    Department of Medicine, University of Ottawa, ON, Canada
    Thromb Res 117:469-74. 2006
    ..Non-Elisa D-dimer in combination with pre-test probability of suspected PE can safely exclude PE at the bedside. Pre-test probability can be assigned by gestalt or by using clinical models (Wells, Wicki, Rodger)...
  50. ncbi Use of low molecular weight heparin in acute venous thromboembolic events in pregnancy
    Janine C Malcolm
    University of Ottawa, Ottawa, ON, Canada
    J Obstet Gynaecol Can 24:568-71. 2002
    ..There was one recurrent VTE during treatment in each of the groups.CONCLUSION: There is no difference in complication rate between LMWH and UFH in the treatment of acute VTE in pregnancy...
  51. ncbi Should we regionalize the management of pulmonary embolism?
    Marc Carrier
    Department of Medicine, Ottawa Hospital, Ottawa Health Research Institute and the University of Ottawa, Ottawa, Ont
    CMAJ 178:58-60. 2008
  52. ncbi Psychosocial aspects of venous thromboembolic disease: an exploratory study
    Holly Etchegary
    University of Ottawa, Ottawa, Ontario, Canada
    Thromb Res 122:491-500. 2008
    ..Despite its prevalence and life-threatening nature, little empirical research explored the psychosocial consequences of VTE...
  53. ncbi Thrombophilia and the risk for hemodialysis vascular access thrombosis
    Greg A Knoll
    Division of Nephrology, Department of Medicine, University of Ottawa, Ontario, Canada K1H 7W9
    J Am Soc Nephrol 16:1108-14. 2005
    ..34 to 2.61). This study suggests that thrombophilia is associated with access thrombosis in dialysis patients. Large, multicenter, prospective cohort studies are needed to confirm the observations from this case-control study...
  54. ncbi Risk for heparin-induced thrombocytopenia with unfractionated and low-molecular-weight heparin thromboprophylaxis: a meta-analysis
    Nadine Martel
    Ottawa Health Research Institute, Ottawa Hospital Civic Campus, Ste F649, 1053 Carling Ave, Ottawa, Ontario, K1Y 4E9, Canada
    Blood 106:2710-5. 2005
    ..The OR was 0.47 (95% CI, 0.22-1.02; P = .06). The inverse variance-weighted average that determined the absolute risk for HIT with LMWH was 0.2%, and with UFH the risk was 2.6%. Most studies were of patients after orthopedic surgery...
  55. ncbi Diagnosis: use of clinical probability algorithms
    Esteban Gandara
    Department of Medicine, Division of Hematology, the Ottawa Hospital and the University of Ottawa, Ottawa, Ontario, Canada
    Clin Chest Med 31:629-39. 2010
    ..This review focuses on the role of clinical prediction rules in the diagnostic process and their clinical application into diagnostic algorithms...
  56. ncbi The role of qualitative D-dimer assays, clinical probability, and noninvasive imaging tests for the diagnosis of deep vein thrombosis and pulmonary embolism
    Philip S Wells
    Department of Medicine, Ottawa Hospital and the University of Ottawa, Ottawa, Ontario
    Semin Vasc Med 5:340-50. 2005
    ..Diagnostic strategies should include pretest clinical probability, D-dimer assays, and noninvasive imaging tests...
  57. ncbi Inhibition of serotonin reuptake by antidepressants and upper gastrointestinal bleeding in elderly patients: retrospective cohort study
    C van Walraven
    Clinical Epidemiology Unit, Ottawa Health Research Institute, Ottawa Hospital, Civic Campus, Ottawa, ON, Canada K1Y 4E9
    BMJ 323:655-8. 2001
    ..To determine the association between inhibition of serotonin reuptake by antidepressants and upper gastrointestinal bleeding...
