BACKGROUND: High level evidence for direct oral anticoagulants (DOACs) in patients with cerebral venous thrombosis is lacking. We performed a systematic review and meta-analysis to assess the efficacy and safety of DOACs versus vitamin K antagonists in patients with cerebral venous thrombosis. METHODS: This systematic review was registered in PROSPERO (CRD42021228800). We searched MEDLINE (via Ovid), EMBASE, CINAHL, and the Web of Science Core Collection between January 1, 2007 and Feb 22, 2022. Search terms included a combination of keywords and controlled vocabulary terms for cerebral venous thrombosis, vitamin K antagonists/warfarin, and DOACs. We included both randomized and nonrandomized studies that compared vitamin K antagonists and DOACs in 5 or more patients with cerebral venous thrombosis. Where studies were sufficiently similar, we performed meta-analyses for efficacy (recurrent venous thromboembolism and complete recanalization) and safety (major hemorrhage) outcomes, using relative risks (RRs). RESULTS: Out of 10 665 records identified, we screened 254 as potentially eligible. Nineteen studies (16 observational studies [n=1735] and 3 randomized controlled trials [n=215]) met the inclusion criteria. All 3 randomized controlled trials had some concerns, and all 16 observational studies had at least moderate risk of bias. When compared with vitamin K antagonist treatment, DOAC had comparable risks of recurrent venous thromboembolism (relative risk [RR], 0.85 [95% CI, 0.52–1.37], I 2 =0%), major hemorrhage (RR, 0.70 [95% CI, 0.40–1.21], I 2 =0%), intracranial hemorrhage (RR, 0.58 [95% CI, 0.30–1.12]; I 2 =0%), death (RR, 1.14 [95% CI, 0.54–2.43], I 2 =1%), and complete venous recanalization (RR, 0.98 [95% CI, 0.87–1.11]; I 2 =0%). CONCLUSIONS: This systematic review and meta-analysis suggest that in patients with cerebral venous thrombosis, DOACs, and warfarin may have comparable efficacy and safety. Given the limitations of the studies included (low number of randomized controlled trials, modest total sample size, rare outcome events), our findings should be interpreted with caution pending confirmation by ongoing randomized controlled trials and large, prospective, observational studies.

Background: The Technology Team at the Ruth Lilly Medical Library, Indiana University (IU), first started exploring virtual reality (VR) in 2016. In 2017, we began offering weekly sessions dubbed VRidays (“VR Fridays”) to give students an opportunity to experience the technology. We also purchased a portable VR setup that allowed us to demonstrate VR at our regional campuses.Description: To lower the entry barrier to VR, the Technology Team collaborated with the IU Advanced Visualization Lab to establish a reality lab in our collaborative learning space. The lab opened in the fall of 2018 and consists of four high-end VR stations that are accessible to students at any time, but they can also make an appointment for a more guided experience. Information and instructions are available on a LibGuide.Conclusion: We are currently collecting data on the number of unique users and evaluating application usage. We are working on a feedback mechanism and looking to develop collaborative partnerships across the university.Virtual Projects are published on an annual basis in the Journal of the Medical Library Association (JMLA) following an annual call for virtual projects in MLAConnect and announcements to encourage submissions from all types of libraries. An advisory committee of recognized technology experts selects project entries based on their currency, innovation, and contribution to health sciences librarianship.

No abstract