This recommendation does not apply to patients requiring VKA therapy for indications in addition to VTE (eg, mechanical heart valves). The panel identified the following additional research priority: sufficiently powered RCTs comparing LMWH/UFH bridging vs VKA interruption alone in VTE patients at high recurrent VTE risk undergoing an invasive procedure. Question: For patients interrupting DOAC therapy for scheduled invasive procedures, should performing laboratory testing for DOAC anticoagulant effect be used vs interrupting DOAC therapy alone? For patients interrupting DOAC therapy for scheduled invasive procedures, the ASH guideline panel suggests against per- forming laboratory testing for DOAC anticoagulant effect prior to procedures (conditional recommendation based on very low certainty in the evidence about effects ). Summary of the evidence. We found no systematic reviews but did identify 5 individual studies that included patients receiving DOAC therapy, mostly for atrial fibrillation, who required temporary interruption of anticoagulation for an invasive No studies directly compared outcomes for patients interrupting DOAC therapy for invasive procedures in which laboratory testing to assess DOAC anticoagulant effect was and was not performed prior to the procedure; thus, intervention and control studies represent different populations. Event rates for the intervention groups171,172,174 came from different studies than the event rate for the control groups.170,173 Three studies reported mortality outcomes,170,171,174 and 5 studies reported development of any thromboembolism and major bleeding.170-174 No studies reported quality of life or delays in procedure outcomes. The EtD framework is shown online at https://dbep.gradepro.org/ profile/ee27563e-0db8-464d-ae48-0e72bec3da3b. Benefits. For benefits, see the evidence profile in the EtD framework referenced at the end of the previous section, available online. 