The study by Le Gal et al. [1] published in this issue of European Journal of Internal Medicine, offers the starting point for a series of remarks on the prophylaxis of venous thromboembolism (VTE) in medical patients in contemporary times. It should be stated these are data deriving from an administrative database and this always raises some doubts about reliability but it should also be anticipated that databases of the size of the Optum Market Clarity Research Database today also boast representativeness and accuracy requirements being anything but negligible and their use by expert clinicians, as in this specific case, with the support of algorithms carefully calibrated for endpoint identification, offers guarantees.