Clinical comprehensive evaluation framework for direct oral anticoagulants in the prevention of cancer-associated venous thromboembolism
- VernacularTitle:直接口服抗凝药用于肿瘤相关静脉血栓预防的临床综合评价体系研究
- Author:
Yue WU
1
,
2
;
Bingzheng SHEN
1
,
2
;
Fan ZHANG
1
,
2
;
Junfen ZENG
1
,
2
;
Yanzhuo LIU
1
,
2
;
Gang LIU
1
,
2
;
Benhong ZHOU
1
Author Information
1. Dept. of Pharmacy，Renmin Hospital of Wuhan University，Wuhan 430060，China
2. School of Pharmaceutical Sciences，Wuhan University，Wuhan 430070，China
- Publication Type:Journal Article
- Keywords:
direct oral anticoagulants;
cancer-associated
- From:
China Pharmacy
2025;36(11):1384-1388
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To establish a clinical comprehensive evaluation framework for direct oral anticoagulants （DOACs） in the prevention of cancer-associated venous thromboembolism （CAVTE）， providing a methodological reference for the rational prevention and treatment of CAVTE as well as for the formulation and adjustment of macro-management strategies for anticoagulant drugs. METHODS Through literature retrieval， evaluation indicators were collected and organized to establish a preliminary indicator pool. The selection of evaluation indicators was carried out through two rounds of Delphi surveys using average score of indicator importance≥3.5 and a coefficient of variation （CV） ＜0.25 as the screening criteria. Analytic hierarchy process （AHP） was employed to finalize the indicator weights. RESULTS The authority levels （C）r of the two rounds of expert consultations were 0.877 and 0.943， with CV of 0.24 and 0.18， respectively. The Kendall concordance coefficients were 0.331 and 0.535 （P＜0.05）. After expert validation， six primary indicators and forty-six secondary indicators were finalized for inclusion in the evaluation framework. The primary indicators and their weightings， ranked in descending order， were as follows：“ effectiveness” （38.86%）， “safety” （38.86%），“ cost-effectiveness” （10.67%），“ accessibility” （5.51%），“ suitability” （3.48%）， and “innovation” （2.64%）. The secondary indicators exhibited a weight range from 0.02% to 20.25%， with the top five secondary indicators being：“ incidence of intracranial hemorrhage” （20.25%）， “reduction in all-cause mortality” （15.29%）， “decrease in the incidence of pulmonary embolism” （8.82%）， “reduction in the incidence of deep vein thrombosis” （7.25%）， and “drug contraindications” （4.74%）. CONCLUSIONS This study has established an authoritative， scientific， and reliable comprehensive clinical evaluation framework for the use of DOACs in the prevention of CAVTE.
