Screening for thrombophilia

Dr Alfonso Iorio is a professor in the Division of Hematology and Thromboembolism, Division of General Internal Medicine, and Department of Health Research Methods, Evidence, and Impact at McMaster University.

Whom should we screen for thrombophilia?

Alfonso Iorio, MD, PhD: This is a million dollar question. I cannot answer it in a complete way and I am telling you the reason. The reason is that we are reviewing the evidence about thrombophilia screening as part of a guideline process for the American Society of Hematology. We are close to concluding the process, so stay tuned for new recommendations on indications to screen for thrombophilia.

A general concept I would like to make here is that we should screen only when knowing the result of the screening will affect our way of managing the patient, which to date has not been proven to be the case in any situation. The only case may be family members of a patient with thrombosis when they are young females going to undertake oral contraception, but only in a relative or family member with clots. Screening is currently done on a population basis and creates a problem, tension, and anxiety where it is not needed.