Comparisons of the ASH thrombophilia panel’s recommendations with the recommendations based on decision modeling
| (R) numbers . | Populations . | ASH Considered strategies (after 3-6 mo of treatment) . | ASH panel recommendations . | Recommendations based on decision model with all 3 strategies . |
|---|---|---|---|---|
| R1 | Unprovoked VTE | Test vs treat all | Do not test for thrombophilia; recommend indefinite anticoagulant treatment to all patients | Do not test for thrombophilia; recommend indefinite anticoagulation (regardless of assumed bleeding risk) |
| R2 | VTE provoked by surgery | Test vs treat none | Do not test for thrombophilia; recommend discontinuing anticoagulant treatment | Do not test for thrombophilia; recommend extended anticoagulation (low bleeding risk) Do not test for thrombophilia; discontinue anticoagulant treatment (high bleeding risk) |
| R3 | VTE provoked by nonsurgical major transient risk factor | Test vs treat none | Test for thrombophilia; recommend indefinite anticoagulant treatment for patients with thrombophilia with stopping anticoagulant treatment for patients without thrombophilia | Do not test for thrombophilia; recommend indefinite anticoagulation (regardless of assumed bleeding risk) |
| R4 | VTE provoked by pregnancy or postpartum | Test vs treat none | Test for thrombophilia; recommend indefinite anticoagulant treatment for patients with thrombophilia with stopping anticoagulant treatment for patients without thrombophilia | Do not test for thrombophilia; recommend indefinite anticoagulation (regardless of assumed bleeding risk) |
| R5 | VTE associated with use of COC | Test vs treat none | Test for thrombophilia; recommend indefinite anticoagulant treatment for patients with thrombophilia with stopping anticoagulant treatment for patients without thrombophilia | Do not test for thrombophilia; recommend indefinite anticoagulation (regardless of assumed bleeding risk) |
| R6 | An unspecified type of VTE (ie, not specified as provoked or unprovoked VTE) | Test vs treat all | Do not test for thrombophilia; recommend indefinite anticoagulant treatment to all patients | Do not test for thrombophilia; recommend indefinite anticoagulation (regardless of assumed bleeding risk) |
| (R) numbers . | Populations . | ASH Considered strategies (after 3-6 mo of treatment) . | ASH panel recommendations . | Recommendations based on decision model with all 3 strategies . |
|---|---|---|---|---|
| R1 | Unprovoked VTE | Test vs treat all | Do not test for thrombophilia; recommend indefinite anticoagulant treatment to all patients | Do not test for thrombophilia; recommend indefinite anticoagulation (regardless of assumed bleeding risk) |
| R2 | VTE provoked by surgery | Test vs treat none | Do not test for thrombophilia; recommend discontinuing anticoagulant treatment | Do not test for thrombophilia; recommend extended anticoagulation (low bleeding risk) Do not test for thrombophilia; discontinue anticoagulant treatment (high bleeding risk) |
| R3 | VTE provoked by nonsurgical major transient risk factor | Test vs treat none | Test for thrombophilia; recommend indefinite anticoagulant treatment for patients with thrombophilia with stopping anticoagulant treatment for patients without thrombophilia | Do not test for thrombophilia; recommend indefinite anticoagulation (regardless of assumed bleeding risk) |
| R4 | VTE provoked by pregnancy or postpartum | Test vs treat none | Test for thrombophilia; recommend indefinite anticoagulant treatment for patients with thrombophilia with stopping anticoagulant treatment for patients without thrombophilia | Do not test for thrombophilia; recommend indefinite anticoagulation (regardless of assumed bleeding risk) |
| R5 | VTE associated with use of COC | Test vs treat none | Test for thrombophilia; recommend indefinite anticoagulant treatment for patients with thrombophilia with stopping anticoagulant treatment for patients without thrombophilia | Do not test for thrombophilia; recommend indefinite anticoagulation (regardless of assumed bleeding risk) |
| R6 | An unspecified type of VTE (ie, not specified as provoked or unprovoked VTE) | Test vs treat all | Do not test for thrombophilia; recommend indefinite anticoagulant treatment to all patients | Do not test for thrombophilia; recommend indefinite anticoagulation (regardless of assumed bleeding risk) |