  58. ncbi Serum lipoprotein (a) levels in patients with first unprovoked venous thromboembolism is not associated with subsequent risk of recurrent VTE
    M A Rodger
    Thrombosis Program, Division of Hematology, Department of Medicine, University of Ottawa, Clinical Epidemiology Unit, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ottawa, Ontario, Canada
    Thromb Res 126:222-6. 2010
    ..We sought to determine if serum Lp(a) levels in patients with unprovoked VTE who discontinue anticoagulants after 5 to 7 months of therapy predict VTE recurrence in a prospective cohort study...
  59. ncbi Comparing multiple competing interventions in the absence of randomized trials using clinical risk-benefit analysis
    Alejandro Lazo-Langner
    Department of Medicine, University of Western Ontario, London ON, Canada
    BMC Med Res Methodol 12:3. 2012
    ....
  60. ncbi A systematic review of perceived risks, psychological and behavioral impacts of genetic testing
    Jodi T Heshka
    Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada
    Genet Med 10:19-32. 2008
    ..Our data would suggest better knowledge among carriers would not have significant psychological impacts and therefore, it is worth pursuing improved educational strategies...
  61. ncbi The interobserver reliability of pretest probability assessment in patients with suspected pulmonary embolism
    Marc A Rodger
    Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
    Thromb Res 116:101-7. 2005
    ..We sought to determine (for patients with suspected PE) the interobserver reliability of pretest probability assessment (by overall impression (gestalt) versus an explicit clinical model)...
  62. ncbi The rationale and evidence for the treatment of lower-extremity deep venous thrombosis with thrombolytic agents
    Alan J Forster
    Department of Medicine and the Ottawa Health Research Institute, University of Ottawa, Ontario, Canada
    Curr Opin Hematol 9:437-42. 2002
    ..Therefore, the authors conclude that although the lysis rate is greater for thrombolytic agents, they cannot be recommended routinely for DVT treatment...
  63. ncbi Outpatient treatment of patients with pulmonary embolism
    P S Wells
    Department of Medicine, Ottawa Hospital and the University of Ottawa, Ottawa, Ontario, Canada
    Semin Vasc Med 1:229-34. 2001
    ..Low-molecular-weight heparin or intravenous unfractionated heparin, followed by oral anticoagulant therapy, provide adequate therapy in most patients with PE, and many can be treated as outpatients...
  64. ncbi Prediction of the warfarin maintenance dose after completion of the 10 mg initiation nomogram: do we really need genotyping?
    G Le Gal
    Thrombosis Program, Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
    J Thromb Haemost 8:90-4. 2010
    ..A '10-mg nomogram' warfarin initiation protocol permits safe therapeutic anticoagulation in outpatients started on warfarin. We aimed to develop a safe and effective warfarin maintenance dose prediction tool in these patients...
  65. ncbi The safety of dosing dalteparin based on actual body weight for the treatment of acute venous thromboembolism in obese patients
    E Al-Yaseen
    London Health Sciences Center, London, Ontario, Canada
    J Thromb Haemost 3:100-2. 2005
    ..0-3.0. All patients were followed for 12 weeks post diagnosis. Only two patients had a major hemorrhage, 4 and 8 weeks from diagnosis. This study supports the safety of dosing dalteparin based on actual body weight in obese patients...
  66. ncbi Improvements in the diagnostic approach for patients with suspected deep vein thrombosis or pulmonary embolism
    D R Anderson
    Department of Medicine, QEII Health Sciences Centre, Halifax, Nova Scotia, Canada
    Thromb Haemost 82:878-86. 1999
    ..There is still need to improve management strategies for the diagnosis of recurrent venous thrombosis and to determine whether diagnostic testing results may be correlated with long-term patient treatment needs...
  67. ncbi Clinical utility of a rapid whole-blood D-dimer assay in patients with cancer who present with suspected acute deep venous thrombosis
    A Y Lee
    McMaster University, Hamilton, Ontario, Canada
    Ann Intern Med 131:417-23. 1999
    ..Although D-dimer assays have high negative predictive values for the diagnosis of deep venous thrombosis, their accuracy in patients with cancer is uncertain...
