Key result
The self-administered ISTH-BAT demonstrated 88.5% agreement (95% CI 0.83-0.93) with the physician-administered version, with 96.9% sensitivity for detecting a bleeding tendency.
Why the study?
A self-administered ISTH-BAT could enhance screening and save time during outpatient clinic visits, but its reliability and feasibility needed investigation.
Does the self-administered ISTH-BAT reliably and feasibly detect a bleeding tendency compared to the physician-administered ISTH-BAT in patients with suspected congenital platelet defects?
Cross-Sectional (n=156)
Does the self-administered ISTH-BAT reliably and feasibly detect a bleeding tendency compared to the physician-administered ISTH-BAT in patients with suspected congenital platelet defects?
The self-administered ISTH-BAT is a reliable and feasible screening tool for detecting bleeding tendencies in patients with suspected congenital platelet defects, potentially saving time in outpatient clinics.
Self-BAT shows acceptable reliability for bleeding screening in suspected CPD; leaves open need for validation in broader populations before routine use.
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.
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Punt et al. (2019) conducted a cross-sectional in Congenital platelet defect (CPD) (n=156). Self-administered ISTH-Bleeding Assessment Tool (self-BAT) vs. Physician-administered ISTH-BAT was evaluated on Agreement of normal/abnormal scores between ISTH-BAT and self-BAT (95% CI 0.83-0.93). The self-administered ISTH-BAT demonstrated 88.5% agreement (95% CI 0.83-0.93) with the physician-administered version, with 96.9% sensitivity for detecting a bleeding tendency.
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