Evidence-Based Hematology

426 Pages·2008·14.793 MB·English

by  Mark A. Crowther, Jeffrey Ginsberg, Holger Schünemann, Ralph M. Meyer, Richard Lottenberg

BLFS004-Crowther April15,2008 8:22
Evidence-based Hematology
Evidence-based Hematolog y . Edited by Mark A. Crowther, Jeff Ginsberg,
Holger J. Schu¨nemann, Ralph M. Meyer, and Richard Lottenberg.
© 2008 Blackwell Publishing, ISBN: 978-1-405-15747-6.
BLFS004-Crowther April15,2008 8:22
Evidence-based
Hematology
EDITED BY
MARK A. CROWTHER md, msc, frcpc
ProfessorandDivisionDirector
DivisionofHematology
McMasterUniversity
Hamilton,Canada
JEFF GINSBERG md, frcpc
Professor,DepartmentofMedicine
McMasterUniversity
Hamilton,Canada
HOLGER J. SCHU¨ NEMANN md, phd, msc, facp, fccp
Professor
ItalianNationalCancerInstitute“ReginaElena”
Rome,Italy,and
McMasterUniversity
Hamilton,Canada
RALPH M. MEYER md, frcpc
EdithEisenhauerChairinClinicalCancerResearch
Professor,DepartmentsofOncologyandMedicine
Queen’sUniversity
Kingston,Canada
RICHARD LOTTENBERG md, facp
ProfessorofMedicine
UniversityofFlorida
Gainesville,USA
BLFS004-Crowther April15,2008 8:22
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LibraryofCongressCataloging-in-PublicationData
Evidence-basedhematology/editedbyMarkA.Crowther...[etal.].
p. ; cm.
Includesbibliographicalreferencesandindex.
ISBN978-1-4051-5747-6(alk.paper)
1.Blood—Diseases. 2.Hematology. 3.Evidence-basedmedicine. I.Crowther,Mark,1966-
[DNLM:1. HematologicDiseases–therapy. 2.Evidence-BasedMedicine. 3.Hematologic
Diseases–diagnosis.WH120E932008]
RC636.E942008
616.1(cid:3)5—dc22
2007047284
ISBN:978-1-4051-5747-6
AcataloguerecordforthisbookisavailablefromtheBritishLibrary.
Setin9.25/12byAptara,Inc.
PrintedinSingaporebyFabulousPrintersPteLtd
1 2008
BLFS004-Crowther April15,2008 8:22
Contents
ListofContributors,vii 10 Long-TermAnticoagulationinVenous
Thromboembolism,73
Preface,xi
CliveKearon
Part1 AGuidetotheEvidence 11 ThrombolyticTherapyforDeepVeinThrombosisand
PulmonaryEmbolism,88
Editor:HolgerJ.Schu¨nemann
SimonJ.McRae,JohnW.Eikelboom
1 RatingtheQualityofEvidenceandMaking
12 InferiorVenaCavaInterruption,99
Recommendations:AGuidetotheSpectrumof
MichaelB.Streiff,ChristineL.Hann
ClinicalResearch,3
HolgerJ.Schu¨nemann,MartinStanulla, 13 ManagementofVenousThromboembolismin
JanL.Brozek,GordonG.Guyatt Pregnancy,110
2 AnOverviewofSystematicReviews,10 Wee-ShianChan
MartinPrins,ArinatenCate-Hoek,PieterLeffers
14 PediatricThrombosis,120
3 InterpretingResultsinClinicalResearch:Overviewof AnthonyK.C.Chan,PaulMonagle
measuresofeffect,measuresofprecision,and
15 BridgingAnticoagulationinPatientsWhoRequire
measuresofdiagnosticaccuracyforcliniciansand
TemporaryInterruptionofWarfarinforSurgery,124
researchers,15
JamesD.Douketis,ScottKaatz
MarcelloDiNisio,HarryR.Bu¨ller,PatrickM.M.Bossuyt
16 Evidence-basedApproachtotheDiagnosisand
4 FindingtheEvidenceinHematology,23
ManagementofThromboticThrombocytopenic
