American Society of Hematology, ABHH, ACHO, Grupo CAHT, Grupo CLAHT, SAH, SBHH, SHU, SOCHIHEM, SOMETH, Sociedad Panameña de Hematología, SPH, SVH 2023 guidelines for diagnosis of venous thromboembolism and management in children and pregnant women in Latin America

Background: Implementation of international guidelines in Latin American settings requires additional considerations (i.e., values and preferences, resources, accessibility, feasibility, and impact on health equity). Objective: To provide evidence-based guidelines about diagnosis of VTE and management in children and during pregnancy. Methods: We used the GRADE ADOLOPMENT method to adapt recommendations from three American Society of Hematology, ASH, VTE guidelines (Diagnosis of VTE, VTE in Pregnancy and VTE in Pediatric population). ASH and 12 local hematology societies formed a guideline panel comprised of medical professionals from 10 countries in Latin America. Panelists prioritized 10 questions about VTE diagnosis and 18 about management in special populations that were relevant for the Latin American context. A knowledge synthesis team updated evidence reviews of health effects conducted for the original ASH guidelines and summarized information about factors specific to the Latin American context. Results: In comparison with the original guideline, there were significant changes in 2/10 diagnostic recommendations (changes in the diagnostic algorithms) and in 9/18 management recommendations (4 changed direction and 5 changed strength). Conclusions: This guideline ADOLOPMENT project highlighted the importance of contextualization of recommendations in other settings, based on differences in values, resources, feasibility and health equity impact.