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ISTH Bleeding Assessment Tool

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1. Diagnostic utility of the ISTH bleeding assessment tool in patients with suspected platelet function disorders Full Text available with Trip Pro

Diagnostic utility of the ISTH bleeding assessment tool in patients with suspected platelet function disorders Essentials The utility of bleeding assessment tools regarding platelet function disorders is still elusive. We studied consecutive patients in a prospective cohort study in a tertiary hospital. Substantially higher scorings were observed in patients with platelet function disorders. Bleeding assessment tools might provide a useful screening tool.Bleeding assessment tools (BATs) have (...) been widely implemented in the evaluation of patients with suspected bleeding disorders. However, diagnostic BAT utility regarding platelet function disorders is still elusive.We aimed to assess the diagnostic value of the International Society on Thrombosis and Haemostasis BAT (ISTH-BAT) for platelet function disorders in clinical practice.The clinical characteristics and laboratory data of all consecutive patients with a suspected bleeding disorder referred between January 2012 and March 2017

2019 EvidenceUpdates

2. The international society on thrombosis and haemostasis-bleeding assessment tool (ISTH-BAT) and the risk of future bleeding. Full Text available with Trip Pro

The international society on thrombosis and haemostasis-bleeding assessment tool (ISTH-BAT) and the risk of future bleeding. Essentials ISTH Bleeding Assessment Tool (ISTH-BAT) is used to assist the diagnosis of bleeding disorders. We examined whether the ISTH-BAT is capable of predicting the risk of future bleeding. 136 subjects were administered the ISTH-BAT and followed for up to four years. The ISTH-BAT score failed to predict the risk of future bleeding.Background The ISTH Bleeding (...) Assessment Tool (ISTH-BAT) is a diagnostic tool used in subjects with suspected inherited bleeding disorders. Aim To evaluate whether the ISTH-BAT, applied at first work-up in a tertiary-care center, predicts the risk of subsequent bleeding events. Methods This was an observational cohort study including all consecutive subjects, of either sex and any age, referred between 2011 and 2015 because of a suspected bleeding disorder. The analysis was restricted to those with an ISTH-BAT score of ≥ 3. Incidence

2017 Journal of Thrombosis and Haemostasis

3. ISTH Bleeding Assessment Tool

ISTH Bleeding Assessment Tool ISTH Bleeding Assessment Tool 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 ISTH Bleeding Assessment (...) Tool ISTH Bleeding Assessment Tool Aka: ISTH Bleeding Assessment Tool , ISTH-BAT , International Society of Thrombosis and Hemostasis BAT II. Indications Screening for congenital s III. Precautions and are poor for inherited platelet function disorders IV. Criteria Score 0: None or Trivial Score 1: More than 5 per year, or lasting >10 minutes Score 2: Only Score 3: Treated with packing, cauterization or antifibrinolytics Score 4: , replacement (e.g. Factor VIIa, PCC4), Cutaneous symptoms Score 0

2018 FP Notebook

4. Bleeding and bruising in Osteogenesis Imperfecta: International Society on Thrombosis and Haemostasis bleeding assessment tool and haemostasis laboratory assessment in 22 individuals. (Abstract)

patients and to screen for possible underlying haematological disorders. Bleeding tendency was investigated using the International Society on Thrombosis and Haemostasis bleeding assessment tool (ISTH-BAT) in 22 adult OI patients. Laboratory testing was performed to investigate for bleeding disorders or abnormal coagulation. Four patients [OI type 1(n = 3), OI type 4(n = 1)] had a bleeding score (BS) fitting with a bleeding tendency, but without test results pointing to a coagulopathy. Two patients [OI (...) Bleeding and bruising in Osteogenesis Imperfecta: International Society on Thrombosis and Haemostasis bleeding assessment tool and haemostasis laboratory assessment in 22 individuals. Osteogenesis imperfecta (OI) is characterized by susceptibility to bone fractures. Other symptoms, such as easy bruising and bleeding complications during surgery necessitating transfusions, have also been reported. The aim of the cross-sectional pilot study was to assess the bleeding and bruising tendency in OI

2019 British journal of haematology

5. Prospective evaluation of a pediatric bleeding questionnaire and the ISTH bleeding assessment tool in children and parents in routine clinical practice. Full Text available with Trip Pro