  68. ncbi Validation of a diagnostic approach to exclude recurrent venous thromboembolism
    G Le Gal
    Thrombosis Program, Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
    J Thromb Haemost 7:752-9. 2009
    ..Our objective was to evaluate the safety of a diagnostic strategy utilizing comparison of diagnostic test results with baseline imaging results to rule out suspected recurrent VTE...
  69. ncbi Outpatient treatment of patients with deep-vein thrombosis or pulmonary embolism
    P S Wells
    Department of Medicine, Ottawa Health Research Institute, 737 Parkdale Avenue, Ottawa, Ontario K1Y 1J8, Canada
    Curr Opin Pulm Med 7:360-4. 2001
    ..Low-molecular-weight heparin followed by oral anticoagulant therapy provides adequate therapy in most patients with deep-vein thrombosis or pulmonary embolism, and many patients can be treated as outpatients...
  70. ncbi Prospective assessment of a nomogram for the initiation of oral anticoagulation therapy for outpatient treatment of venous thromboembolism
    M J Kovacs
    Department of Medicine, London Health Sciences Centre, London, Ontario, Canada
    Pathophysiol Haemost Thromb 32:131-3. 2002
    ..There were no major bleeds and only 6 instances of INR >4.5. This outpatient warfarin nomogram appears to be safe and efficacious in obtaining timely therapeutic levels of warfarin and deserves further study...
  71. ncbi A pilot study of central venous catheter survival in cancer patients using low-molecular-weight heparin (dalteparin) and warfarin without catheter removal for the treatment of upper extremity deep vein thrombosis (The Catheter Study)
    M J Kovacs
    Department of Medicine, Victoria Hospital, London, ON, Canada
    J Thromb Haemost 5:1650-3. 2007
    ..Central venous catheters in patients with cancer are associated with development of deep vein thrombosis (DVT); however, there is no accepted standard treatment...
  72. ncbi Expanding eligibility for outpatient treatment of deep venous thrombosis and pulmonary embolism with low-molecular-weight heparin: a comparison of patient self-injection with homecare injection
    P S Wells
    Department of Medicine, University of Ottawa, Ontario, Canada
    Arch Intern Med 158:1809-12. 1998
    ....
  73. ncbi Assessment of deep vein thrombosis or pulmonary embolism by the combined use of clinical model and noninvasive diagnostic tests
    P S Wells
    Department of Medicine, Ottawa Hospital and the University of Ottawa, Ontario, Canada
    Semin Thromb Hemost 26:643-56. 2000
    ..In addition, a negative result with less-sentive D-dimer testing and a low clinical probability excludes DVT or PE...
  74. ncbi Combined use of clinical assessment and d-dimer to improve the management of patients presenting to the emergency department with suspected deep vein thrombosis (the EDITED Study)
    D R Anderson
    Department of Medicine, QEII Health Sciences Center, Dalhousie University, Halifax, Nova Scotia, Canada
    J Thromb Haemost 1:645-51. 2003
    ..5%) developed pulmonary embolism in the follow-up period. A diagnostic strategy for the evaluation of patients with suspected DVT based on pretest probability and d-dimer is safe and feasible in the emergency department setting...
  75. ncbi Thrombolysis in deep vein thrombosis: is there still an indication?
    P S Wells
    Department of Medicine, University of Ottawa, Canada
    Thromb Haemost 86:499-508. 2001
    ..We conclude that more work is needed to define the role of thrombolytic therapy but it is too early to abandon this therapeutic modality...
  76. ncbi Extended outpatient therapy with low molecular weight heparin for the treatment of recurrent venous thromboembolism despite warfarin therapy
    C Luk
    University of Western Ontario, London, Ontario, Canada
    Am J Med 111:270-3. 2001
    ....
  77. ncbi Derivation of a simple clinical model to categorize patients probability of pulmonary embolism: increasing the models utility with the SimpliRED D-dimer
    P S Wells
    Department of Medicine, University of Ottawa, Ontario, Canada
    Thromb Haemost 83:416-20. 2000
    ..The combination of a score < or =4.0 by our simple clinical prediction rule and a negative SimpliRED D-Dimer result may safely exclude PE in a large proportion of patients with suspected PE...
