Bleeding assessment tools in the diagnosis of von Willebrand disease: systematic review & meta-analysis of test accuracy.
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.
We systematically reviewed diagnostic test accuracy results of bleeding assessment tools (BATs) to screen patients for VWD.
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.
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.
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
CommentsThis 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 CitationKalot 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 Date1 Oct 2021
- Irish Centre for Vascular Biology
- School of Pharmacy and Biomolecular Sciences
- Vascular Biology
PublisherAmerican Society of Hematology
- Published Version (Version of Record)