Cancer-associated thrombosis is the second leading cause of death in ambulatory patients with cancer. It is associated with significant morbidity and mortality and it is a preventable complication for anti-cancer therapy. Recent studies have focused on thrombotic risk-stratification using clinical prediction tools and pharmacologic prevention using low-dose direct oral anticoagulants. The overall clinical and cost-effectiveness associated with such strategies have not been evaluated in the general populations. The major objective for the current proposal is to examine the impact of low-dose anticoagulant prophylaxis strategy on provider implementation and patient outcomes in the local commun...

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Cancer-associated thrombosis is the second leading cause of death in ambulatory patients with cancer. It is associated with significant morbidity and mortality, and it is a preventable complication for anti-cancer therapy. Recent studies have focused on thrombotic risk-stratification using clinical prediction tools and pharmacologic prevention using low-dose direct oral anticoagulants. The overall clinical and cost-effectiveness associated with such strategies have not been evaluated in the general populations. The major objective for the current proposal is to examine the impact of low-dose anticoagulant prophylaxis strategy on provider implementation and patient outcomes in the local community.

Specifically, we aim to first characterize the incidence and mortality rate of cancer-associated thrombosis in patients who reside in Harris County, Texas. We will then prospectively validate the performance of existing clinical risk prediction tools and novel biomarkers in high-risk patient populations. We will assess the burden of thrombosis and bleeding in cancer patients by interviewing patients to estimate the utility weights for quality of life adjustment and to model the cost-effectiveness of a low-dose DOAC thromboprophylaxis strategy.

Finally, we will pilot the impact of automated electronic thrombosis risk-stratification tool on provider behaviors and patient outcomes. The results of our research will influence future development of clinical oncology guidelines. Most importantly, it will allow physicians and patients with cancer to make personalized and informed decision to prevent thrombotic complications.

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