Volume 12, Number 1

David Fitzmaurice FRCGP MD Professor of Primary Care Research, Department of General Practice, The Medical School, Birmingham

The atrial fibrillation (AF) guideline produced by the National Institute for Health and Clinical Excellence (NICE) demonstrates a huge commitment of time and effort by the guideline development group led by Professor Lip. While the guideline is overtly evidence-based, there remains room for some debate over several issues. The guideline follows the standard NICE format, with background to the problem, a statement of the evidence, a section entitled ‘from evidence to recommendations’ and finally a set of recommendations with the appropriate evidence level stated.

Ellen Murray PhD Research Fellow, University of Birmingham; Caroline Baglin RGN Nurse Specialist, Addenbrooke’s Hospital, Cambridge

The British Society for Haemostasis and Thrombosis (BSHT) 2007 conference in Bath was a combined meeting with the UK Haemophilia Centre Doctors’ Organisation (UKHCDO). The meeting consisted of invitational lectures, a nursing symposium, posters, free communications, and a trade exhibition. This article is a report of the nursing symposium, a new feature of the conference, led and chaired by nurses working in the field of haemostasis and thrombosis.

Phil Carson FIBMS DMS MSc CSci Clinical Scientist, Haematology Department, Royal Cornwall Hospitals Trust, Truro

Increasing workloads and concerns regarding quality of care have resulted in a re-evaluation of practice and the consideration of alternative models of care for anticoagulant therapy. Satisfactory desktop coagulometers have allowed rapid testing of the international normalised ratio (INR) – the routine monitoring test of oral anticoagulant therapy – to become attractive to sites for one-stop clinics. While more expensive in terms of test cost, this can be outweighed by the time-saving advantages and an improved patient pathway.

Paul Harrison MBBS FRCP FRCPath Consultant Haematologist, Dudley Group of Hospitals NHS Trust

Venous thromboembolism (VTE), comprising both deep vein thrombosis (DVT) and pulmonary embolism (PE), is a relatively common disease, with an incidence in Europe of approximately 100 per 100,000, for DVT, and 50 per 100,000 for PE. Risk factors for the development of VTE are well known and include: increasing age, immobility, surgery, malignancy, thrombophilia, pregnancy and heart failure. Given the aging population in the UK, the ongoing impact should not be underestimated.

Patrick Kesteven MBBS FRACP FRCP FRCPath PhD Consultant Haematologist, Freeman Hospital, Newcastle-upon-Tyne

Following the death of a young woman from massive pulmonary embolism after a flight in 2000, there has been intense media interest in traveller’s thrombosis. At that time it was generally accepted that such a condition existed but no one knew the extent of the problem or what should be done.

Peter Rose, Editor

The role of thromboprophylaxis in pregnancy for the prevention of venous thromboembolism (VTE) is still a problem for obstetricians and haematologists. Considerable variability remains in practice for VTE thromboprophylaxis in pregnancy, mainly due to the lack of prospective studies in this group of patients.