Management of venous thromboembolic diseases and the role of thrombophilia testing: summary of NICE guidance

Venous thromboembolic diseases range from asymptomatic deep venous thrombosis (DVT) to fatal pulmonary embolism. Non-fatal venous thromboembolic diseases may also cause serious long term conditions such as post-thrombotic syndrome or chronic thromboembolic pulmonary hypertension. In the United Kingdom, pathways to diagnosis and to decisions on long term treatment or further investigation for thrombophilia and cancer vary, so guidance is needed in these areas. This article summarises the most recent recommendations from the National Institute for Health and Clinical Excellence (NICE) on the management of confirmed or suspected venous thromboembolic diseases in adults (excluding pregnant women).1 NICE recommendations are based on systematic reviews of best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on the Guideline Development Group’s experience and opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets. ### Diagnostic investigations for deep venous thrombosis