Bleeding assessment tools in the diagnosis of VWD in adults and children: a systematic review and meta-analysis of test accuracy
| Autor: | James S. O’Donnell, Omar Abughanimeh, Osama Diab, Reem A. Mustafa, Aref Qureini, Claire McLintock, Robert R. Montgomery, Mohamad A. Kalot, Romina Brignardello-Petersen, Nedaa Husainat, Jorge Di Paola, Barbara Ameer, Bader Madoukh, Vicki Jacobs-Pratt, Nathan T. Connell, Jeroen Eikenboom, Abdallah El Alayli, Ahmad Bilal Dimassi, Paula D. James, Robert F. Sidonio, Veronica H. Flood, Sammy Tayiem |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Pediatrics medicine.medical_specialty MEDLINE Sensitivity and Specificity Cohort Studies Von Willebrand factor Bias hemic and lymphatic diseases Von Willebrand disease Medicine Humans Mass Screening Child biology business.industry Hematology medicine.disease Confidence interval Test (assessment) Pre- and post-test probability von Willebrand Diseases Meta-analysis biology.protein business Cohort study |
| Zdroj: | Blood Advances, 5(23), 5023-5031. ELSEVIER |
| ISSN: | 2473-9537 |
| Popis: | 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 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 the revised tool for the quality assessment of diagnostic accuracy studies and certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation 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, 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. |
| Databáze: | OpenAIRE |
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