How to Trip Rapid Review

Step 1: Select articles relevant to your search (remember the system is only optimised for single intervention studies)

Step 2: press

Step 3: review the result, and maybe amend the or if you know better! If we're unsure of the overall sentiment of the trial we will display the conclusion under the article title. We then require you to tell us what the correct sentiment is.

377 results for

Heparin Induced Thrombocytopenia Pre-Test Scoring System

by
...
Alerts

Export results

Use check boxes to select individual results below

SmartSearch available

Trip's SmartSearch engine has discovered connected searches & results. Click to show

1. Heparin Induced Thrombocytopenia Pre-Test Scoring System

Heparin Induced Thrombocytopenia Pre-Test Scoring System Heparin Induced Thrombocytopenia Pre-Test Scoring System Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous (...) Abuse Cancer Administration 4 Heparin Induced Thrombocytopenia Pre-Test Scoring System Heparin Induced Thrombocytopenia Pre-Test Scoring System Aka: Heparin Induced Thrombocytopenia Pre-Test Scoring System , HIT Pre-Test Probability II. Criteria (Mnemonic: 4Ts) Score 2: decreased more than 50% from baseline with nadir >20,000 Score 1 decreased 30-50% from baseline with nadir 10-20,000 Score 0: decreased less than 30% from baseline with nadir <10,000 Timing after onset of current course Score 2

2018 FP Notebook

2. A Computerized Scoring System to Improve Assessment of Heparin-induced Thrombocytopenia Risk. (PubMed)

A Computerized Scoring System to Improve Assessment of Heparin-induced Thrombocytopenia Risk. Essentials Current risk scores for heparin-induced thrombocytopenia (HIT) are not computer-friendly. We compared a new computerized risk score with the 4Ts score in a large healthcare system. The computerized risk score agrees with the 4Ts score 85% of the time. The new score could potentially improve HIT diagnosis via incorporation into decision support. SUMMARY: Background (HIT) is an immune-mediated (...) adverse drug event associated with life-threatening thrombotic complications. The 4Ts score is widely used to estimate the risk for HIT and guide diagnostic testing, but it is not easily amenable to computerized clinical decision support (CDS) implementation. Objectives Our main objective was to develop an HIT computerized risk (HIT-CR) scoring system that provides platelet count surveillance for timing and degree of thrombocytopenia to identify those for whom diagnostic testing should be considered

2018 Journal of Thrombosis and Haemostasis

3. Pediatric heparin-induced thrombocytopenia: prevalence, thrombotic risk, and application of the 4Ts scoring system (PubMed)

Pediatric heparin-induced thrombocytopenia: prevalence, thrombotic risk, and application of the 4Ts scoring system To characterize heparin-induced thrombocytopenia (HIT) at a single pediatric center including the prevalence and the accuracy of the 4Ts scoring system as a predictor of HIT.In this retrospective cohort study, we identified 155 consecutive patients <21 years old with sufficient data for 4Ts scoring. The 4Ts scoring system is a validated pretest tool in adults that predicts (...) . Application of the 4Ts system as a pretest tool may reduce laboratory evaluation for HIT in heparin-exposed children with low risk 4Ts scores, decreasing unnecessary further testing, intervention, and cost.Copyright © 2015 Elsevier Inc. All rights reserved.

Full Text available with Trip Pro

2015 EvidenceUpdates

4. Clinical effectiveness of a Bayesian algorithm for the diagnosis and management of heparin-induced thrombocytopenia

Clinical effectiveness of a Bayesian algorithm for the diagnosis and management of heparin-induced thrombocytopenia Essentials We previously published a diagnostic algorithm for heparin-induced thrombocytopenia (HIT). In this study, we validated the algorithm in an independent large healthcare system. The accuracy was 98%, sensitivity 82% and specificity 99%. The algorithm has potential to improve accuracy and efficiency in the diagnosis of HIT.Background Heparin-induced thrombocytopenia (HIT (...) ) is a life-threatening drug reaction caused by antiplatelet factor 4/heparin (anti-PF4/H) antibodies. Commercial tests to detect these antibodies have suboptimal operating characteristics. We previously developed a diagnostic algorithm for HIT that incorporated 'four Ts' (4Ts) scoring and a stratified interpretation of an anti-PF4/H enzyme-linked immunosorbent assay (ELISA) and yielded a discriminant accuracy of 0.97 (95% confidence interval [CI], 0.93-1.00). Objectives The purpose of this study