K.AnnMcKibbon,CynthiaJ.Walker-Dilks,R.BrianHaynes
Purpura,131
5 ApplyingEBMinClinicalPractice,32
BrianBoulmay,CraigS.Kitchens
AlessandroSquizzato,WalterAgeno,DavideImberti
17 DiagnosisandManagementofDisseminated
6 UsingEvidencetoGuidetheDiagnosisofDisease,37
IntravascularCoagulation,138
LucasM.Bachmann,HolgerJ.Schu¨nemann
JuliaA.M.Anderson
Part2 HemostasisandThrombosis 18 DiagnosisandManagementofHereditaryBleeding
Disorders:IncludingCongenital/AcquiredPlatelet
Editor:JeffGinsberg
FunctionDisorders,145
NigelS.Key,AliceD.Ma
7 DiagnosisofDeepVeinThrombosis,49
Lori-AnnLinkins 19 DiagnosisandManagementofAcquiredBleeding
8 TheDiagnosisofAcutePulmonaryEmbolism,56 Disorders:VitaminKAntagonists,152
VictorF.Tapson MiguelA.Escobar
9 InitialTherapyofDeepVeinThrombosisand 20 DiagnosisandManagementofHeparin-Induced
PulmonaryEmbolism,65 Thrombocytopenia,158
SamSchulman TheodoreE.Warkentin,AndreasGreinacher
v
BLFS004-Crowther April15,2008 8:22
Contents
21 ManagementofAntiphospholipidAntibody 37 ChronicMyeloidLeukemia,300
Syndrome,168 IrwinWalker
WendyLim,MarkA.Crowther
38 SelectedManagementofPatientswithMyelodysplastic
Syndromes,305
Part3 BenignHematologicDisorders
JohnM.Storring,KarenW.L.Yee
Editor:RichardLottenberg
39 Evidence-basedTreatmentofBurkittLymphomain
Adults,311
22 ClinicalQuestionsinIronOverload,179
JohnGerecitano,DavidJ.Straus
AntonelloPietrangelo,NicolaMagrini
23 AplasticAnemia,ParoxysmalNocturnal 40 PrimaryCentralNervousSystemLymphoma,317
Hemoglobinuria,andPureRedCellAplasia,189 TamaraShenkier
ShivaniSrivastava,RichardW.Childs 41 DiffuseLargeB-cellLymphoma,327
24 AcquiredAnemias:IronDeficiency,Cobalamin MichaelCrump
Deficiency,andAutoimmuneHemolyticAnemia,197
42 FollicularLymphoma,334
MarcS.Zumberg,MarcJ.Kahn
KevinImrie,MatthewCheung
25 ImmuneThrombocytopenicPurpura,206
43 LymphoblasticLymphoma,342
JamesN.George,SaraK.Vesely,GeorgeR.Buchanan
TylerY.Kang,JohnW.Sweetenham
26 Neutropenia,215
44 MantleCellLymphoma,347
DavidC.Dale
C.TomKouroukis
27 Hypereosinophilia:PrimaryandSecondary,221
45 ManagementofPatientswithPeripheralT-cell
FlorenceRoufosse,MichelGoldman,ElieCogan
Lymphoma,352
28 Porphyrias,229 KerryJ.Savage
GaganSood,KarlE.Anderson
46 SelectedManagementIssuesofPatientswithHodgkin
29 MembraneandEnzymeAbnormalitiesofthe Lymphoma,365
Erythrocyte,238 RalphM.Meyer
PatrickG.Gallagher,ErnestBeutler
47 LymphocytePredominantHodgkinLymphoma,372
30 SickleCellDisease,244
BrandonMcMahon,JonathanW.Friedberg
RichardLottenberg,SallyC.Davies
48 ManagementofPatientswithEssential
31 Evidence-basedTreatmentofThalassemiaMajor,251
Thrombocythemia,378
IssacOdame,DeborahRund
GuidoFinazzi,GiovanniBarosi,TizianoBarbui
49 ManagementofPatientswithPolycythemia
Part4 MalignantHematologicDisorders
Vera,385
Editor:RalphM.Meyer
GuidoFinazzi,RobertoMarchioli,TizianoBarbui
32 AcuteLymphoblasticLeukemiainAdults,263 50 Evidence-basedReviewofTherapiesinMultiple
StephenCouban,AndreaKew Myeloma,390
