Beverley Hunt, OBE, FRCP, FRCPath, Guy’s and St Thomas’ NHS Foundation Trust, London, UK, discusses the viability of conducting randomized control trials (RCTs) to assess the use of low-molecular-weight heparin (LMWH) as thromboprophylaxis during pregnancy. Given the lack of adequately powered RCTs and limited knowledge of optimal trial candidates, Prof. Hunt worked alongside health economists to investigate which groups of patients would benefit from a clinical trial. Decision analysis revealed that women with high-risk thrombophilia or a history of clots would benefit from a large RCT; however, clinicians and patients expressed a need for administering treatment in all individuals, reducing the feasibility of recruiting this group. Instead, investigating postpartum thromboprophylaxis in obese women, an area in which there is a high degree of uncertainty, was deemed the most ethically and economically viable approach. This interview took place at the 64th Annual Scientific Meeting of the British Society for Haematology (BSH) Congress in Liverpool, UK.
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