Generation and optimization of the self-administered bleeding assessment tool and its validation as a screening test for von Willebrand disease.
Generation and optimization of the self-administered bleeding assessment tool and its validation as a screening test for von Willebrand disease.
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自我管理的出血评估工具的生成和优化及其作为对von Willebrand疾病的筛查测试的验证。
DOI：
10.1111/hae.12747
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发表时间：
2015-09
期刊：
影响因子：
--
通讯作者：
James PD
中科院分区：
文献类型：
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作者：
Deforest M;Grabell J;Albert S;Young J;Tuttle A;Hopman WM;James PD
我们的目标是生成、优化和验证针对冯·维勒布兰德病 (VWD) 的自我管理出血评估工具 (BAT)。在第一阶段，专家管理的 ISTH-BAT 中的医学术语被转换为 4 级阅读水平，以产生 Self-BAT 的第一个版本，然后对其进行优化，以确保与 ISTH-BAT 一致。在第二阶段，确定出血评分的正常范围并分析重测可靠性。在第 3 阶段，优化的 Self-BAT 作为首次转诊到血液学诊所的筛查工具进行了测试。 Self-BAT 最终优化版本的 BS 在第 1 阶段中与 ISTH-BAT BS 表现出出色的组内相关系数 (ICC)，为 0.87。在第 2 阶段，优化的 Self-BAT 出血评分的正常范围确定为女性 0 至 +5，男性 0 至 +3，并且显示出出色的重测可靠性（ICC = 0.95）。在第3阶段，我们表明，阳性Self-BAT BS（女性≥6，男性≥4）对于VWD的敏感性为78％，特异性为23％，阳性预测值（PPV）为0.15，阴性预测值（NPV）为0.86；当仅分析雌性时，这些数字有所改善；敏感性为 100%，特异性为 21%，PPV=0.17，NPV=1.0。我们证明，优化的 Self-BAT 可以产生与专家管理的 ISTH-BAT 相当的 BS，并且是一种可靠、有效的筛查工具，可纳入对可能患有出血性疾病的个人（尤其是女性）的评估。
Our aim was to generate, optimize and validate a self-administered bleeding assessment tool (BAT) for von Willebrand disease (VWD). In Phase 1, medical terminology in the expert-administered ISTH-BAT was converted to a grade 4 reading level to produce the first version of the Self-BAT which was then optimized to ensure agreement with the ISTH-BAT. In Phase 2, the normal range of bleeding scores was determined and test-retest reliability analyzed. In Phase 3, the optimized Self-BAT was tested as a screening tool for first time referrals to the Hematology clinic. BS from the final optimized version of the Self-BAT showed an excellent intra-class correlation coefficient (ICC) of 0.87 with ISTH-BAT BS in Phase 1. In Phase 2, the normal range of bleeding scores for the optimized Self-BAT was determined to be 0 to +5 for females and 0 to +3 for males and excellent test-retest reliability was shown (ICC = 0.95). In Phase 3, we showed that a positive Self-BAT BS (≥ 6 for females, ≥ 4 for males) has a sensitivity of 78%, specificity of 23%, positive predictive value (PPV) of 0.15 and negative predictive value (NPV) of 0.86 for VWD; these figures improved when just the females were analyzed; sensitivity of 100%, specificity of 21%, PPV=0.17 and NPV=1.0. We show an optimized Self-BAT can generate comparable BS to the expert-administered ISTH-BAT and is a reliable, effective screening tool to incorporate into the assessment of individuals, particularly women, referred for a possible bleeding disorder.