33 AcuteMyeloidLeukemiainAdults:Remission MichaelSebag,A.KeithStewart
InductionTherapy,268 51 ManagementofWaldenstrom’s
CaraA.Rosenbaum,RichardA.Larson Macroglobulinemia,396
34 AcuteMyeloidLeukemiainAdults:Postremission ChristineI.Chen
Therapy,278
52 TheRoleofHematopoieticGrowthFactorsin
CaraA.Rosenbaum,RichardA.Larson
ManagingPatientswithHematologicMalignancies,
35 CurrentAreasofControversyintheTreatmentof 402
PatientsWithNewlyDiagnosedAcutePromyelocytic HeloisaP.Soares,AmbujKumar,CharlesBennett,
Leukemia,287 BenjaminDjulbegovic
MartinS.Tallman,SyedA.Abutalib
36 ChronicLymphocyticLeukemia,294
Index,413
BruceD.Cheson
Companionwebsite:www.blackwellpublishing.com/medicine/bmj/hematology
vi
BLFS004-Crowther April15,2008 8:22
List of contributors
SyedA.Abutalib MD GiovanniBarosi MD JanL.Brozek MD,PhD
NorthwesternUniversityFeinbergSchoolof Director,UnitofEpidemiologyCenterforthe ItalianNationalCancerInstitute“ReginaElena”
Medicine StudyofMyelofibrosis Rome,Italy
RobertH.LurieComprehensiveCancerCenter IRCCSPoliclinicoS.MatteoFoundation PolishInstituteforEBM
Chicago Pavia,Italy Krakow,Poland
Illinois,USA
CharlesBennett MDPhD GeorgeR.Buchanan MD
WalterAgeno MD DivisionofHematology-Oncology
DivisionofHematology/Oncology
DepartmentofClinicalMedicine DepartmentofPediatrics
DepartmentofMedicine
UniversityofInsubria UniversityofTexas
FeinbergSchoolofMedicine
Varese,Italy SouthwesternMedicalCenteratDallas
Mid-WestCenterforHealthServicesPolicy
Dallas
Research
Texas,USA
JuliaA.M.Anderson MBChB, ChicagoVA/LakesideDivision
NorthwesternUniversityMedicalSchool
BSc(Hons),MDFRCP(Edin),FRCPath,FACP
DepartmentofMedicine Chicago HarryR.Bu¨ller MD
McMasterUniversity Illinois,USA DepartmentofVascularMedicine
Hamilton AcademicMedicalCenter
Ontario,Canada UniversityofAmsterdam
ErnestBeutler MD Amsterdam,TheNetherlands
DepartmentofMolecularandExperimental
KarlE.Anderson MD Medicine
DepartmentsofPreventiveMedicineand TheScrippsResearchInstitute ArinatenCate-Hoek MD
CommunityHealth LaJolla DepartmentofEpidemiology
InternalMedicineandPharmacologyand California,USA CareandPublicHealthResearchInstitute
Toxicology UniversityofMaastricht
UniversityofTexasMedicalBranch Maastricht,TheNetherlands
Galveston PatrickM.M.Bossuyt PhD
Texas,USA DepartmentofClinicalEpidemiologyand AnthonyK.C.Chan MBBS,FRCPC
Biostatistics
DepartmentofPediatrics
AcademicMedicalCenter
LucasM.Bachmann MD,PhD McMasterUniversity
UniversityofAmsterdam
ReaderinClinicalEpidemiology Hamilton
Amsterdam
DeputyDirector,HortenCentreforPatient Ontario,Canada
TheNetherlands
OrientedResearch
UniversityofZu¨rich Wee-ShianChan MD,FRCPC,MSc
Zu¨rich,Switzerland BrianBoulmay MD DepartmentofMedicine
DepartmentofMedicine Women’sCollegeHospital
TizianoBarbui MD HealthScienceCenter DepartmentofObstetricsandGynecology
DepartmentofHematology-Oncology UniversityofFlorida SunnybrookHealthSciencesCentre
OspedaliRiunitidiBergamo Gainesville Toronto
Bergamo(Bg),Italy Florida,USA Ontario,Canada
