Letters

Family history and risk of venous thromboembolism with oral contraception

BMJ 2001; 323 doi: http://dx.doi.org/10.1136/bmj.323.7315.752 (Published 29 September 2001) Cite this as: BMJ 2001;323:752

Family history is important tool

  1. Jan P Vandenbroucke ([email protected]), professor of clinical epidemiology,
  2. Felix J M van der Meer, physician,
  3. Frans M Helmerhorst, senior lecturer,
  4. Frits R Rosendaal, professor
  1. Department of Clinical Epidemiology
  2. Haemostasis and Thrombosis Centre
  3. Department of Obstetrics and Gynaecology
  4. Department of Clinical Epidemiology and Department of Obstetrics and Gynaecology, Leiden University Medical Center, 2300 RC Leiden, Netherlands
  5. Cardiovascular Department, Division of Angiology, Unità Ricerca Clinica sulla Trombofilia “M Golinelli”, University Hospital, S Orsola-Malpighi, 40138, Bologna, Italy

    EDITOR—Cosmi et al in their article claim that family history has poor diagnostic test qualities to detect prothrombotic mutations.1 They also indicate that overall population screening is not cost effective. Although it always was obvious that family history would never make a perfect test (of families with many cases of venous thrombosis, up to 40 or 50% have factor V Leiden2), the finding of an equal predictive value for a positive and a negative family history by Cosmi et al is surprising and might be due to the small numbers included or the type of history that was considered “positive.”

    Even if family history is far from perfect as a diagnostic test for one or two mutations, the question is whether one should refrain from using it. …

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