von Willebrand factor levels in the diagnosis of von Willebrand disease: a systematic review and meta-analysis
| Autor: | Aref Qureini, Claire McLintock, Osama Diab, Abdallah El Alayli, Veronica H. Flood, Barbara Ameer, Mohamad A. Kalot, Robert F. Sidonio, Bader Madoukh, Reem A. Mustafa, Ahmad Bilal Dimassi, Jeroen Eikenboom, James S. O’Donnell, Omar Abughanimeh, Nikole Scappe, Nicolas Giraud, Nathan T. Connell, Simon McRae, Nedaa Husainat, Romina Brignardello-Petersen, Sammy Tayiem, Robert R. Montgomery, Paula D. James |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
congenital hereditary and neonatal diseases and abnormalities Hemorrhage Disease Health benefits Oral cavity bleeding Gastroenterology von Willebrand Disease Type 1 Continuous variable Von Willebrand factor Internal medicine hemic and lymphatic diseases von Willebrand Factor medicine Von Willebrand disease Humans In patient biology business.industry Hematology medicine.disease von Willebrand Diseases Meta-analysis biology.protein Systematic Review Blood Coagulation Tests business circulatory and respiratory physiology |
| Zdroj: | Blood Advances, 6(1), 62-71. ELSEVIER Blood Advances |
| Popis: | Von Willebrand Disease (VWD) is associated with significant morbidity as a result of excessive mucocutaneous bleeding symptoms. Patients with VWD can experience easy bruising, epistaxis, gastrointestinal and oral cavity bleeding, as well as heavy menstrual bleeding and bleeding after dental work, surgical procedures, and childbirth. Early diagnosis and treatment is important to prevent and treat these symptoms. We systematically reviewed the accuracy of diagnostic tests using different cut-off values of VWF:Ag and platelet-dependent VWF activity assays in the diagnosis of VWD. We searched Cochrane Central, MEDLINE, and EMBASE for eligible studies. 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 and reported patient important outcomes when relevant. This review included 21 studies that evaluated VWD diagnosis, including the approach to patients with VWF levels that have normalized with age (6 studies), VWF cut-off levels for the diagnosis of Type 1 VWD (9 studies), and platelet-dependent VWF activity/VWF:Ag ratio cut-off levels for the diagnosis of Type 2 VWD (6 studies). The results showed low certainty in the evidence for a net health benefit from reconsidering the diagnosis of VWD versus simply removing the disease in patients with VWF levels that have normalized with age. For the diagnosis of Type 1 VWD, in patients with VWF:Ag |
| Databáze: | OpenAIRE |
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