vii
BLFS004-Crowther April15,2008 8:22
Listofcontributors
ChristineI.Chen MD,MMED,FRCP MarcelloDiNisio MD,PhD JohnGerecitano MD,PhD
DepartmentofMedicalOncologyandHematology DepartmentofMedicineandAging DepartmentofMedicine
PrincessMargaretHospital SchoolofMedicine,andAgingResearchCenter, LymphomaService
UniversityofToronto Ce.S.I. MemorialSloan-KetteringCancerCenter
Toronto “GabrieleD’Annunzio” NewYork,USA
Ontario,Canada UniversityFoundation
Chieti-Pescara,Italy
BruceD.Cheson MD MichelGoldman MD,PhD
DivisionofHematology/Oncology InstituteforMedicalImmunology
GeorgetownUniversityHospital BenjaminDjulbegovic MD,PhD Universite´LibredeBruxelles
Washington,DC,USA DepartmentofInterdisciplinaryOncology Charleroi-Gosselies,Belgium
H.LeeMoffittCancerCenterandResearch
Institute
MatthewCheung MD,SM,FRCP(C) UniversityofSouthFlorida AndreasGreinacher
DivisionofHematology/Oncology
Tampa DepartmentofImmunologyandTransfusion
DepartmentofMedicine
Florida,USA MedicineandTransfusionMedicine
UniversityofTorontoSunnybrookHealthSciences
ThrombosisandHemostasisService
Centre
Universita¨tsklinikumGreifswald
Toronto,Ontario JamesD.Douketis MD,FRCP(C)
Ernst-Moritz-ArndtUniversityGreifswald
Canada DepartmentofMedicine
Greifswald,Germany
McMasterUniversityandStJoseph’sHealthcare
RichardW.Childs MD Hamilton
HematologyBranch Ontario,Canada GordonG.Guyatt MD,MSc
NationalHeart,Lung,andBloodInstitute CLARITYResearchGroup
NationalInstitutesofHealth JohnW.Eikelboom MBBS,MSc,FRACP, DepartmentofClinicalEpidemiologyand
Bethesda Biostatistics
FRCPA
Maryland,USA McMasterUniversity
DepartmentofMedicine
Hamilton
ElieCogan MD,PhD McMasterUniversity Ontario,Canada
DepartmentofInternalMedicine Hamilton
ErasmeHospital,Brussels Ontario,Canada
Universite´LibredeBruxelles(ULB) ChristineL.Hann MD,PhD
Belgium MiguelA.Escobar MD DepartmentofOncology
JohnsHopkinsUniversitySchoolofMedicine
DepartmentofPediatricsandInternalMedicine
StephenCouban MD,FRCPC DivisionofHematology Baltimore
QueenElizabethIIHealthSciencesCentre UniversityofTexasHealthScienceCenterat Maryland,USA
Halifax Houston
NovaScotia,Canada Houston R.BrianHaynes MD,PhD
Texas,USA HealthInformationResearchUnit
MarkA.Crowther MD,MSc,FRCPC
DepartmentofClinicalEpidemiologyand
ProfessorandDivisionDirector
GuidoFinazzi MD Biostatistics
DivisionofHematology
McMasterUniversity,and Director,TransfusionMedicineandHaemostasis McMasterUniversityFacultyofHealthSciences
St.Joseph’sHospital andThrombosisServices Hamilton
Hamilton OspedaliRiuniti Ontario,Canada
Ontario,Canada Bergamo,Italy
DavideImberti MD
MichaelCrump MD,FRCPC JonathanW.Friedberg MD HeadofThrombosisCenter
PrincessMargaretHospital JamesP.WilmotCancerCenter EmergencyDepartment
DivisionofMedicalOncologyandHematology UniversityofRochester HospitalofPiacenza
DepartmentofMedicine Rochester Piacenza,Italy
UniversityofToronto NewYork,USA
Toronto
Ontario,Canada KevinImrie MD,FRCPC
PatrickG.Gallagher MD,FAAP
