For patients receiving anticoagulation therapy for treatment of VTE, the ASH guideline panel recommends against using a daily lottery (see recommendation 13a) plus electronic re- minders (see recommendation 13b) to improve medication adherence (strong recommendation based on very low cer- tainty in the evidence about effects ). Remark: This recommendation applies specifically to a sophisticated alert system used in the study evaluated by the panel. Summary of the evidence. One RCT reported the effect of a daily lottery-based incentive intervention combined with an electronic medication monitoring system with a daily alarm to remind patients to take their anticoagulant medication as scheduled.162 The main outcome was anticoagulation control as measured by out-of-range INRs, and secondary outcomes included mortality, bleeding, and thromboem- bolic events. The EtD framework is shown online at https://dbep. gradepro.org/profile/06290825-AF53-134F-9191-7E26113C0FDA. Benefits. For benefits, see the evidence profile in the EtD framework referenced at the end of the previous section, available online. The percentage time outside of the INR range was lower in the group with the daily lottery plus electronic reminder than in controls, but the CI was wide and included no effect (adjusted OR for likelihood of being out of INR range, 0.77 [95% CI, 0.54-1.09]; very low certainty). There was no difference in median days with incorrect adherence between the group with the daily lottery plus electronic reminder and the control group (difference in the fully adjusted model for percentage incorrect adherence, 24.6% [95% CI, 211.1 to 1.9]; very low certainty). Harms and burden. There was no effect of a daily lottery plus electronic reminders on mortality and PE/DVT because these outcomes did not occur in any study patient. 