American Society of Hematology 2023 Guidelines for Management of Venous Thromboembolism: Thrombophilia Testing.

The panel issued a strong recommendation against testing the general population before starting combined oral contraceptives (COC), and conditional recommendations for thrombophilia testing in the following scenarios: a) patients with VTE associated with non-surgical major transient or hormonal risk factors; b) patients with cerebral or splanchnic venous thrombosis, in settings where anticoagulation would otherwise be discontinued; c) individuals with a family history of antithrombin, protein C or protein S deficiency when considering thromboprophylaxis for minor provoking risk factors, and for guidance to avoid COC/HRT; d) pregnant women with a family history of high-risk thrombophilia types; e) patients with cancer at low or intermediate risk of thrombosis and with a family history of VTE. For all other questions, the panel provided conditional recommendations against testing for thrombophilia.