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CC BY 4.0 · TH Open 2019; 03(04): e350-e355
DOI: 10.1055/s-0039-3400483
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Reliability and Feasibility of the Self-Administered ISTH-Bleeding Assessment Tool

Marieke C. Punt
1   Van Creveldkliniek, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
,
Maaike W. Blaauwgeers
1   Van Creveldkliniek, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
,
Merel A. Timmer
1   Van Creveldkliniek, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
,
Paco M.J. Welsing
2   Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
,
Roger E.G. Schutgens
1   Van Creveldkliniek, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
,
Karin P.M. van Galen
1   Van Creveldkliniek, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
› Author Affiliations
Further Information

Publication History

09 August 2019

11 October 2019

Publication Date:
29 November 2019 (online)

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Abstract

Introduction Standardized bleeding assessment tools (BATs), such as the International Society for Thrombosis and Hemostasis (ISTH)-BAT, are screening instruments used during the diagnostic workup of suspected bleeding disorders. A self-administered ISTH-BAT (self-BAT) would enhance screening and save time during an outpatient clinic visit.

Aim This study was aimed to investigate the reliability and feasibility of the self-BAT.

Methods The electronic self-BAT was created from the ISTH-BAT and paper-version of self-BAT and optimized by patients and physicians. Patients with a (suspected) congenital platelet defect (CPD), who had previously undergone physician-administered ISTH-BAT assessment, were invited to complete the self-BAT. Optimal self-BAT cut-off values to detect a bleeding tendency, as defined by the ISTH-BAT, were evaluated by receiver operator characteristic (ROC) curve analysis to reach a sensitivity ≥95%. Reliability was tested by assessing sensitivity, specificity, and intraclass correlation (ICC). Feasibility was evaluated on comprehension and length of self-BAT.

Results Both versions of the BAT were completed by 156 patients. Optimal cut-off values for self-BAT to define a bleeding tendency were found to be identical to those of the ISTH-BAT. Normal/abnormal scores of the ISTH-BAT and self-BAT were agreed in 88.5% (138/156, 95% confidence interval [CI]: 0.83–0.93) of patients. The sensitivity and specificity of the self-BAT to detect a bleeding tendency were 96.9 and 48.1%, respectively. The ICC was 0.73. Self-BAT questions were graded by 96.8% (151/156) as “very easy,” “easy,” and “satisfactory” and questionnaire length as “exactly right” by 91% (142/156) of patients.

Conclusion In patients with a (suspected) CPD, the self-BAT is sufficiently reliable and feasible to detect a bleeding tendency, which supports its use as a screening tool.

Keywords

self-BAT - ISTH-BAT - bleeding tendency - congenital platelet defects

Supplementary Material

 

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