scholarly journals Diagnostic challenges of inherited mild bleeding disorders: a bait for poorly explored clinical and basic research

2019 ◽  
Vol 17 (2) ◽  
pp. 257-270 ◽  
Author(s):  
D. Mezzano ◽  
T. Quiroga
Keyword(s):  
Basic Research ◽  
Bleeding Disorders ◽  
Mild Bleeding Disorders

scholarly journals Evaluation of a whole blood remote platelet function test for the diagnosis of mild bleeding disorders

2014 ◽  
Vol 12 (5) ◽  
pp. 660-665 ◽  
Author(s):  
N. Dovlatova ◽  
M. Lordkipanidzé ◽  
G. C. Lowe ◽  
B. Dawood ◽  
J. May ◽  
...  
Keyword(s):  
Platelet Function ◽  
Whole Blood ◽  
Bleeding Disorders ◽  
Platelet Function Test ◽  
Function Test ◽  
Mild Bleeding Disorders

Evaluation of mild bleeding disorders andeasy bruising

Blood Reviews ◽  
1994 ◽  
Vol 8 (2) ◽  
pp. 98-104 ◽  
Author(s):  
R SHAM ◽  
C FRANCIS
Keyword(s):  
Bleeding Disorders ◽  
Mild Bleeding Disorders

scholarly journals Mild bleeding disorders in adults

2021 ◽  
Vol 193 (10) ◽  
pp. E339-E339
Author(s):  
Dongmei Sun ◽  
Chai W. Phua
Keyword(s):  
Bleeding Disorders ◽  
Mild Bleeding Disorders

The Diagnostic Accuracy of Bleeding Assessment Tools for the Identification of Patients with Mild Bleeding Disorders: A Systematic Review

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4473-4473
Author(s):  
Floor CJI Moenen ◽  
Yvonne MC Henskens ◽  
Saskia AM Schols ◽  
Patty J Nelemans ◽  
Harry C. Schouten ◽  
...  
Keyword(s):  
High Risk ◽  
Diagnostic Accuracy ◽  
Patient Selection ◽  
Validation Studies ◽  
Bleeding Disorder ◽  
Risk Of Bias ◽  
Index Test ◽  
Bleeding Disorders ◽  
Reference Standard ◽  
Mild Bleeding Disorders

Abstract Introduction A study of diagnostic test accuracy compares a single index test to a gold standard to determine status of disease. The observed accuracy of a test varies among patient subgroups and is sensitive to bias. To achieve reliable estimates of diagnostic accuracy, an appropriate study design in a clinically relevant population is warranted. Recently a review was published about the evolution of the bleeding assessment tool (BAT) in diagnosing patients with mild bleeding disorders (MBD) (Rydz et al. J Thromb Haemost 2012). Many validation studies have been done. However, a critical appraisal addressing the quality of these validation studies is lacking. Objective We performed a systematic review to determine the quality and applicability of studies assessing the diagnostic utility of the BAT for MBD among clinic based cohorts. Methods The literature search was conducted using the electronic database PubMed. The final search date was March 2, 2015. The search terms: 'bleeding disorder OR bleeding tendency' AND 'bleeding questionnaire' were used. All studies assessing the diagnostic accuracy of bleeding questionnaires in identifying adults (age > 18 years) with MBD were considered eligible, irrespective of study design or used reference standard. The methodological quality and applicability of each included study was assessed using a Quality Assessment of Diagnostic studies-2 (QUADAS-2) tool. This tool consists of four domains specific for patient selection, index test, reference standard and participant flow. For each domain bias was assessed using signaling questions, for the first three domains applicability was assessed. Results The search yielded 530 citations, from which 35 possible relevant full-text studies were identified. Twenty-two studies were excluded, reasons for exclusion were: letter to the editor, validation of questionnaire combined with laboratory results and primary care population. Table 1 shows the 13 included studies, the assessed BAT and the targeted bleeding condition. Risk of bias and applicability concerns are summarized in figure 1. In 77% of the studies there was a high risk of bias for patient selection and applicability concerns. Many studies used a case control design, comparing patients with a known bleeding disorder with healthy controls. This leads to spectrum bias and might generate higher estimates of sensitivity and specificity (Rutjes et al. Clin Chem 2005). In 46% there was a high risk of bias for index test due to the use of a self-administered questionnaire or because the person conducting the questionnaire was aware of the diagnosis. This leads to observer bias caused by better awareness and over-reporting of bleeding symptoms. Finally, there was high risk of bias in study flow in 38% of the studies. These studies included symptoms after diagnosis of the bleeding disorder. Since bleeding disorders are managed by interventions to prevent bleeding, underestimation of the bleeding symptoms may occur. Conclusion This review highlights the difficulties and advantages of the BAT validation studies. It provides the ability for medical practitioners to apply the BAT with full awareness of its restrictions and benefits. With the evaluation of the risks of bias in the included studies we highlighted limitations, especially in method of patient selection and use of index test, that future studies preferably should try to avoid. Disclosures No relevant conflicts of interest to declare.

