Medical knowledge regarding thrombophilia screening: a descriptive questionnaire-based study
DOI:
https://doi.org/10.17267/2594-7907ijeh.2026.e6515Keywords:
Thrombophilia, Venous Thrombosis, Medical Education, Evidence-Based Practice, Continuing Medical EducationAbstract
INTRODUCTION: The management of venous thromboembolism has undergone significant changes in recent years and remains an area with relatively limited evidence, involving multiple medical specialties. Consequently, variability in clinical practice is expected and may occasionally lead to adverse outcomes, potentially reflecting gaps in medical education. OBJECTIVES: To assess physicians’ knowledge regarding thrombophilia screening and to provide participants with updated evidence on the topic. MATERIALS AND METHODS: This descriptive study was conducted using an online questionnaire consisting of four identification questions and five clinical case scenarios. Participants were asked to indicate whether thrombophilia investigation was warranted in each scenario. Responses were classified according to current scientific evidence. RESULTS: A total of 29 responses were collected from physicians who graduated between 1976 and 2024. Among them, 17 were from clinical specialties and 12 were general practitioners or from surgical specialties. In Case 1 (patient with elevated body mass index), 75% of physicians did not recommend screening, consistent with current evidence. In Case 2 (patient with relevant family history), 89.2% recommended screening. In Case 3 (pregnant patient with previous miscarriages), 92.3% recommended testing, contrary to robust evidence. Cases 4 and 5 showed greater concordance with current guidelines. Specialties such as gynecology, rheumatology, nephrology, and oncology demonstrated lower accuracy rates. CONCLUSION: Significant discrepancies were observed between evidence-based recommendations and clinical practice regarding thrombophilia screening. These findings may reflect gaps in medical education and uncertainty in the management of complex clinical scenarios. The results highlight the importance of continuing medical education to improve adherence to evidence-based practices, avoid unnecessary healthcare costs, and uphold the principles of quaternary prevention.
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1. Blann AD, Lip GYH. Venous thromboembolism. BMJ. 2006;332(7535):215-9. https://doi.org/10.1136/bmj.332.7535.21
2. Christiansen SC, Cannegieter SC, Koster T, Vandenbroucke JP, Rosendaal FR. Thrombophilia, clinical factors, and recurrent venous thrombotic events. JAMA. 2005;293(19):2352-61. https://doi.org/10.1001/jama.293.19.2352
3. Lijfering WM, Brouwer JL, Veeger NJ, Bank I, Coppens M, Middeldorp S, et al. Selective testing for thrombophilia in patients with first venous thrombosis: results from a retrospective family cohort study on absolute thrombotic risk for currently known thrombophilic defects in 2479 relatives. Blood. 2009;113(21):5314-22. https://doi.org/10.1182/blood-2008-10-184879
4. Albricker ACL, Freire CMV, Santos SN, Alcantara ML, Saleh MH, Cantisano AL, et al. Diretriz Conjunta sobre Tromboembolismo Venoso – 2022. Arq Bras Cardiol. 2022;118(4):797-857. https://doi.org/10.36660/abc.20220213
5. Middeldorp S, Nieuwlaat R, Kreuziger LB, Coppens M, Houghton D, James AH, et al. American Society of Hematology 2023 guidelines for management of venous thromboembolism: thrombophilia testing. Blood Adv. 2023;7(22):7101-38. https://doi.org/10.1182/bloodadvances.2023010177
6. Ribeiro DD, Lijfering WM, Barreto SM, Rosendaal FR, Rezende SM. Epidemiology of recurrent venous thrombosis. Braz J Med Biol Res. 2011;45(1):1-7. https://doi.org/10.1590/S0100-879X2011007500166
7. Ministério da Saúde (Brasil). Portaria GM nº 3721, de 23 de dezembro de 2020. Inclui procedimentos na Tabela de Procedimentos, Medicamentos, Órteses, Próteses e Materiais Especiais do Sistema Único de Saúde - SUS. [Internet]. Diário Oficial da União. 2020 dez. 23. Disponível em: http://bvsms.saude.gov.br/bvs/saudelegis/gm/2020/prt3721_23_12_2020.html
8. Moore GW. Thrombophilia screening: not so straightforward. Semin Thromb Hemost. 2024;50(8):1131-52. https://doi.org/10.1055/s-0044-1786807
9. Shen YM, Tsai J, Taiwo E, Gavva C, Yates SG, Patel V, et al. Analysis of thrombophilia test ordering practices at an academic center: a proposal for appropriate testing to reduce harm and cost. PLoS One. 2016;11(5):e0155326. https://doi.org/10.1371/journal.pone.0155326
10. Anderson Z, Ahsan M, Aguirre C, Ramirez M, Plowman K. Inpatient thrombophilia workup; does hematology consult prevent unnecessary testing? J Investig Med. 2024;72(4):392-5. https://doi.org/10.1177/10815589241235663
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Copyright (c) 2026 Eliza Freitas Evangelista, Vitor Augusto Queiroz Mauad
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International License.