Prospective evaluation of a pediatric bleeding questionnaire and the ISTH bleeding assessment tool in children and parents in routine clinical practice. Diagnosing mild bleeding disorders (BDs) in children is difficult. Bleeding scores (BSs) have been proposed for obtaining standardized quantitative histories.To compare the Canadian pediatric bleeding questionnaire (PBQ) with the new ISTH bleeding assessment tool (ISTH BAT) for the determination of BS in a routine pediatric outpatient (...) no BD and VWD (P = 0.0001), but the area under the receiver characteristics curve to detect any mild BD was only 0.76. Despite the inherited nature of the BD, a family score did not increase the ability to discriminate between no BD and VWD (P = 0.2052). There was no significant difference between the two tools used (P = 0.3253) or simple qualitative criteria, such as yes/no questions regarding bleeding (P = 0.3477).The two tools translated into German did not differ substantially. Both were able

2012 Journal of Thrombosis and Haemostasis

6. ISTH Bleeding Assessment Tool

ISTH Bleeding Assessment Tool ISTH Bleeding Assessment Tool 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 ISTH Bleeding Assessment (...) Tool ISTH Bleeding Assessment Tool Aka: ISTH Bleeding Assessment Tool , ISTH-BAT , International Society of Thrombosis and Hemostasis BAT II. Indications Screening for congenital s III. Precautions and are poor for inherited platelet function disorders IV. Criteria Score 0: None or Trivial Score 1: More than 5 per year, or lasting >10 minutes Score 2: Only Score 3: Treated with packing, cauterization or antifibrinolytics Score 4: , replacement (e.g. Factor VIIa, PCC4), Cutaneous symptoms Score 0

2016 FP Notebook

7. Utility of the ISTH bleeding assessment tool in predicting platelet defects in participants with suspected inherited platelet function disorders Full Text available with Trip Pro

Utility of the ISTH bleeding assessment tool in predicting platelet defects in participants with suspected inherited platelet function disorders The ISTH bleeding assessment tool (ISTH-BAT) was developed to record bleeding symptoms and to aid diagnosis in patients with a possible bleeding disorder.To investigate the utility of the ISTH-BAT in predicting functional defects in platelet activation in participants with suspected inherited platelet function disorders.Participants with clinical (...) characteristic curve = 0.501 [95% confidence interval 0.372-0.630, P = 0.98] and odds ratio 1.01 [95% confidence interval 0.93-1.09, P = 0.91]).The ISTH-BAT is a powerful tool for documenting lifelong bleeding history. However, the score obtained is not predictive of the presence of a platelet defect on lumiaggregometry in patients with suspected inherited platelet function disorders.© 2013 International Society on Thrombosis and Haemostasis.

2013 Journal of Thrombosis and Haemostasis

8. Thromboelastometry as a diagnostic tool in mild bleeding disorders: A prospective cohort study. (Abstract)

single-centre prospective cohort study.Haematology outpatient unit of a tertiary general hospital in Central Switzerland.All consecutive patients referred over a 32-month period with a suspected bleeding disorder were included and thromboelastometry was conducted using a ROTEM delta (EXTEM, INTEM and FIBTEM). Diagnostic work-up was performed according to current guidelines including the ISTH bleeding assessment tool (ISTH BAT).Distribution of clotting time (CT) and maximum clot firmness (MCF) results (...) Thromboelastometry as a diagnostic tool in mild bleeding disorders: A prospective cohort study. Major guidelines emphasise the potential of visco-elastic methods to overcome the limitations of conventional laboratory assays in the peri-operative setting. Their sensitivity regarding mild bleeding disorders (MBDs), the most common bleeding disorders in the general population, is however unknown.The aim of this study was to investigate the sensitivity of thromboelastometry for diagnosis of MBD.A

2019 European Journal of Anaesthesiology

9. Preoperative screening for bleeding disorders: A comprehensive laboratory assessment of clinical practice Full Text available with Trip Pro

