bloodadvances.2021004368.pdf (965.88 kB)
Download file

Bleeding assessment tools in the diagnosis of von Willebrand disease: systematic review & meta-analysis of test accuracy.

Download (965.88 kB)
journal contribution
posted on 01.11.2021, 17:14 by Mohamad A Kalot, Nedaa Husainat, Sammy Tayiem, Abdallah El Alayli, Ahmad Bilal Dimassi, Osama Diab, Omar Abughanimeh, Bader Madoukh, Aref Qureini, Barbara Ameer, Jeroen CJ Eikenboom, Jorge Di Paola, Vicki Jacobs-Pratt, Claire McLintock, Robert R Montgomery, James O'DonnellJames O'Donnell, Robert Francis Sidonio, Romina Brignardello-Petersen, Veronica H Flood, Nathan T Connell, Paula D James, Reem A Mustafa

Background

Von Willebrand Disease (VWD) can be associated with significant morbidity. Patients with VWD can experience bruising, mucocutaneous bleeding, and bleeding after dental and surgical procedures. Early diagnosis and treatment are important to minimize the risk of these complications. Several bleeding assessment tools (BATs) have been used to quantify bleeding symptoms as a screening tool for VWD.

Objective

We systematically reviewed diagnostic test accuracy results of bleeding assessment tools (BATs) to screen patients for VWD.

Methods

We searched Cochrane Central, MEDLINE, and EMBASE for eligible studies, reference lists of relevant reviews, registered trials, and relevant conference proceedings. Two investigators screened and abstracted data. Risk of bias was assessed using QUADAS-2 and certainty of evidence using the GRADE framework. We pooled estimates of sensitivity and specificity.

Results

The review included 7 cohort studies that evaluated the use of BATs to screen adult and pediatric patients for VWD. The pooled estimates for sensitivity and specificity were 75% (95% confidence interval [CI] 66%-83%) and 54% (29%-77%), respectively. Certainty of evidence varied from moderate to high.

Conclusion

This systematic review provides accuracy estimates for validated BATs as a screening modality for VWD. A BAT is a useful initial screening test to determine who needs specific blood testing. The pretest probability of VWD (often determined by the clinical setting/patient population), along with sensitivity and specificity estimates will influence patient management

History

Comments

This research was originally published in Blood Advances. Mohamad A. Kalot, Nedaa Husainat, Sammy Tayiem, Abdallah El Alayli, Ahmad Bilal Dimassi, Osama Diab, Omar Abughanimeh, Bader Madoukh, Aref Qureini, Barbara Ameer, Jeroen C.J. Eikenboom, Jorge Di Paola, Vicki Jacobs-Pratt, Claire McLintock, Robert R Montgomery, James O'Donnell, Robert Francis Sidonio, Romina Brignardello-Petersen, Veronica H Flood, Nathan T. Connell, Paula D. James, Reem A. Mustafa; Bleeding assessment tools in the diagnosis of von willebrand disease: systematic review & meta-analysis of test accuracy. Blood Adv.:bloodadvances.2021004368. © the American Society of Hematology.

Published Citation

Kalot MA, et al. Bleeding assessment tools in the diagnosis of von Willebrand disease: systematic review & meta-analysis of test accuracy. Blood Adv. 2021:bloodadvances.2021004368.

Publication Date

1 Oct 2021

PubMed ID

34597385

Department/Unit

  • Irish Centre for Vascular Biology
  • School of Pharmacy and Biomolecular Sciences

Research Area

  • Vascular Biology

Publisher

American Society of Hematology

Version

  • Published Version (Version of Record)