Table 4.

The double-edged sword of thrombophilia testing

Reasons to test for inherited thrombophilia	Reasons not to test for inherited thrombophilia
To decide on preventive measures in case of a positive test result; eg,	Decisions on preventive measures will not be modified on the basis of the test result
Not to take oral contraceptives	Patients with a negative test result are being falsely reassured
To use anticoagulant prophylaxis in high-risk situations; eg, pregnancy, after minor surgical procedures (arthroscopy)	Patients with a positive result will be harmed as a result of preventive measures taken (eg, bleeding associated with anticoagulation, unwanted pregnancies resulting from suboptimal contraceptive measures)
To have an explanation for the disease	High number to test to identify 1 individual with thrombophilia
Patient’s request (eg, the patient feels thoroughly investigated, well taken care of)	Very high number to test to avoid 1 episode of VTE
The physician thinks it can show his or her expert skills	High costs
	Pitfalls in laboratory diagnosis
	Psychological and social effects; eg, issues with acquiring life insurances