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Effective screening of pathology tests controls costs: thrombophilia testing
  1. N O’Connor,
  2. R Carter-Johnson
  1. Department Haematology, Royal Shrewsbury Hospital, Mytton Oak Road, Shrewsbury SY6 6BY, UK; richard.pearce@rsh.nhs.uk

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    In patients aged less than 45 with a true idiopathic lower limb deep vein thrombosis (DVT), the chance of finding an inherited thrombophilia is less than 50%, but for pulmonary embolism this falls to less than 10%. The chances of finding a prothrombotic state are much lower if the patient is older or the DVT provoked. As detecting a prothrombotic state should not alter treatment decisions, some investigators have cautioned against undertaking these studies in patients with venous thromboembolism.1 Most UK haematologists agree that prothrombotic tests should be targeted at patients aged less than 50 with unexpected or recurrent venous thrombosis; and these tests are undertaken by most district haematology departments. However, the tests are expensive, with a thrombophilia screen …

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