© 2001 Journal of Clinical Pathology
Correspondence
Thrombophilia testing: science or medicine?
Department of Haematology, Addenbrook's NHS Trust, Cambridge, CB2 2QQ, UK tpb20@cam.ac.uk
Dr Murphy1 supports a more discriminate approach to thrombophilia testing than I describe in my own practice2 and points out that my opinion is at variance with British Committee for Standards in Haematology (BCSH) guidelines. In respect of the latter, these guidelines were not evidence based and were published 10 years ago. Dr Murphy identifies the main indications for thrombophilia testing from the guidelines as: (1) patients with venous thromboembolism before the age of 45 years, (2) recurrent venous thrombosis or thrombophlebitis, (3) thrombosis in an unusual site, and (4) a first venous thromboembolic event with a clear history of venous thrombosis. Applying current criteria for graded recommendations on levels of evidence these indications would be classified as grade C based on level IV evidence.3 The haemostasis and thrombosis task force for the BCSH is currently preparing an updated guideline on the investigation and management of heritable thrombophilia. This guideline
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