The panel esti- mated moderate resource requirements associated with AMS care, mainly secondary to personnel costs. Several studies indicated that AMS care is cost-effective compared with care provided by the patient s regular health care provider; however, these studies were of very low quality and generally did not take into account startup costs associated with establishing an AMS.122,143,148-151 The option to refer patients to an AMS might help practitioners feel more confident prescribing anticoagulation therapy. On the other hand, if the AMS is situated in a hospital, rural patients out-of-pocket costs for visits might be higher. Given these competing impacts, the panel was not able to determine the effect of AMS care on health equity. The panel agreed that in general, AMS care seems acceptable to patients and providers, but the willingness of health system administrators to dedicate funds to setting up and running an AMS was less certain, especially considering that DOAC manage- ment based on AMS has been less well studied. Conclusions and research needs for this recommendation. The guideline panel determined that there is very low certainty evidence for a net health benefit from using AMS care over the care usually provided by a patient s regular health care provider for VTE treatment. Based on the body of available evidence, it is likely that AMS care reduces the risk of developing recurrent VTE and possibly also major bleeding, as well as improving TTR. There is very low certainty that AMS care has an effect on mortality. The panel agreed that this recommendation mainly applies to patients using VKA, as all but 2 of the studies focused on VKA treatment. Furthermore, AMS is most likely to be beneficial when implemented in a population with inadequate TTR managed by nonspecialized providers. 