Chair,CancerCareOntarioHematologyDisease
DavidC.Dale MD,FACP DepartmentofPediatrics SiteGroup,and
DepartmentofMedicine YaleSchoolofMedicine Toronto-SunnybrookRegionalCancerCentre
UniversityofWashington NewHaven Toronto
Seattle Connecticut,USA Ontario,Canada
Washington,USA
JamesN.George MD ScottKaatz DO,MSc,FACP
SallyC.Davies MB,FRCP,FRCPath Hematology–OncologySection HenryFordHealthSystem
FacultyofMedicine UniversityofOklahomaHealthSciencesCenter Detroit
ImperialCollegeatCentralMiddlesexHospital OklahomaCity Michigan,USA
London,UK Oklahoma,USA
viii
BLFS004-Crowther April15,2008 8:22
Listofcontributors
MarcJ.Kahn MD PieterLeffers BrandonMcMahon MD
SchoolofMedicine DepartmentofEpidemiology NorthwesternUniversity
TulaneUniversitySchoolofMedicine CareandPublicHealthResearchInstitute FeinbergSchoolofMedicine
NewOrleans MaastrichtUniversity RobertH.LurieComprehensiveCancerCenter
Louisiana,USA Maastricht,TheNetherlands Chicago
Illinois,USA
TylerY.Kang MD
Hematology/OncologyFellow WendyLim MD,MSc SimonJ.McRae MBBS,FRACP,FRCPA
TaussigCancerCenter St.Joseph’sHospital TheQueenElizabethHospital
ClevelandClinic DepartmentofMedicine Woodville
Cleveland McMasterUniversity SouthAustralia
Ohio,USA Hamilton Australia
Ontario,Canada
CliveKearon MB,MRCPI,FRCPC,PhD RalphM.Meyer MD,FRCP(C)
McMasterUniversity Lori-AnnLinkins MD,MSc,FRCPC Director,NationalCancerInstituteofCanada
ClinicalTrialsGroup
Hamilton HendersonResearchCentre
EdithEisenhauerChairinClinicalCancer
Ontario,Canada HamiltonHealthSciencesCorporation
Research
Hamilton
Professor,DepartmentsofOncologyandMedicine
AndreaKew MD,FRCPC Ontario,Canada Queen’sUniversity
QueenElizabethIIHealthSciencesCentre Kingston,Ontario
Halifax RichardLottenberg MD,FACP Canada
NovaScotia,Canada
DivisionofHematology/Oncology
DepartmentofMedicine PaulMonagle MBBS,MSc,MD,FRACP,
NigelS.Key MB,ChB,FRCP(UK) UniversityofFloridaCollegeofMedicine FRCPA,FCCP
DepartmentofMedicine Gainesville DepartmentofHaematology
UniversityofNorthCarolinaatChapelHill Florida,USA RoyalChildren’sHospital
ChapelHill DepartmentofPathology
NorthCarolina,USA UniversityofMelbourne
AliceD.Ma MD Melbourne
CraigS.Kitchens MD,MACP UniversityofNorthCarolinaSchool Victoria,Australia
ofMedicine
VeteransAffairsMedicalCenter
UniversityofFlorida DivisionofHematology/Oncology IsaacOdame MB,ChB,FRCPCH,FRCPath,
HaroldR.RobertsComprehensiveHemophilia
Gainesville FRCPC
CenterCB
Florida,USA DivisionofHematology/Oncology
ChapelHill
TheHospitalforSickChildren
NorthCarolina,USA
C.TomKouroukis MD,MSc,FRCPC Toronto
Hematology-Oncology Ontario,Canada
JuravinskiCancerCentre NicolaMagrini MD
DepartmentofOncology CeVEASNHSCentrefortheEvaluationofthe AntonelloPietrangelo MD.PhD
McMasterUniversity EffectivenessofHealthCare DepartmentofMedicine
Hamilton ModenaLocalHealthAuthority CenterforHemochromatosis
Ontario,Canada Modena,Italy UniversityofModenaandReggioEmilia
Modena,Italy
AmbujKumar MD,MPH
