title: A study of thrombophilia testing and counseling practices of family physicians using the script concordance method in Calgary, Canada.
abstract: BACKGROUND
  Thrombophilia testing helps to identify populations at risk of venous thromboembolism, but motivations for testing individuals are frequently unclear.
  
  
  OBJECTIVE
  Our goals were to assess the motivations for thrombophilia testing among family physicians (FPs) to determine whether testing was congruent with expert opinion, and to study counseling practices.
  
  
  METHODS
  The FPs and experts completed a survey involving hypothetical thrombophilia patients. Responses between groups were compared using the script concordance method.
  
  
  RESULTS
  The FPs referred 35.9% of cases. Of the five scenarios, two resulted in disagreement regarding appropriateness of testing (P ≤ .037). The FPs were more likely to test male, obese, or pediatric patients, patients with a family history of myocardial infarction or infertility, and patients with a recent event (P ≤ .043). The FPs were more likely to counsel patients after testing (P ≤ .016).
  
  
  CONCLUSIONS
  Disagreement exists between physician groups about the utility of thrombophilia testing. Self-reported lack of pretest counseling among FPs warrants further study.
authors.affiliation: Departments of Medicine, University of Calgary, Calgary, Alberta, Canada. n.schneider12@gmail.com
authors.forename: N
authors.initials: N
authors.lastname: Schneider-MacRae
authors.forename: S C
authors.initials: SC
authors.lastname: Jackson
authors.forename: K A
authors.initials: KA
authors.lastname: Valentine
authors.forename: J
authors.initials: J
authors.lastname: Lockyer
authors.forename: M-C
authors.initials: MC
authors.lastname: Poon
mesh_terms: D000367:Age Factors; D000416:Alberta; D003625:Data Collection; D005260:Female; D006801:Humans; D007246:Infertility / Q000150:complications / Q000175:diagnosis; D008297:Male; D009765:Obesity / Q000150:complications / Q000175:diagnosis; D010820:Physicians; D012307:Risk Factors; D012737:Sex Factors; D019851:Thrombophilia / Q000150:complications / Q000175:diagnosis*; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000209:etiology