Full Text available with Trip Pro

2017 EvidenceUpdates

5. Clinical and laboratory tests for the diagnosis of heparin-induced thrombocytopenia. (PubMed)

Clinical and laboratory tests for the diagnosis of heparin-induced thrombocytopenia. A rapid diagnostic work-up is required in patients with suspected heparin-induced thrombocytopenia (HIT). However, diagnosis of HIT is challenging due to a number of practical issues and methodological limitations. Many laboratory tests and a few clinical scoring systems are available but the individual characteristics and the diagnostic accuracy of these are hard to appraise. The 4Ts score is a well evaluated (...) by immunoassays alone. In addition, only some of them are immediately accessible, particularly in small laboratories. While functional assays such as the serotonin release assay (SRA) and the heparin-induced platelet activation assay (HIPA) are considered as gold standard for diagnosis of HIT, they require a highly specialised laboratory. In addition, some of them are not adequately evaluated. In clinical practice, we recommend an integrated diagnostic approach combining not only clinical assessment (the 4Ts

Full Text available with Trip Pro

2016 Thrombosis and haemostasis

6. Efficacy and Safety of Apixaban in the Treatment of Heparin Induced Thrombocytopenia (HIT)

Efficacy and Safety of Apixaban in the Treatment of Heparin Induced Thrombocytopenia (HIT) Efficacy and Safety of Apixaban in the Treatment of Heparin Induced Thrombocytopenia (HIT) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more (...) studies before adding more. Efficacy and Safety of Apixaban in the Treatment of Heparin Induced Thrombocytopenia (HIT) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03594045 Recruitment Status : Recruiting First Posted

2018 Clinical Trials

7. Pediatric heparin-induced thrombocytopenia: prevalence, thrombotic risk, and application of the 4Ts scoring system. (PubMed)

Pediatric heparin-induced thrombocytopenia: prevalence, thrombotic risk, and application of the 4Ts scoring system. To characterize heparin-induced thrombocytopenia (HIT) at a single pediatric center including the prevalence and the accuracy of the 4Ts scoring system as a predictor of HIT.In this retrospective cohort study, we identified 155 consecutive patients <21 years old with sufficient data for 4Ts scoring. The 4Ts scoring system is a validated pretest tool in adults that predicts (...) . Application of the 4Ts system as a pretest tool may reduce laboratory evaluation for HIT in heparin-exposed children with low risk 4Ts scores, decreasing unnecessary further testing, intervention, and cost.Copyright © 2015 Elsevier Inc. All rights reserved.

Full Text available with Trip Pro

2015 Journal of Pediatrics

8. Diagnostic Accuracy of IgG-Specific Versus Polyspecific Enzyme-Linked Immunoassay for the Diagnosis of Heparin-Induced Thrombocytopenia: a Systematic Review and Meta-Analysis. (PubMed)

Diagnostic Accuracy of IgG-Specific Versus Polyspecific Enzyme-Linked Immunoassay for the Diagnosis of Heparin-Induced Thrombocytopenia: a Systematic Review and Meta-Analysis. Essentials Immunoassay specificity varies in heparin-induced thrombocytopenia (HIT) testing. This meta-analysis examined 9 studies that tested samples by both IgG and polyspecific methods. IgG-specific assays confer superior diagnostic accuracy compared with polyspecific assays. These results further support (...) recommendations in favor of IgG-specific testing.Background There are conflicting data on whether the IgG-specific or polyspecific antiplatelet factor 4/heparin (PF4/H) enzyme-linked immunosorbent assay (ELISA) is preferred for the laboratory diagnosis of heparin-induced thrombocytopenia (HIT). Objectives To directly compare diagnostic accuracy of IgG-specific versus polyspecific ELISA in HIT. Patients/Methods A systematic search yielded nine studies comprising 1948 patients with suspected HIT tested by both