DepartmentofHealthOutcomesandBehavior RobertoMarchioli MD MartinPrins MD,PhD
LaboratoryofClinicalEpidemiologyof
andOncologicSciences DepartmentofEpidemiology
CardiovascularDisease
H.LeeMoffittCancerCenterandResearch CareandPublicHealthReseachInstitute
DepartmentofClinicalPharmacologyand
Institute UniversityofMaastrichtandDepartmentof
Epidemiology
UniversityofSouthFlorida EpidemiologyandMedicalTechnologyAssessment
ConsorzioMarioNegriSud
Tampa AcademicHospitalMaastricht
SantaMariaImbaro,Italy
Florida,USA Maastricht,TheNetherlands
RichardA.Larson MD K.AnnMcKibbon MLS,PhD CaraA.Rosenbaum MD
SectionofHematology/Oncology HealthInformationResearchUnit SectionofHematology/Oncology
DepartmentofMedicineandCancerResearch DepartmentofClinicalEpidemiologyand DepartmentofMedicineandCancerResearch
Center Biostatistics Center
UniversityofChicago McMasterUniversityFacultyofHealthSciences UniversityofChicago
Chicago Hamilton Chicago
Illinois,USA Ontario,Canada Illinois,USA
ix
BLFS004-Crowther April15,2008 8:22
Listofcontributors
FlorenceRoufosse MD,PhD GaganSood MD MartinS.Tallman MD
DepartmentofInternalMedicine DivisionofGastroenterologyandHepatology NorthwesternUniversityFeinbergSchoolof
HoˆpitalErasme DepartmentofInternalMedicine Medicine
Universite´LibredeBruxelles(ULB) TheUniversityofTexasMedicalBranch RobertH.LurieComprehensiveCancerCenter
InstituteforMedicalImmunology Galveston Chicago
Universite´LibredeBruxelles(ULB) Texas,USA Illinois,USA
Gosselies
Brussels,Belgium AlessandroSquizzato MD VictorF.Tapson MD
DepartmentofClinicalMedicine DivisionofPulmonaryandCriticalCareMedicine
DeborahRund MD UniversityofInsubria DukeUniversityMedicalCenter
HematologyDepartment Varese,Italy Durham
NorthCarolina,USA
HebrewUniversity
HadassahUniversityHospital
EinKerem ShivaniSrivastava MD SaraK.Vesely PhD
BoneMarrowandStemCellTransplantation
Jerusalem,Israel DepartmentofBiostatisticsandEpidemiology
IUSimonCancerCenter
UniversityofOklahomaHealthSciencesCenter
IndianaUniversity
OklahomaCity
KerrySavage BSc,MD,MSc,FRCPC Indianapolis Oklahoma,USA
UniversityofBritishColumbia Indiana,USA
DivisionofMedicalOncology
CynthiaJ.Walker-Dilks MLS
BritishColumbiaCancerAgency
MartinStanulla MD,MSc HealthInformationResearchUnit
Vancouver,BritishColumbia
DepartmentofPediatricHematologyand DepartmentofClinicalEpidemiologyand
Canada
Oncology Biostatistics
Children’sHospital McMasterUniversityFacultyofHealthSciences
SamSchulman MD,PhD,FRCPS HannoverMedicalSchool Hamilton
ClinicalThromboembolismProgram Hannover,Germany Ontario,Canada
McMasterUniversity
Hamilton A.KeithStewart MBCHB,FRCPC,FACP IrwinWalker MBBS,FRACP,FRCPC
Ontario,Canada CollegeofMedicine,MayoClinic HematologyandBoneMarrowTransplantation
Scottsdale McMasterUniversityMedicalCentre
HolgerJ.Schu¨nemann MD,PhD,MSc, Arizona,USA Hamilton
Ontario,Canada
FACP,FCCP
CLARITYResearchGroup JohnM.Storring MD
TheodoreE.Warkentin MD,
DepartmentofEpidemiologyItalianNational McGillUniversityHealthCentre
