Quality statement 6: Thrombophilia testing

Quality statement

People with provoked deep vein thrombosis or pulmonary embolism are not offered testing for thrombophilia.

Rationale

Thrombophilia testing does not provide benefit and is unnecessary for people with provoked deep vein thrombosis (DVT) or pulmonary embolism (PE).

Quality measure

Structure: Evidence of local arrangements to ensure people with provoked DVT or PE do not have testing for thrombophilia.

Process: The proportion of people with provoked DVT or PE who are tested for thrombophilia.

Numerator – the number of people in the denominator who receive testing for thrombophilia.

Denominator – the number of people with provoked DVT or PE.

What the quality statement means for each audience

Service providers ensure systems are in place to ensure that people with provoked DVT or PE are not tested for thrombophilia.

Healthcare professionals ensure people with provoked DVT or PE are not tested for thrombophilia.

Commissioners ensure they commission services that do not carry out testing for thrombophilia in people with provoked DVT or PE.

People who have had a provoked (with an obvious cause) deep vein thrombosis or pulmonary embolism are not offered tests forthrombophilia (a condition that makes the blood more likely to form clots).

Source guidance

NICE guideline CG144 recommendation 1.6.4.

Data source

Structure: Local data collection.

Process: Local data collection. Contained within NICE guideline CG144 clinical audit tools (thrombophilia testing), standard 2.

Definition

Provoked DVT or PE is defined as DVT or PE that occurred in the presence of an antecedent (within 3 months) and transient major clinical risk factor for VTE (for example surgery, trauma or significant immobility). The NICE Guideline Development Group also considered VTE that occurs in association with hormonal therapy (oral contraceptive or hormone replacement therapy) to be provoked because it has been shown that people having these therapies have a lower risk of VTE recurrence.