An audit of thrombophilia screens: results from the National Pathology Alliance benchmarking review.
OBJECTIVE
The National Pathology Alliance benchmarking review has completed six years of data collection and analysis of the workload and organisation of haematology laboratories in the UK. This study audits national practice of routine thrombophilia screening against the current standards, as set out in the British committee for standards in haematology (BCSH) guidelines on investigation of heritable thrombophilia.


METHODS
Each laboratory completed a standard data collection questionnaire about the number of routine thrombophilia assays performed each year. Information was collected on which thrombophilia tests were performed as part of a routine thrombophilia screen. These results were then compared against the BCSH guidelines on investigation of heritable thrombophilia.


RESULTS
Of the 57 National Health Service trusts that submitted data for review in 2002/2003, 47 performed a routine thrombophilia screen. Ten laboratories complied with the guidelines but 37 laboratories did not.


CONCLUSIONS
There was variation in practice in the tests used in routine thrombophilia screens. There is evidence that some laboratories deviate from what may be regarded as "evidence based practice". The lack of compliance with the guidelines was in general associated with the performance of additional tests not recommended in the guideline. In a minority of laboratories, a clinically significant diagnosis would be missed by the failure to include one or more tests in a thrombophilia screen.
Lyons
S
S
Department of Clinical and Laboratory Haematology, Sunderland Royal Hospital, Kayll Road, Sunderland SR4 7TP, UK.
Galloway
M J
MJ
Osgerby
J
J
Hanley
J
J
D019985:Benchmarking; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006403:Hematologic Tests / Q000379:methods / Q000592:standards; D006801:Humans; D007753:Laboratories / Q000592:standards; D008403:Mass Screening / Q000379:methods / Q000592:standards; D008485:Medical Audit; D017410:Practice Guidelines as Topic; D013222:State Medicine / Q000592:standards; D019851:Thrombophilia / Q000175:diagnosis* / Q000235:genetics; D006113:United Kingdom