. Screening modalities included the ISTH Bleeding Assessment Tool (ISTH-BAT), PT, aPTT, TT, Euglobulin Lysis Time (ELT), and Platelet Function Analyser (PFA).In 21 of 240 (8.8%) patients reporting bleeding symptoms, hemostatic abnormalities were found, including 7 reduced coagulation factor levels, 10 platelet function abnormalities, and 4 reduced vWF levels. In comparison, 10 of 95 (10.5%) patients not reporting bleeding symptoms had abnormalities. The ISTH-BAT could not identify patients (...) Preoperative screening for bleeding disorders: A comprehensive laboratory assessment of clinical practice Patients with mild bleeding disorders are at risk of perioperative bleeding, but screening for these disorders remains challenging.We aimed to assess the prevalence of hemostatic abnormalities in patients with and without reported bleeding symptoms on a preoperative questionnaire, consisting of guideline-proposed questions, and appraised the diagnostic value of several screening modalities

2018 Research and Practice in Thrombosis and Haemostasis

10. Significant gynecological bleeding in women with low von Willebrand factor levels Full Text available with Trip Pro

Significant gynecological bleeding in women with low von Willebrand factor levels Gynecological bleeding is frequently reported in women with von Willebrand disease (VWD). Low von Willebrand factor (VWF) may be associated with significant bleeding phenotype despite only mild plasma VWF reductions. The contribution of gynecological bleeding to this phenotype has yet to be described. The optimal clinical bleeding assessment tool (BAT) to evaluate bleeding remains unclear. Using a standardized (...) approach to phenotypic assessment, we evaluated gynecological bleeding and directly compared the Condensed Molecular and Clinical Markers for the Diagnosis and Management of type 1 VWD (Condensed MCMDM-1 VWD) and International Society on Thrombosis and Haemostasis (ISTH) BAT scores in 120 women enrolled in the Low von Willebrand in Ireland Cohort study. Heavy menstrual bleeding (HMB) was reported in 89% of female participants; 45.8% developed iron deficiency. Using identical data, Condensed MCMDM-1 VWD

2018 Blood advances

11. A decreased and less sustained desmopressin response in hemophilia A carriers contributes to bleeding Full Text available with Trip Pro

Assessment Tool (ISTH-BAT). DDAVP (0.3 μg/kg) was administered either IV or subcutaneously (SC), and blood was drawn at baseline and 1, 2, and 4 hours postadministration. Blood was assessed for factor VIII (FVIII) level, von Willebrand factor (VWF) antigen (VWF:Ag), VWF activity (VWF:RCo or VWF:GPIbM), thromboelastography (TEG), and thrombin generation assay (TGA) at all points, and for VWF propeptide (VWFpp):Ag ratio and ABO blood type at baseline. Carriers were older than control patients (median age (...) A decreased and less sustained desmopressin response in hemophilia A carriers contributes to bleeding The cause of hemophilia A carrier bleeding is not well established. Desmopressin (DDAVP), used clinically to treat or prevent bleeding, can also be used as a medical stress surrogate. This study's objective was to compare the response to DDAVP in hemophilia A carriers with that in normal control patients. Bleeding was assessed by the International Society on Thrombosis and Hemostasis Bleeding

2018 Blood advances

12. Bleeding spectrum in children with moderate or severe von Willebrand disease: Relevance of pediatric-specific bleeding. Full Text available with Trip Pro

-16 years) with Type 1 (n = 60), 2 (n = 44), and 3 (n = 9) VWD with von Willebrand factor (VWF) antigen and/or VWF ristocetin cofactor levels ≤ 30 U/dL from a nation-wide cross-sectional study ("Willebrand in the Netherlands" study). Bleeding severity and frequency were determined using the International Society on Thrombosis and Hemostasis-Bleeding Assessment Tool (ISTH-BAT) with supplementary pediatric-specific bleeding symptoms (umbilical stump bleeding, cephalohematoma, cheek hematoma (...) Bleeding spectrum in children with moderate or severe von Willebrand disease: Relevance of pediatric-specific bleeding. The bleeding phenotype of children with von Willebrand disease (VWD) needs to be characterized in detail to facilitate diagnosis during childhood and aid in the planning and assessment of treatment strategies. The objective was to evaluate the occurrence, type, and severity of bleeding in a large cohort of children with moderate and severe VWD. We included 113 children (aged 0

