The ASH guidelines make a graded recommendation in favor of using AMS, whereas ACCP provided an ungraded best practice statement suggesting that health care providers who manage oral anticoagulation therapy should do so in a systematic and coordinated fashion, incorporating patient education, system- atic INR testing, tracking, follow-up, and good patient communica- tion of results and dosing decisions. Both ASH and ACCP guidelines favor PSM over other methods of INR monitoring; however, the ASH guidelines makes a strong recommendation for PSM, whereas the ACCP guidelines make a weak (or conditional) recommendation favoring PSM. For patients with renal insufficiency (creatinine clearance of ,30 mL/min), ACCP recommends using reduced LMWH doses over standard doses, whereas the ASH guidelines suggest against using anti factor Xa monitoring to adjust LMWH doses in this patient population. These recom- mendations are complementary, suggesting that for patients with renal insufficiency, clinicians should use reduced LMWH doses without anti factor Xa monitoring. Both ASH and ACCP guidelines suggest against administering vitamin K to patients presenting with INRs between 4.5 and 10.0 and no evidence of bleeding. Both guidelines suggest the administration of 4-factor PCC over FFP for patients with VKA-associated life-threatening bleeding. The ASH guidelines include recommendations for optimal man- agement of DOAC therapy, whereas the ACCP guidelines do not, as DOAC agents were introduced during the time when the ACCP guidelines were being prepared. Although both guidelines evalu- ated evidence pertaining to supplemental patient anticoagulant therapy education, only the ASH guidelines make a graded suggestion in favor of this intervention. Limitations of these guidelines The limitations of these guidelines are inherent in the low or very low certainty in the evidence we identified for many of the questions. In addition, clinicians may encounter clinical questions that were not included among those prioritized by the panel. 