title: Use of ISTH bleeding assessment tool to predict inherited platelet dysfunction in resource constrained settings.
abstract: BACKGROUND
  The International Society of Thrombosis & Hemostasis (ISTH) bleeding assessment tool (ISTH-BAT) is used to record bleeding symptoms in patients with possible bleeding disorders.
  
  
  OBJECTIVE
  To investigate the utility of the ISTH-BAT in predicting platelet dysfunction in individuals with suspected inherited platelet function disorders.
  
  
  METHODS
  Individuals with clinical evidence of bleeding and suspected inherited platelet function disorder and healthy volunteers were included in the study. The ISTH-BAT questionnaire was applied prior to light transmission aggregometry (LTA).
  
  
  RESULTS
  A total of 261 participants were included (100 healthy volunteers, and 161 with suspected inherited platelet function disorders). The ISTH-BAT score in participants with suspected inherited platelet function disorders (median 2; interquartile range [IQR] 5-1) was significantly higher than in healthy volunteers (median 0; IQR 2-0). There was also a significant difference between participants with suspected inherited platelet function disorders with a platelet defect detected by LTA (median 4; IQR 8-3) and those with normal platelet function (median 2; IQR 3-1) (p < 0.001). The ISTH-BAT score was associated with a demonstrable platelet defect on platelet function testing (area under the receiver operating characteristic curve = 0.8 [95% confidence interval 0.72-0.87, p = < 0.001] and odds ratio 3.25 [95% confidence interval 2.13-4.37, p = < 0.001]).
  
  
  CONCLUSIONS
  The ISTH-BAT is a useful tool for documenting bleeding symptoms and the score obtained is also predictive of the presence of a platelet defect on LTA in patients with suspected inherited platelet dysfunction.
authors.affiliation: a Department of Pathology & Laboratory Medicine , the Aga Khan University Hospital , Karachi, Pakistan.
authors.forename: Anila
authors.initials: A
authors.lastname: Rashid
authors.affiliation: a Department of Pathology & Laboratory Medicine , the Aga Khan University Hospital , Karachi, Pakistan.
authors.forename: Bushra
authors.initials: B
authors.lastname: Moiz
authors.affiliation: a Department of Pathology & Laboratory Medicine , the Aga Khan University Hospital , Karachi, Pakistan.
authors.forename: Farheen
authors.initials: F
authors.lastname: Karim
authors.affiliation: a Department of Pathology & Laboratory Medicine , the Aga Khan University Hospital , Karachi, Pakistan.
authors.forename: Muhammad Shariq
authors.initials: MS
authors.lastname: Shaikh
authors.affiliation: a Department of Pathology & Laboratory Medicine , the Aga Khan University Hospital , Karachi, Pakistan.
authors.forename: Huma
authors.initials: H
authors.lastname: Mansoori
authors.affiliation: a Department of Pathology & Laboratory Medicine , the Aga Khan University Hospital , Karachi, Pakistan.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Raheem
mesh_terms: D000293:Adolescent; D000328:Adult; D025861:Blood Coagulation Disorders, Inherited / Q000175:diagnosis / Q000235:genetics; D001791:Blood Platelet Disorders / Q000175:diagnosis / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D005260:Female; D064368:Healthy Volunteers; D006470:Hemorrhage / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010979:Platelet Function Tests; D012372:ROC Curve; D012720:Severity of Illness Index; D013053:Spectrophotometry
keywords: Bleeding score; bleeding assessment tools; inherited platelet disorders; light transmission aggregometry; platelet aggregation; platelet function