2015 American journal of hematology

13. Diagnosis and Management of Acute Pulmonary Embolism Full Text available with Trip Pro

of contents Abbreviations and acronyms 4 1 Preamble 5 2 Introduction 6 2.1 Why do we need new Guidelines on the diagnosis and management of pulmonary embolism? 6 2.2 What is new in the 2019 Guidelines? 7 2.2.1 New/revised concepts in 2019 7 2.2.2 Changes in recommendations 2014–19 7 2.2.3 Main new recommendations 2019 8 3 General considerations 8 3.1 Epidemiology 8 3.2 Predisposing factors 9 3.3 Pathophysiology and determinants of outcome 10 4 Diagnosis 12 4.1 Clinical presentation 12 4.2 Assessment (...) Assessment of pulmonary embolism severity and the risk of early death 18 5.1 Clinical parameters of pulmonary embolism severity 18 5.2 Imaging of right ventricular size and function 18 5.2.1 Echocardiography 18 5.2.2 Computed tomographic pulmonary angiography 19 5.3 Laboratory biomarkers 19 5.3.1 Markers of myocardial injury 19 5.3.2 Markers of right ventricular dysfunction 19 5.3.3 Other laboratory biomarkers 19 5.4 Combined parameters and scores for assessment of pulmonary embolism severity 20 5.5

2019 European Society of Cardiology

14. Interventional Therapies for Acute Pulmonary Embolism: Current Status and Principles for the Development of Novel Evidence: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

different approaches to treatment. Fifth, patients may shift between risk categories over time. For these reasons, we suggest that risk stratification is a valuable aid to decision-making but should not dictate management separately from sound clinical assessment of the patient. Furthermore, treatment decisions will be influenced by a patient’s risk of bleeding ( ; see the Risks of Interventional PE Therapies section), the extent and location of thrombus, operator expertise, and individual patient (...) which patients with PE would derive the greatest net benefit from their use in various clinical settings. First, definitions and limitations of commonly used risk stratification tools for PE are reviewed. An adjudication of risks and benefits of available interventional therapies for PE follows. Next, considerations for optimal future evidence development in this field are presented in the context of the current US regulatory framework. Finally, the document concludes with a discussion of the pros

2019 American Heart Association

15. Is there a role for DOAC level monitoring in clinical practice?

to have the clear advantage in terms of rapid, reliable, widely-available laboratory testing and drug reversal agents. For an anticoagulated patient presenting with an acute bleed, thromboembolic event, and/or a need for an urgent invasive procedure, the evidence and tools available to reliably assess levels of anticoagulation and reverse continue to buoy warfarin’s modern clinical relevance. A DOAC lab measurement analogous to prothrombin time (PT)/international normal ratio (INR) would be a valuable (...) , a switch to another DOAC or warfarin/enoxaparin should be considered rather than increasing the dose of the original DOAC 11,32 . Acute Bleed/Hemorrhage: The Subcommittee on Control of Anticoagulation of the International Society on Thrombosis and Haemostasis (ISTH) recommends administration of an antidote for patients presenting with clinically significant bleeding & a DOAC concentration > 50 ng/mL 33,34 . In cases of a hemodynamically unstable/life-threatening bleeding event, in addition

2019 Clinical Correlations

16. Stroke Prevention in Patients With Atrial Fibrillation: A Systematic Review Update

thinking efficacy Therapeutic efficacy Patient outcome efficacy KQ 1 Tools Clinical and imaging tools and associated risk factors for assessment/evaluation of thromboembolic risk Tools Clinical tools and individual risk factors for assessment/ evaluation of ICH bleeding risk ES-2 Results/Key Findings Accuracy and Utility of Clinical and Imaging Tools To Predict Stroke Risk • CHADS2 score (continuous): Based on a meta-analysis of 14 studies (10 low risk of bias, 4 medium risk of bias, 761,128 patients (...) of their findings. Furthermore, although event rates were consistently reported, c-statistics and measures of calibration, strength of association, and diagnostic accuracy were inconsistently reported. • The outcome of impact on clinical decisionmaking (diagnostic thinking, therapeutic efficacy, and patient outcome efficacy) was not assessed by any studies. ES-3 Accuracy and Utility of Clinical Tools To Predict Bleeding Risk • AF patients on warfarin: 13 studies (10 low risk of bias, 2 medium risk of bias, 1