Full Text available with Trip Pro

2017 Journal of thrombosis and haemostasis : JTH

9. Optimizing the Diagnosis of Heparin Induced Thrombocytopenia

Institute Information provided by (Responsible Party): Ottawa Hospital Research Institute Study Details Study Description Go to Brief Summary: Multicentre (Ottawa and Halifax) prospective cohort study using a diagnostic approach in patients clinically suspected to have HIT that combines pretest probability assessment with quantitative interpretation of anti-PF4 assay. Condition or disease Intervention/treatment Phase Heparin-induced Thrombocytopenia (HIT) Diagnostic Test: Diagnostic algorithm (...) Official Title: Optimizing the Diagnosis of Heparin Induced Thrombocytopenia Using Quantified Anti-Platelet Factor 4 Immunological Testing: A Pilot Multicentre Cohort Study Actual Study Start Date : November 23, 2018 Estimated Primary Completion Date : June 2020 Estimated Study Completion Date : October 2020 Resource links provided by the National Library of Medicine related topics: available for: resources: Arms and Interventions Go to Arm Intervention/treatment Experimental: diagnostic algorithm

2017 Clinical Trials

10. Heparin Induced Thrombocytopenia Pre-Test Scoring System

Heparin Induced Thrombocytopenia Pre-Test Scoring System Heparin Induced Thrombocytopenia Pre-Test Scoring System Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous (...) Abuse Cancer Administration 4 Heparin Induced Thrombocytopenia Pre-Test Scoring System Heparin Induced Thrombocytopenia Pre-Test Scoring System Aka: Heparin Induced Thrombocytopenia Pre-Test Scoring System , HIT Pre-Test Probability II. Criteria (Mnemonic: 4Ts) Score 2: decreased more than 50% from baseline with nadir >20,000 Score 1 decreased 30-50% from baseline with nadir 10-20,000 Score 0: decreased less than 30% from baseline with nadir <10,000 Timing after onset of current course Score 2

2015 FP Notebook

11. Diagnosis and management of Heparin induced thrombocytopenia: second edition

of the onset, the presence of new or progressive thrombosis, and whether an alternative cause of thrombocytopenia is likely. A ‘4Ts’ scoring system (Table ) was devised to assess the pretest probability (Warkentin, ; Warkentin & Heddle, ). It has subsequently been shown that if the score is low, HIT can be excluded without the need for laboratory investigation (Lo et al , ; Pouplard et al , ; Bryant et al , ; Sachs et al , ). If the pretest probability is not low, heparin should be stopped (...) , A. , Arepally, G. , Crowther, M.A. , Rice, L. , Datko, F. , Hook, K. , Propert, K.J. , Kuter, D.J. , Ortel, T.L. , Konkle, B.A. & Cines, D.B. ( 2010 ) The HIT Expert Probability (HEP) Score: a novel pretest probability model for heparininduced thrombocytopenia based on broad expert opinion . Journal of Thrombosis and Haemostasis , 8 , 2642 – 2650 . Dyke, C.M. , Aldea, G. , Koster, A. , Smedira, N. , Avery, E. , Aronson, S. , Spiess, B.D. & Lincoff, A.M. ( 2007 ) Off‐pump coronary artery bypass

2012 British Committee for Standards in Haematology

12. Economic Evaluation of Unfractionated Heparin Versus Low-Molecular-Weight Heparin to Prevent Venous Thromboembolism in General Medical and Non Orthopedic Surgical Patients

, these consequences were not incorporated, but were tested in a sensitivity analysis using the same approach and parameters as used in a prior economic analysis. 4 The conceptual design of the model is detailed in Figure 1. Figure 1: Overview of Economic Model CTEPH = chronic thromboembolic pulmonary hypertension; DVT = deep venous thrombosis; HIT = heparin-induced thrombocytopenia; HITT = heparin-induced thrombocytopenia and thrombosis; ICH = intracranial hemorrhage; PE = pulmonary embolism; PTS = post (...) of drugs used to prevent venous thromboembolism (VTE) in hospitalized patients, an economic evaluation was conducted to determine the incremental cost-effectiveness of LMWH compared with UFH for the prevention of VTE in medical and non-orthopedic surgery patients who are hospitalized. In the reference case, the differential risk of heparin-induced thrombocytopenia (HIT) with or without thrombosis (HITT) due to treatment with LMWH compared with UFH was not included, as these outcomes could

