Selecting the timing between INR measurements (INR recall interval) Recommendation 5. For patients receiving VKA therapy for treatment of VTE, the ASH guideline panel suggests using an INR recall interval of 4 weeks or fewer rather than intervals longer than 4 weeks following VKA dose adjustment due to an out-of-target- range INR (conditional recommendation based on very low certainty in the evidence about effects ). Recommendation 6. For patients receiving maintenance VKA therapy for treatment of VTE, the ASH guideline panel suggests using a longer (6-12 weeks) INR recall interval rather than a shorter (4 weeks) INR recall interval during periods of stable INR control (conditional recommendation based on very low certainty in the evidence about effects ). Laboratory monitoring of the anticoagulant response Recommendation 7. For patients with renal dysfunction (creatinine clearance, ,30 mL/min) receiving LMWH therapy for treatment of VTE, the ASH guideline panel suggests against using anti factor Xa concentration monitoring to guide LMWH dose adjustment (conditional recommendation based on very low certainty in the evidence about effects ). Remark: Instead of monitoring anti factor Xa concentrations, providers should con- sider using doses adjusted for renal function as recommended in product labeling (eg, enoxaparin) or switching to an alternative anticoagulant with lower renal clearance, such as unfractionated heparin (UFH) or a different LMWH. Recommendation 8. For patients with obesity receiving LMWH therapy for treatment of VTE, the ASH guideline panel suggests against using anti factor Xa concentration monitoring to guide LMWH dose adjustment (conditional recommendation based on very low certainty in the evidence about effects ). Remark: Providers should consider LMWH using doses based on actual body weight (see recommendation 1) and not monitoring anti factor Xa concentrations, similar to the approach used in nonobese patients. Recommendation 9. 