CancerInstituteReginaElena Montreal BSc(Med),FRCP(C),FACP
Rome,Italy Quebec,Canada DepartmentofPathologyandMolecular
Medicine,andDepartmentofMedicineMcMaster
University
MichaelSebag MD,PhD,FRCPC DavidJ.Straus MD TransfusionMedicine
MayoClinicArizona LymphomaService HamiltonRegionalLaboratoryMedicineProgram
Scottsdale DepartmentofMedicine ServiceofClinicalHematology
Arizona,USA MemorialSloan–KetteringCancerCenter Hamilton,Ontario
NewYork Canada
NewYork,USA
TamaraShenkier MDCM,FRCPC
KarenW.L.Yee MD
DepartmentofMedicalOncology
UniversityofBritishColumbia MichaelB.Streiff MD DepartmentofMedicalOncologyandHematology
UniversityHealthNetwork—PrincessMargaret
BritishColumbiaCancerAgency DepartmentofMedicine
Hospital
Vancouver JohnsHopkinsMedicalInstitutions
Toronto
BritishColumbia,Canada Baltimore
Ontario,Canada
Maryland,USA
HeloisaP.Soares MD MarcS.Zumberg MD
DepartmentofInternalMedicine JohnW.Sweetenham MD,FRCP DepartmentofMedicine
MountSinaiMedicalCenter TaussigCancerCenter DivisionofHematology/Oncology
MiamiBeach ClevelandClinic UniversityofFlorida
Florida,USA Cleveland Gainesville
Ohio,USA Florida,USA
x
BLFS004-Crowther April15,2008 8:22
Preface
Evidence-basedmedicineisdefinedvariably,howeverfundamen- Althoughmosttextssuchasthisareinevitablydelayedintheir
taltoitspractice,itisthesystematicappraisalofavailableevidence productionand,asaresult,theevidencepresentedmaybealready
andtheformulationoftherapeuticplans,whichtakeintoaccount out of date, we have made every effort to update the material,
thisevidence.Evidence-basedmedicineisflexibleanduses“best makingEvidence-basedHematologyatimelyadditiontotheliter-
practice”evidenceasbroadlyaspossibletoanswerclinicallyrele- ature.Wehopethatreaderswillusethetechniquesemployedin
vantquestions. thistext(formulationofaclinicallyrelevantquestion,systematic
Evidence-basedHematologyfocusesonclinicalquestionswithin literaturereview,andgradingofevidence)toupdatetheirknowl-
alldomainsofhematology.Thequestionsaredesignedtoaddress edgeinspecificcontentareasusingtheirownpersonalcontinuous
clinicalproblemsseeninday-to-daypractice.Wehavesystemati- learningtechniques.Ourhopeisthatyouwillfindthistextuseful
callyreviewedtheliteratureavailableasitappliestoeachofthese inyourday-to-dayclinicalpractice.Additionally,wehopethatit
questionsandhavemaderecommendationsthatreflectthisevi- spursyourinterestinevidence-basedhematology,thusassisting
dence.Wehopethatthistextwillassistreadersinunderstanding youinprovidingthebestpossiblecaretoyourpatients.
howtoformulateandanswertheirownclinicalquestionsusing
MarkA.Crowther
thebestavailableevidence.
Hamilton,Ontario,April1,2008
CompanionWebsite
AcompanionsiteforthisbookisavailableatthefollowingURL:
www.blackwellpublishing.com/medicine/bmj/hematology
Thesiteincludesthefollowing:
(cid:2) web-onlytables(Tables22.5and22.6,Appendix22.1)
(cid:2) updatessection
(cid:2) moreabouttheWiley–Blackwellevidence-based
products.
xi