An Electronic Best Practice Alert Based on Choosing Wisely Guidelines Reduces Thrombophilia Testing in the Outpatient Setting
Thrombophilia testing in the setting of acute venous thromboembolism (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE), is often inappropriate. Interpretation of many of the biochemical thrombophilia assays is confounded by anticoagulation or acute thrombus, and thrombophilia testing rarely affects immediate clinical decision-making.1, 2, 3
In an effort to curtail inappropriate thrombophilia testing, the American Society of Hematology (ASH) has issued Choosing Wisely guidelines recommending against thrombophilia testing in patients with VTE in the setting of major transient risk factors (surgery, trauma, and immobility).4 We evaluated the effect of a “Choosing Wisely” best practice alert (BPA) embedded into the electronic medical record (EMR) on thrombophilia testing patterns.
This before-and-after study involved patients with a diagnosis of VTE seen at our center between January 1, 2016 and April 30, 2017. The study was approved by the...
KEY WORDSthrombophilia best practice alert venous thromboembolism
We gratefully acknowledge Mehran Teymourtash, Melissa Meixsell, and Anibal Perez, RN, for their assistance with data acquisition for this study.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they do not have a conflict of interest.
- 4.American Society of Hematology | Choosing Wisely. http://www.choosingwisely.org/societies/american-society-of-hematology/. Accessed January 27, 2017.