Optimal utilization of thrombophilia testing

The global incidence of venous thromboembolism is high so laboratory testing for hereditary thrombophilia and selected acquired thrombophilia is common. Given the costs associated with testing and multiple pre-analytic and analytic variables affecting the assays, careful patient selection and timing of testing and diligent application to patient management are critical to providing high-value clinical care. Collaboration between the ordering providers and performing laboratories has the potential to achieve these goals. Herein, utility of thrombophilia testing, variables that affect the assays, and impact on patient management are reviewed. Where available, information on cost-effectiveness is discussed.