Venous thromboembolism
Our clinical research group focuses on venous thromboembolism (deep vein thrombosis and pulmonary embolism) with the aim at:
1) developing diagnostic strategies in suspected deep vein thrombosis or pulmonary embolism, from decision analysis models to outcome studies and cost-effectiveness analyses ;
2) studying new antithrombotic compounds for prevention and treatment of venous thromboembolism ;
3) and at organizing and/or steering international co-operative clinical studies in this field.
Practically, during the past fifteen years, our group has significantly contributed to the introduction and validation of sequential diagnostic strategies in clinically suspected deep vein thrombosis or pulmonary embolism. These strategies resort to the initial dosage of a plasma component (fibrin D-dimer , a specific degradation product of crosslinked fibrin) that has a high sensitivity to the presence of venous thromboembolism. If positive, this dosage is followed by more specific tests such as venous compression ultrasonography, ventilation-perfusion lung scintigraphy or helical computed tomography. Rational combination of these tests allowed to diminish the number of traditional, invasive procedures like phlebography or pulmonary angiography. In addition, patient work-up may be stratified by using prior clinical probability of having the disease. Tools in order to assess clinical probability were intensively studied in Geneva. Finally, the favorable impact of these strategies has been studied in formal cost-effectiveness analyses.
The participation of our group to multinational multicenter studies on prevention and treatment of venous thromboembolism allowed our patients to get earlier access to new promising therapies.