2018 Effective Health Care Program (AHRQ)

17. Standardized Library of Atrial Fibrillation Outcome Measures

, or intramuscular with compartment syndrome AND/OR bleeding causing a fall in hemoglobin level of 2 g/dL (1.24 mmol/L) or more, or leading to transfusion of two or more units of blood. ISTH definition (8) A-3 OMF CATEGORY OUTCOME MEASURE DEFINITION REFERENCE Events of Interest Periprocedural bleeding (any bleeding during 12-month interval which occurs within 30d of procedure) Major bleeding: Fatal bleeding AND/OR symptomatic bleeding in a critical area or organ, such as intracranial, intraspinal, intraocular (...) treatment for bleeding; change in antithrombotic therapy (including interruption or discontinuation). Minor bleeding: All nonmajor bleeds. Minor bleeds are further divided into clinically relevant and not. Note: Registries should clearly report how they communicate with patients (phone, in- person visit) to obtain information on bleeding events. ISTH definition (8) A-4 OMF CATEGORY OUTCOME MEASURE DEFINITION REFERENCE Events of Interest Myocardial infarction The term acute myocardial infarction (MI

2018 Effective Health Care Program (AHRQ)

18. Management of Antiplatelet Therapy among Patients on Antiplatelet Therapy for Coronary or Cerebrovascular Disease

of Bias tool. 11 However, we identified no trials. Cohort studies were assessed on design (eg, retrospective vs prospective), representativeness of the enrolled subjects, assessments of the exposure and outcome, follow-up rates, and statistical methods. DATA SYNTHESIS Data were too heterogeneous to support statistical pooling. We plotted MACE and bleeding outcomes by the preoperative APT and the perioperative management, and assessed for trends or patterns. We then assessed possible explanations (...) the impact of APT management for the wide range of procedures. It is likely that factors other than the perioperative management of APT play a role in differences in bleeding and MACE rates observed between studies. The strength (or quality) of the evidence was insufficient for all key questions. Management of Antiplatelet Therapy Evidence-based Synthesis Program 3 Applicability Several studies specifically assessed Veterans, including the largest study. Even though the remaining studies were not in VA

2017 Veterans Affairs Evidence-based Synthesis Program Reports

19. High Blood Pressure in Adults: Guideline For the Prevention, Detection, Evaluation and Management

) Advisory Council recommended that the NHLBI focus speci?cally on reviewing the highest- quality evidence and partner with other organizations to develop recommendations (P-1,P-2).Accordingly,the ACC and AHA collaborated with the NHLBI and stake- holder and professional organizations to complete and publish 4 guidelines (on assessment of cardiovascular risk, lifestyle modi?cations to reduce cardiovascular risk, management of blood cholesterol in adults, and man- agement of overweight and obesity (...) ) Management of primary aldosteronism: case detection, diagnosis, and treatment Endocrine Society 2016 (S1.5-12) Stable ischemic heart disease ACC/AHA/AATS/PCNA/SCAI/STS 2014 (S1.5-13)* 2012 (S1.5-9) Pheochromocytoma and paraganglioma Endocrine Society 2014 (S1.5-14) Atrial ?brillation AHA/ACC/HRS 2014 (S1.5-15) Valvular heart disease ACC/AHA 2017 (S1.5-16) Assessment of cardiovascular risk ACC/AHA 2013 (S1.5-17) Hypertension in pregnancy ACOG 2013 (S1.5-18) Heart failure ACC/AHA 2017 (S1.5-19) 2013 (S1.5

2017 American College of Cardiology

20. Arrhythmias in Congenital Heart Disease: A Position Paper of EHRA, AEPC, and ESC Working Group on Grown-up Congenital Heart Disease

modification . . . . . . . 6 Ventriculararrhythmias 6 Stablemonomorphicventriculartachycardia 6 Polymorphicventriculartachycardia 6 Work-up of patients with congenital heart disease andarrhythmias 6 Acute assessment of the congenital heart disease patientpresentingwitharrhythmia 7 Collaboration between adults with congenital heart diseaseandarrhythmiaspecialists 7 General assessment of the congenital heart disease patientwitharrhythmias 7 Arrhythmiamanagementviaimplanteddevices 8 Imaging requirements (...) to guidelines, we have opted for an easier and Arrhythmias in congenital heart disease 3 Downloaded from https://academic.oup.com/europace/advance-article-abstract/doi/10.1093/europace/eux380/4944677 by guest on 21 March 2018user-friendly system of ranking using ‘coloured hearts’ that should allow physicians to easily assess current status of evidence and conse- quent guidance (Table1). Thus, a ‘green heart’ indicates a recommended statement or rec- ommended/indicated treatment (or procedure) and is based

2017 Heart Rhythm Society

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