Haematology

Who should receive thromboprophylaxis after lower-limb immobilisation? This RCEM 2017 update introduces the TiLLI project, reviews the uncertainty around risk prediction and outlines how evidence synthesis, expert consensus and economic modelling could inform more consistent decisions.

Could oral rivaroxaban replace fondaparinux injections for superficial vein thrombosis? This 2017 appraisal of SURPRISE examines its non-inferiority design, composite outcomes, bleeding and generalisability, asking how convenience should be weighed against uncertainty about benefits and harms.

How common is venous thromboembolism after major trauma, and who is most at risk? This 2017 systematic-review appraisal finds widely varying estimates and limited evidence, exploring why differences in populations and testing make simple conclusions difficult.

Does low-molecular-weight heparin prevent symptomatic clots after lower-limb casting? This 2016 review of POT-CAST examines a trial that found no statistically significant reduction, while discussing patient selection, low event numbers and the unresolved question of benefit in higher-risk groups.

How convincing were the early results for andexanet alfa in major bleeding associated with factor Xa inhibitors? This 2016 appraisal examines an interim report, distinguishing laboratory reversal from clinical haemostasis and questioning whether limited, unblinded data could establish effectiveness and safety.

Which balance of plasma, platelets and red cells should be used in major traumatic haemorrhage? This 2015 appraisal of the PROPPR trial examines mortality, haemostasis and deaths from bleeding, considering study power and the practical challenges of interpreting the results for transfusion protocols.