Choosing Wisely:

Don’t do workup for clotting disorder (order hyper-coagulable testing) for patients who develop first episode of deep vein thrombosis (DVT) in the setting of a known cause.

Rationale and Comments: Lab tests to look for a clotting disorder will not alter treatment of a venous blood clot, even if an abnormality is found. DVT is a very common disorder, and recent discoveries of clotting abnormalities have led to increased testing without proven benefit.
Sponsoring Organizations:
  • Society for Vascular Medicine
  • Sources:
  • Prospective cohort studies
  • Disciplines:
  • Hematologic
  • References: • Dalen JE. Should patients with venous thromboembolism be screened for thrombophilia? Am J Med. 2008;121(6):458-63.
    • Baglin T, et al. Incidence of recurrent venous thromboembo-lism in relation to clinical and thrombophilic risk factors: prospective cohort study. Lancet. 2003;362:523-6.
    • Ho WK, et al. Risk of recurrent venous thromboembolism in patients with common thrombophilia. Arch Intern Med. 2006;166:729-36.
    • Baglin T, et al. Clinical guidelines for testing for heritable thrombophilia. Br J Haematol. 2010;149:209-20.

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