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Current Indications for Thrombophilia Testing - A Modified Delphi Consensus Study in Switzerland.

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Experts reached consensus on 32 clinical indications for thrombophilia testing. This aims to standardize testing for hereditary or acquired thrombophilia, reducing venous thromboembolism (VTE) risk and recurrence.

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Area of Science:

  • Hematology
  • Clinical Medicine
  • Medical Diagnostics

Background:

  • Thrombophilia, a condition increasing venous thromboembolism (VTE) risk, has inconsistent patient selection criteria for testing across guidelines.
  • This variability highlights uncertainty in routine thrombophilia testing strategies.
  • Establishing expert consensus is crucial for standardizing diagnostic approaches.

Purpose of the Study:

  • To establish expert consensus on clinical indications for thrombophilia testing in Switzerland.
  • To address the heterogeneity in current thrombophilia testing practices.
  • To provide guidance for consistent and evidence-based diagnostic decisions.

Main Methods:

  • A modified Delphi study involving 42 clinical experts managing VTE patients in Switzerland.
  • Two rounds of surveys presenting clinical scenarios and statements on thrombophilia testing.
  • Consensus defined as ≥70% agreement on a 7-point Likert scale (≥5).

Main Results:

  • Consensus was achieved on 32 statements covering various clinical scenarios for thrombophilia testing.
  • Key areas included unprovoked VTE, provoked VTE (hormone-associated), unusual site VTE, and pediatric VTE.
  • Specific recommendations support testing in patients <60 with unprovoked/unusual site VTE and women with hormone-associated VTE.

Conclusions:

  • The modified Delphi process successfully generated expert consensus on 32 thrombophilia testing indications.
  • These consensus statements can guide clinical decision-making and promote consistent testing practices.
  • The findings may inform future development of evidence-based guidelines for thrombophilia diagnostics.