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Rapid response to:


One versus two years of elastic compression stockings for prevention of post-thrombotic syndrome (OCTAVIA study): randomised controlled trial

BMJ 2016; 353 doi: (Published 31 May 2016) Cite this as: BMJ 2016;353:i2691

Rapid Response:

Compression stockings to prevent post-phlebitic syndrome: a living review updated with the OCTAVIA trial

Living systematic reviews (1) and rapid reviews (2) have been proposed to maintain a synthesis of research studies as the evidence base evolves. Accordingly, we have added the OCTAVIA trial to an online living review (3).

Prior to the OCTAVIA trial, we believe the evidence, albeit low quality according to the GRADE rubric, showed benefit from wearing high-pressure compression stockings for two years (see Figure). This is shown when limiting meta-analysis to the two trials with high rates of compliance in wearing of stockings by patients.

The OCTAVIA trial likewise reported benefit among patients with high compliance. This is consistent with the prior trials but OCTAVIA was able to isolate the benefit of wearing stockings in the second year after a thrombosis.

We suggest that practitioners should offer high-pressure stockings for two years at the time of thromboses. While the evidence is of low quality, patients may choose stockings due to the low cost and lack of lasting adverse effects.

The methods underpinning this review are detailed online (3). The review is hosted at GitHub and executed with openCPU. GitHub supports team science and hosts diverse groups and governments with open-source projects including Google and the U.S. National Center for Biotechnology Information.

1. Schünemann HJ, Moja L. Reviews: Rapid! Rapid! Rapid! …and systematic. Syst Rev. 2015 Jan 14;4:4. doi: 10.1186/2046-4053-4-4. PMID: 25589399
2. Elliott JH, Turner T, Clavisi O, Thomas J, Higgins JP, Mavergames C, Gruen RL. Living systematic reviews: an emerging opportunity to narrow the evidence-practice gap. PLoS Med. 2014 Feb 18;11(2):e1001603. PMID: 24558353
3. GitHub Contributors. Compression stockings to prevent post-phlebitic syndrome. GitHub. Available at Accessed July 4, 2016.

Competing interests: No competing interests

05 July 2016
Robert G Badgett
Professor of Internal Medicine
Rahal, Ahmad K. Fellow in Hematology and Oncology. Baylor College of Medicine Department of Internal Medicine. 1 Baylor Plaza, Houston, TX 77030
The University of Kansas School of Medicine-Wichita
1010 N Kansas St. Wichita, KS 67214