2017 CADTH - Plasma Products

13. Advances in the pathophysiology and treatment of heparin-induced thrombocytopenia. (PubMed)

Advances in the pathophysiology and treatment of heparin-induced thrombocytopenia. To review the recent developments in understanding the pathophysiology of heparin-induced thrombocytopenia (HIT) and in applying this knowledge to the treatment of patients with suspected and proven HIT.HIT pathophysiology is dynamic and complex. HIT pathophysiology is initiated by four essential components--heparin (Hep), platelet factor 4 (PF4), IgG antibodies against the Hep-PF4 complex, and platelet FcγRIIa (...) and the inadequacies of current diagnostic tests and scoring systems. In proven HIT, approved treatments reduce but do not eliminate thrombosis, and have substantial bleeding risk. Rational novel therapeutic strategies, directed at the initiating steps in HIT pathophysiology and with potential combinations staged over time, are in various phases of development.Progress continues in understanding the breadth of molecular and cellular players in HIT. Translation to improved diagnosis and treatment is needed.

Full Text available with Trip Pro

2014 Current Opinion in Hematology

14. Clinical and laboratory diagnosis of heparin-induced thrombocytopenia: an integrated approach. (PubMed)

systems such as the 4Ts and HIT Expert Probability (HEP) score. Laboratory tests include immunoassays, such as the PF4/heparin enzyme-linked immunosorbent assay (ELISA) and functional tests such as the 14C-serotonin release assay and heparin-induced platelet activation assay. Clinical scoring systems and commercially available immunoassays have high sensitivity but modest specificity. Functional assays are more specific, but they are technically demanding. Novel laboratory assays with faster (...) Clinical and laboratory diagnosis of heparin-induced thrombocytopenia: an integrated approach. Heparin-induced thrombocytopenia (HIT) is a clinicopathologic disorder that predisposes to thrombosis. Diagnosis rests on a compatible clinical picture and laboratory evidence of antiplatelet factor 4 (PF4)/heparin antibodies that activate platelets in a heparin-dependent manner. Rapid and accurate diagnosis is paramount to avoid the perils of misdiagnosis. Clinical evaluation may be guided by scoring

Full Text available with Trip Pro

2014 Seminars In Thrombosis And Hemostasis

15. Rapid Diagnosis of Heparin-Induced Thrombocytopenia in Surgical Critically Ill Patients

Universitaire de Besancon Information provided by (Responsible Party): Centre Hospitalier Universitaire de Besancon Study Details Study Description Go to Brief Summary: The early diagnosis of heparin-induced thrombocytopenia is particularly difficult in surgical critically ill patients. If the use of rapid immunological diagnostic methods and pretest scoring systems has been proposed in the medical intensive care unit (ICU), none of these methods have been specifically evaluated in the diagnosis of HIT (...) in surgical patients. Condition or disease Intervention/treatment Heparin-induced Thrombocytopenia (HIT) Other: HEP score Other: 4Ts score Other: ID-PaGIA test Other: HIT-Ab(PF4-H) test Detailed Description: Heparin-induced thrombocytopenia (HIT) is of concern in critically ill patients, given the high prevalence of heparin use. The diagnosis of HIT in surgical intensive care unit (ICU) is problematic due to the lack of reliable diagnostic method. No gold standard currently exists and the definitive

2013 Clinical Trials

16. Impact of an Immunoglobulin G-Specific Enzyme-Linked Immunosorbent Assay on the Management of Heparin-Induced Thrombocytopenia. (PubMed)

Impact of an Immunoglobulin G-Specific Enzyme-Linked Immunosorbent Assay on the Management of Heparin-Induced Thrombocytopenia. To evaluate whether using an immunoglobulin G (IgG)-specific platelet factor 4 (PF4) test reduces the rate of positive PF4 results and has an impact on prescribing practices of nonheparin anticoagulants (direct thrombin inhibitors and fondaparinux) in patients assessed for heparin-induced thrombocytopenia (HIT).Single-center prospective cohort study with a historical (...) control group.Large academic medical center.A total of 672 patients assessed for HIT.Patients were assessed for HIT by using either an IgG-specific PF4 enzyme-linked immunosorbent assay (ELISA; 336 patients) or a nonspecific PF4 ELISA (336 patients; historical control group).No significant difference was noted in the proportion of patients with a low, intermediate, or high risk of HIT based on the 4Ts pretest clinical scoring system. The PF4 ELISA was positive in 6.9% versus 11.3% of patients (p=0.04