Haemostatic disorders in habitual nose-bleeders

1987 ◽  
Vol 101 (10) ◽  
pp. 1020-1028 ◽  
Author(s):  
Martin Beran ◽  
Lennart Stigendal ◽  
Björn Petruson
Keyword(s):  
Nasal Mucosa ◽  
Bleeding Disorders ◽  
Normal Range ◽  
Mild Bleeding Disorders

AbstractNinety-one habitual nose-bleeders were screened for haemostatic disorders. 46 screening results in 38 nose-bleeders were outside the normal range. After extended investigation, it was found that 25 (27 per cent) habitual nose-bleeders had haemostatic disorders, all except one in the primary haemostasis. The disorders found could be classified as mild bleeding disorders (MBD) and compared to the estimated frequency of MBD in the population there was an increased incidence of haemostatic disorders in the habitual nose-bleeders. Abnormal vessels in the nasal mucosa were present in 85 per cent of the investigated nose-bleeders, equaly distributed between nose-bleeders with and without haemostatic disorders. This indicates that abnormal vessels and haemostatic disorders occur independently of each other. When screening for haemostatic disorders in habitual nose-bleeders, it is possible to detect previously unknown but clinically important disorders.

Thromboelastometry as a diagnostic tool in mild bleeding disorders

2019 ◽  
Vol 36 (6) ◽  
pp. 457-465 ◽  
Author(s):  
Anna Wieland Greguare-Sander ◽  
Walter A. Wuillemin ◽  
Michael Nagler
Keyword(s):  
Diagnostic Tool ◽  
Bleeding Disorders ◽  
Mild Bleeding Disorders

scholarly journals Mild bleeding disorders: what every clinician should know

2017 ◽  
Vol 78 (12) ◽  
pp. 684-710
Author(s):  
HK Hussein ◽  
PLR Nicolson ◽  
K Fordwor ◽  
GC Lowe
Keyword(s):  
Bleeding Disorders ◽  
Mild Bleeding Disorders

scholarly journals Reference Ranges of Coagulation Parameters in Pregnancies of Healthy Women and Women with Mild Bleeding Disorders

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 5068-5068
Author(s):  
Susan Halimeh ◽  
Hannelore Rott ◽  
Ihsan Osseiran ◽  
Guenther Kappert ◽  
Manuela Siebert
Keyword(s):  
Pregnant Women ◽  
Coagulation Factor ◽  
Coagulation Factors ◽  
Reference Ranges ◽  
Bleeding Disorders ◽  
Coagulation Disorders ◽  
Coagulation Parameters ◽  
Healthy Women ◽  
Mild Bleeding Disorders ◽  
Research Grant

Abstract Introduction: It is well know that most of the coagulation factor increase during pregnancy in healthy women. Nevertheless the uninterrupted course of coagulation parameters from the beginning until the end of a pregnancy in healthy women has not been described yet. Only reference ranges for the third month and the sixth month of pregnancy are evaluated. There aren't any data available for the course of coagulation parameters during pregnancy in women with known coagulation disorders. In 2012 we started a study to investigate reference ranges during pregnancy for all coagulation factors, anticoagulants and activation markers of coagulation in 100 healthy pregnant women and 100 pregnant women with a previously known mild bleeding disorders. The study has been approved by the Ethics Committee Nordrhein. Samples and Methods: We analysed samples of pregnant women by conducting the following tests: Blood count, VWF:RCo, VWF:Ag, VWF:CB, Fibrinogen (Clauss), activities of FII, FV, FVII, FVIII (clotting and chromogenic), FIX, FX, FXI, FXII, FXIII. d-dimer, prothrombin fragment 1.2, Quick, partial thromboplastin time, plasma thrombin time , CRP, proteine S, proteine C, antithrombin, Lupus antigoaculant, ACA, ß2-GP in week 10, 16, 22, 28, 34, 40 and 6 weeks post partum (max. +/- 1) Interim Results: Currently 21 pregnant women were included in our study. 16 obviously healthy women were used to calculate the reference ranges for pregnancy. Because of strict inclusion and exclusion criteria (no previous spontaneous abortion, no previous placenta haematoma, no previous pre-eclampsia and only natural pregnancies) most of the women are in the group of the no known coagulation disorder so far. Discussion/Conclusion: There are signs that defects in the coagulation system can be associated to complications during pregnancy like child loss, intrauterine haematoma and genital bleeding. The evaluation of reference ranges helps to detect and to value coagulation disorders during pregnancy. It might be possible to explain the higher abortion rate in women with mild bleeding disorders by determination of reference values of all pro- and anticoagulants during pregnancy. If a treatment with coagulation factor concentrates can help to prevent miscarriage is still subject of ongoing studies. Determination of reference ranges for coagulation factors in the third trimenon might help to determine the peripartum bleeding risk of women with mild coagulation disorders and to help to decide whether a women needs coagulation factor concentrate during labour. Limitation: Based on the strict inclusion and exclusion criteria the number of patients is small. Disclosures Halimeh: Biotest: The authors declare that they receive research grant from Biotest AG Other. Rott:Biotest: The authors declare that they receive research grant from Biotest AG Other. Osseiran:Biotest: The authors declare that they receive research grant from Biotest AG Other. Kappert:Biotest: The authors declare that they receive research grant from Biotest AG Other. Siebert:Biotest: The authors declare that they receive research grant from Biotest AG Other.

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