Bibliography: Campbell et al,222 Pinede et al223 (DOTAVK), Agnelli (WODIT-PE Provoked and Unprovoked), Agnelli et al225 (WODIT-DVT), Couturaud et al60 (PADIS-PE), Siragusa et al226 (DACUS), Eischer et al227 (AUREC-FVIII) 330 Evidence-Based Medicine [ 1 4 9 # 2 C H E S T F E B R U A R Y 2 0 1 6 ] to use the same estimates for the reduction in recurrent VTE and the increase in bleeding with anticoagulation that we used in AT9, and that were based on VKA therapy. Our reasoning was: (1) VKA is still widely used for extended treatment of VTE; (2) we felt that there was not enough evidence of differences in ef cacy and bleeding during extended therapy to justify separate recommendations for NOACs, either as a group or as individual agents; and (3) our recommendations about whether or not to use extended therapy were not sensitive to assuming that there was a one-third reduction in bleeding with extended therapy compared with the estimated risk of bleeding with extended therapy that are shown in Table 11 and were used in AT9 (eg, with a NOAC compared with VKA)27,31,35,49 (the only recommendation to change would be a strong instead of a weak recommendation in favor of extended therapy in patients with a second unprovoked VTE who had a moderate risk of bleeding). Better Selection of Patients for Extended VTE Therapy: The most common and dif cult decision about whether to stop anticoagulants after a time- limited course or to use extended therapy is in patients with a rst unprovoked proximal DVT or PE without a high risk of bleeding. 