2013 Pharmacotherapy

17. Heparin-induced thrombocytopenia: an update. (PubMed)

Heparin-induced thrombocytopenia: an update. Heparin-induced thrombocytopenia (HIT) is an immune response to heparin that can progress to severe thrombosis, amputation, and in some cases death. The diagnosis and treatment of HIT is complex, but needs to be considered in the clinical management of patients exposed to heparin due to its serious outcomes. Early diagnosis based on a comprehensive interpretation of clinical and laboratory information improves clinical outcomes. This begins (...) with careful monitoring for thrombocytopenia and thrombosis during and for at least 5 to 10 days after heparin treatment of any dose and duration. Appropriate use and knowledgeable interpretation of laboratory tests for HIT are important, as these vary in sensitivity and specificity, with each type providing unique information. Clinical management of patients with HIT is with a non-heparin anticoagulant such as a direct thrombin inhibitor or danaparoid followed by a vitamin K antagonist for long-term

2012 Seminars In Thrombosis And Hemostasis

18. Evaluating heparin-induced thrombocytopenia: the old and the new. (PubMed)

Evaluating heparin-induced thrombocytopenia: the old and the new. Heparin-induced thrombocytopenia (HIT) is a rare but potentially serious complication of heparin use. Prompt diagnosis is crucial and requires the integration of clinical assessment and laboratory testing. Pretest clinical scoring systems (i.e., 4 Ts) have been established. Immunoassays can detect the presence of antibodies directed toward heparin-platelet factor 4 (H-PF4) complexes, but provide no information about their ability (...) to activate platelets. A low clinical score, when combined with a negative immunoassay result obviates the need for further testing. However, immunoassays and 4 Ts scores have only modest specificity. Functional testing (serotonin release assay or heparin-induced platelet activation) remain important in confirming the presence of pathogenic H-PF4 antibodies, but are technically demanding to perform and limited in guiding clinical decisions in the acute setting. This review evaluates current immuno

2012 Seminars In Thrombosis And Hemostasis

19. Rivaroxaban for Treatment of Patients With Suspected or Confirmed Heparin-Induced Thrombocytopenia

benefits. For patients with HIT, the benefit will be having a safe, and easy-to-use drug to protect them from developing further life or limb-threatening blood clots. For the Canadian health care system, the benefit will be having a drug that is much less expensive than the drugs currently used to treat HIT. Condition or disease Intervention/treatment Phase Heparin-induced Thrombocytopenia Drug: Rivaroxaban Phase 3 Detailed Description: Consecutive adult patients with an intermediate or high clinical (...) Rivaroxaban for Treatment of Patients With Suspected or Confirmed Heparin-Induced Thrombocytopenia Rivaroxaban for Treatment of Patients With Suspected or Confirmed Heparin-Induced Thrombocytopenia - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove

2012 Clinical Trials

20. The HIT Expert Probability (HEP) Score: a novel pre-test probability model for heparin-induced thrombocytopenia based on broad expert opinion. (PubMed)

The HIT Expert Probability (HEP) Score: a novel pre-test probability model for heparin-induced thrombocytopenia based on broad expert opinion. The diagnosis of heparin-induced thrombocytopenia (HIT) is challenging. Over-diagnosis and over-treatment are common.To develop a pre-test clinical scoring model for HIT based on broad expert opinion that may be useful in guiding clinical decisions regarding therapy.A pre-test model, the HIT Expert Probability (HEP) Score, was constructed based (...) on the opinions of 26 HIT experts. Fifty patients referred to a reference laboratory for HIT testing comprised the validation cohort. Two hematology trainees scored each patient using the HEP Score and a previously published clinical scoring system (4 T's). A panel of three independent experts adjudicated the 50 patients and rendered a diagnosis of HIT likely or unlikely. All subjects underwent HIT laboratory testing with a polyspecific HIT ELISA and serotonin release assay (SRA).The HEP Score exhibited

Full Text available with Trip Pro

2010 Journal of Thrombosis and Haemostasis

To help you find the content you need quickly, you can filter your results via the categories on the right-hand side >>>>