  78. ncbi Does the type of hormone replacement therapy influence the risk of deep vein thrombosis? A prospective case-control study
    J D Douketis
    Department of Medicine, McMaster University, Hamilton, Canada
    J Thromb Haemost 3:943-8. 2005
    ..Although hormone replacement therapy (HRT) is associated with an increased risk of deep vein thrombosis (DVT), it is not clear if the risk differs in users of combined estrogen-progestin HRT and estrogen-only HRT...
  79. ncbi Randomized assessment of a warfarin nomogram for initial oral anticoagulation after venous thromboembolic disease
    M J Kovacs
    Department of Hematology, London Health Sciences Centre, London, Ont, Canada
    Haemostasis 28:62-9. 1998
    ..0 vs. 5.6 days, p = 0.02). The warfarin nomogram as tested is safe and leads to a significantly shorter length of stay for patients with primary venous thromboembolism as compared to standard practice...
  80. ncbi Protein C and protein S levels can be accurately determined within 24 hours of diagnosis of acute venous thromboembolism
    M J Kovacs
    Department of Medicine, London Health Sciences Centre, London, ON, Canada
    Clin Lab Haematol 28:9-13. 2006
    ..8% of initial protein C and protein S results were accurate. If protein C and protein S are measured at the time of diagnosis of acute venous thromboembolism, the majority of the results will be normal and false positives are uncommon...
  81. ncbi A comparison of three rapid D-dimer methods for the diagnosis of venous thromboembolism
    M J Kovacs
    Department of Medicine, London Health Sciences Centre, London, Ontario, Canada
    Br J Haematol 115:140-4. 2001
    ..The SimpliRED D-dimer was found to be less sensitive than the Accuclot or IL-Test. When combined with pre-test probability all three methods are probably acceptable for use in the diagnosis of venous thromboembolism...
  82. ncbi Diagnosis of pulmonary embolism
    M Rodger
    Department of Medicine, Ottawa Hospital and the University of Ottawa, Ottawa, Ontario, Canada
    Thromb Res 103:V225-38. 2001
    ..These algorithms permit safe diagnostic management of patients with suspected PE while limiting invasiveness, inaccessibility and expense...
  83. ncbi Steady-state end-tidal alveolar dead space fraction and D-dimer: bedside tests to exclude pulmonary embolism
    M A Rodger
    Department of Medicine, University of Ottawa, Ontario, Canada
    Chest 120:115-9. 2001
    ..15, (2) a negative D-dimer result, and (3) the combination of a steady-state end-tidal AVDSf of < 0.15 and a negative D-dimer result. Study design: Prospective cohort study...
  84. ncbi Diagnostic value of arterial blood gas measurement in suspected pulmonary embolism
    M A Rodger
    Department of Medicine, University of Ottawa, Ontario, Canada
    Am J Respir Crit Care Med 162:2105-8. 2000
    ..We conclude that ABG data alone or in combination with other clinical data are not useful in the assessment of suspected PE...
  85. ncbi Diagnosis of deep-vein thrombosis in the year 2000
    P S Wells
    Department of Medicine and Epidemiology and Community Medicine, Ottawa Hospital and the University of Ottawa, Ontario, Canada
    Curr Opin Pulm Med 6:309-13. 2000
    ..The combination of the D-dimer with clinical model assessment will enable diagnostic testing strategies that are more safe, effective, and convenient for patients...
  86. ncbi Use of recombinant-hirudin in pulmonary thromboendarterectomy
    F D Rubens
    Department of Surgery, University of Ottawa, Ontario, Canada
    Ann Thorac Surg 69:1942-3. 2000
    ..Techniques for administration as well as monitoring of this drug's effects are discussed...
