Defining indications for thrombophilia testing – a modified Delphi consensus study in Switzerland

Introduction Thrombophilia is a hereditary or acquired condition associated with an increased risk of venous thromboembolic events (VTE) and VTE-recurrence. The clinical relevance of thrombophilia testing remains uncertain, and existing recommendations regarding patient selection for testing are inconsistent. This has resulted in considerable variability of thrombophilia testing in clinical practice nationally and internationally. This Delphi survey was conducted to establish expert consensus on thrombophilia testing in Switzerland. Method A modified Delphi study was performed with clinical experts managing VTE-patients in Switzerland. A steering committee developed clinical scenarios and statements on thrombophilia testing. These were distributed to the expert panel who rated their agreement and provided written feedback. Consensus was defined as≥70% of experts rating a statement≥5 on a 7-point Likert scale [ 1 ] [ 2 ] [ 3 ] [ 4 ]. Results Forty-two clinical experts completed the survey. Consensus was reached after two rounds on 32 statements covering indications such as unprovoked VTE, provoked VTE (incl. hormonal risk factors), unusual site VTE, paediatric VTE, and patients without VTE. [ Fig. 1 ] shows an overview of the modified Delphi process. Strong consensus supported thrombophilia testing in patients