Method:
A case‐based survey was developed by the authors targeting the four
management areas of interest (e.g., the use of the thrombophilia
testing, the approach of treatment (anticoagulation vs. observation),
duration of treatment, and the use of secondary prophylaxis). The survey
was piloted in the primary author’s institution and developed based on
respondent feedback. The final survey was posted twice (January 15,
2020, and February 15, 2020) on the Saudi Arabian Pediatric
Hematology/Oncology Society (SAPHOS) clinical forum/email database. The
survey included three demographic questions: the number of years in
practice, patient population, and an annual number of thrombosis
patients at the respondent’s center. Case scenarios with asymptomatic
CVC‐related thrombosis were utilized. Case management questions included
the use of thrombophilia testing, treatment approach, duration of
treatment, and secondary prophylaxis with subsequent CVC placement for a
4-year-old male who is admitted for a septic shock from a lung
infection. A CVC is placed, and he develops an asymptomatic CVC-related
thrombosis in his right subclavian vein found incidentally while
performing an ultrasound (US) to evaluate large neck lymph nodes. This
is his first thrombotic event, and there is no family history of
thrombosis. A week later, a repeat US demonstrates clot resolution. The
same CVC remains in place. Six months later, he is admitted to the
intensive care unit with a severe trauma injury from motor vehicle
accident requiring placement of a new CVC.
Study data were collected and managed using REDCap electronic data
capture tools15,16.