BMJ 1994;309:1019 (15 October)

Letters

Possible benefits of low molecular weight heparins

EDITOR, - Consideration of the main end points used in the studies included in A Leizorovicz and colleagues' meta-analysis of the possible merits of low molecular weight heparin1 illustrates certain difficulties in persuading the uninitiated of the validity of this form of pooled analysis of different groups' data. The three studies that used clinical end points (the authors' references 30, 32, and 34) account for more than one third (751/2015) of the subjects. They all favoured low molecular weight heparin (the authors' figure 1). They also account for most of the differences in recurrent thromboembolic events, short term haemorrhage, thrombus extension, and total mortality (one of these studies (reference 30) did not cover thrombus extension but is the main source of differences in short term haemorrhage (authors' table II). How reliable are clinical end points in the assessment of deep venous thrombosis?

In contrast, the venographic studies (authors' references 22, . . . [Full text of this article]


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