Adherence to this recommendation according to the guideline could be used as a quality criterion or performance indicator. c For researchers: The recommendation is supported by credible research or other convincing judgments that make additional research unlikely to alter the recommendation. On occasion, a strong recommendation is based on low or very low certainty in the evidence. In such instances, further research may provide important information that alters the recommendations. Conditional recommendation c For patients: The majority of individuals in this situation would want the suggested course of action, but many would not. Decision aids may be useful in helping patients to make decisions consistent with their individual risks, values, and preferences. c For clinicians: Different choices will be appropriate for individual patients, and clinicians must help each patient arrive at a management decision consistent with the patient s values and preferences. Decision aids may be useful in helping individuals to make decisions consistent with their individual risks, values, and preferences. c For policy makers: Policy-making will require substantial debate and involvement of various stakeholders. Performance measures should assess whether decision-making is duly documented. c For researchers: This recommendation is likely to be strength- ened (for future updates or adaptation) by additional research. An evaluation of the conditions and criteria (and the related judgments, research evidence, and additional considerations) that determined the conditional (rather than strong) recom- mendation will help identify possible research gaps. Recommendations Initial anticoagulant dose selection Recommendation 1. In obese patients receiving low-molecular- weight heparin (LMWH) therapy for treatment of acute VTE, the American Society of Hematology (ASH) guideline panel suggests initial LMWH dose selection according to actual body weight rather than dose selection based on a fixed maximum daily dose (ie, capped dose) (conditional recommendation based on very low certainty in the evidence about effects ). 