  87. ncbi Excluding pulmonary embolism at the bedside without diagnostic imaging: management of patients with suspected pulmonary embolism presenting to the emergency department by using a simple clinical model and d-dimer
    P S Wells
    Division of Hematology, The Ottawa Hospital, Civic Campus, Suite 452, 737 Parkdale Avenue, Ottawa, Ontario K1Y 1J8, Canada
    Ann Intern Med 135:98-107. 2001
    ..5% (CI, 99.1% to 100%). CONCLUSION: Managing patients for suspected pulmonary embolism on the basis of pretest probability and D -dimer result is safe and decreases the need for diagnostic imaging...
  88. ncbi Diagnosis of lower-extremity deep vein thrombosis in outpatients
    Daniel L Riddle
    Department of Physical Therapy, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA 23298-0224, USA
    Phys Ther 84:729-35. 2004
  89. ncbi Further validation and simplification of the Wells clinical decision rule in pulmonary embolism
    Nadine S Gibson
    Department of Vascular Medicine, Academical Medical Center, Meibergdreef 9, 1105 AZ Amsterdam
    Thromb Haemost 99:229-34. 2008
    ..This study further validates the diagnostic utility of the Wells rule and indicates that the scoring system can be simplified to one point for each variable...
  90. ncbi Challenges in the diagnosis of acute pulmonary embolism
    Paul D Stein
    Department of Research, St Joseph Mercy Oakland Hospital, Pontiac, Mich, USA
    Am J Med 121:565-71. 2008
    ..A patient-specific approach to the diagnosis of pulmonary embolism can be taken safely in hemodynamically stable patients to increase efficiency and decrease cost and exposure to radiation...
  91. ncbi Inter-observer reliability of measures to assess the post-thrombotic syndrome
    Marc A Rodger
    Thromb Haemost 100:164-6. 2008
  92. ncbi Comparing the quality of oral anticoagulant management by anticoagulation clinics and by family physicians: a randomized controlled trial
    S Jo Anne Wilson
    Department of Pharmacy, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, NS
    CMAJ 169:293-8. 2003
    ..We carried out a randomized controlled trial to evaluate these 2 models of anticoagulant care...
  93. ncbi Methodology for a rapid protocol to rule out pulmonary embolism in the emergency department
    Jeffrey A Kline
    Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC 28203, USA
    Ann Emerg Med 42:266-75. 2003
    ..Finally, we assess the potential effect of the proposed pulmonary embolism rule-out protocol on use of imaging resources and ED throughput...
  94. ncbi Comparison of 10-mg and 5-mg warfarin initiation nomograms together with low-molecular-weight heparin for outpatient treatment of acute venous thromboembolism. A randomized, double-blind, controlled trial
    Michael J Kovacs
    Department of Hematology, London Health Sciences Centre, 800 Commissioners Road East, London, Ontario N6A 4G5, Canada
    Ann Intern Med 138:714-9. 2003
    ..The optimal means of achieving therapeutic oral anticoagulation in the outpatient setting has not been determined...
  95. ncbi Home-treatment of deep vein thrombosis in patients with cancer
    Walter Ageno
    Department of Clinical Medicine, University of Insubria, Varese, Italy
    Haematologica 90:220-4. 2005
    ..We performed a retrospective review of clinical practice patterns to assess the rate of cancer patients who were deemed eligible for outpatient treatment of their DVT...
  96. ncbi Systematic overview of warfarin and its drug and food interactions
    Anne M Holbrook
    Centre for Evaluation of Medicines, St Joseph s Healthcare, Hamilton, Ontario
    Arch Intern Med 165:1095-106. 2005
    ..Drug and food interactions are frequently cited as causes of adverse events with warfarin. We provide an updated systematic overview of the quality, clinical effect, and importance of these reported interactions...
  97. ncbi Diagnosis of lower-extremity deep vein thrombosis in outpatients with musculoskeletal disorders: a national survey study of physical therapists
    Daniel L Riddle
    Department of Physical Therapy, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA 23298 0224, USA
    Phys Ther 84:717-28. 2004
    ....