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What do systematic reviews say?

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Evidence found and GRADE certainty

57 questions · 65 findings · 14 reviews · Headline outcomes only

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No studies found 8 · 12.3%GRADE not reported 5 · 7.7%Very low 15 · 23.1%Low 20 · 30.8%Moderate 10 · 15.4%High 7 · 10.8%

Heparin vs placebo

Symptomatic PE Treatment duration 28 ‐ 42 days · people requiring prevention of venous thromboembolism following total hip or knee replacement or hip fracture repair

Heparin showed no clear difference in symptomatic PE Treatment duration 28 ‐ 42 days compared with placebo (low certainty).

1 finding from 1 review

Heparin vs placebo

Symptomatic VTE · people requiring prevention of venous thromboembolism following total hip or knee replacement or hip fracture repair

Heparin showed no clear difference in symptomatic VTE (DVT and PE) Treatment duration 28 ‐ 42 days compared with placebo (high certainty).

1 finding from 1 review

Heparin vs placebo

Symptomatic DVT · people requiring prevention of venous thromboembolism following total hip or knee replacement or hip fracture repair

Heparin showed no clear difference in symptomatic DVT (proximal or distal) Treatment duration 28 ‐ 42 days compared with placebo (moderate certainty).

1 finding from 1 review

Subcutaneous unfractionated heparin vs unfractionated heparin

Symptomatic recurrent VTE at 3 months · people aged ≥ 18 years with a diagnosis of new or recurrent VTE

Subcutaneous unfractionated heparin showed no clear difference in symptomatic recurrent VTE at 3 months compared with intravenous unfractionated heparin (low certainty).

1 finding from 1 review

Subcutaneous unfractionated heparin vs unfractionated heparin

Symptomatic recurrent DVT at 3 months · people aged ≥ 18 years with a diagnosis of new or recurrent VTE

Subcutaneous unfractionated heparin showed no clear difference in symptomatic recurrent DVT at 3 months compared with intravenous unfractionated heparin (low certainty).

1 finding from 1 review

Subcutaneous unfractionated heparin vs low molecular weight heparin

Symptomatic recurrent VTE at 3 months · people aged ≥ 18 years with a diagnosis of new or recurrent VTE

Subcutaneous unfractionated heparin showed no clear difference in symptomatic recurrent VTE at 3 months compared with low molecular weight heparin (low certainty).

1 finding from 1 review

Subcutaneous unfractionated heparin vs low molecular weight heparin

Symptomatic recurrent DVT at 3 months · people aged ≥ 18 years with a diagnosis of new or recurrent VTE

Subcutaneous unfractionated heparin showed no clear difference in symptomatic recurrent DVT at 3 months compared with low molecular weight heparin (low certainty).

1 finding from 1 review

Low‐molecular‐weight heparins or heparinoids vs unfractionated heparin

Symptomatic intracranial haemorrhage/haemorrhagic transformation of the cerebral infarct during treatment period (range 6 days to 16 days)⁹ · acute ischaemic stroke

Low‐molecular‐weight heparins or heparinoids showed no clear difference in symptomatic intracranial haemorrhage/haemorrhagic transformation of… compared with unfractionated heparin (low certainty).

1 finding from 1 review

Unfractionated heparin vs low molecular weight heparin

DVT (symptomatic, asymptomatic, non‐fatal) · people undergoing major amputation of the lower extremity

It is very uncertain whether unfractionated heparin changes DVT (symptomatic, asymptomatic, non‐fatal) (5 to 8 days after surgery) compared with low molecular weight heparin (very low certainty).

1 finding from 1 review