ISTH_SCC_bleeding_assessment_tool v.0.1.0
An assessment tool given by the International Society on Thrombosis and Haemostasis/ Scientific Standardization Committee (ISTH/SCC), which can be used to evaluate patients with a suspected inherited bleeding disorder.
To calculate and interpret the total score of the ISTH/SCC bleeding assessment tool.
This tool assesses the presence and severity of bleeding symptoms and can serve as a screening tool to determine which patients require additional laboratory evaluation. For the calculation, only symptoms and treatment BEFORE and AT diagnosis should be considered. It has been validated in various inherited bleeding disorder populations, including von Willebrand disease, hemophilia, and platelet disorders. Results may inform the need for further diagnostic workup in patients with a suspected inherited bleeding disorder. - Low scores are associated with a low likelihood of a bleeding disorder, and additional evaluation may not be warranted. - Elevated scores indicate an increased risk of bleeding; further evaluation for an underlying inherited bleeding disorder is appropriate (e.g., laboratory studies, specialty consultation). Distinction between 0 and 1 is of critical importance. Score 1 means that the symptom is judged as present in the patient’s history by the interviewer but does not qualify for a score 2 or more. * Consultation only: the patient sought medical evaluation and was either referred to a specialist or offered detailed laboratory investigation. ** E.g., 1 extraction/surgery resulting in bleeding (100%): the score to be assigned is 2; 2 extractions/surgeries, 1 resulting in bleeding (50%): the score to be assigned is 2; 3 extractions/surgeries, 1 resulting in bleeding (33%): the score to be assigned is 2; 4 extractions/surgeries, 1 resulting in bleeding (25%): the score to be assigned is 1.
The tool has been validated for use in adults and children, although sensitivity is lower in pediatric populations. It has low sensitivity for acquired bleeding disorders. Results are not intended to be diagnostic but should be used as part of a comprehensive evaluation in conjunction with clinical judgment and specialty consultation.
Rodeghiero F, et al. ISTH/SCC bleeding assessment tool: a standardized questionnaire and a proposal for a new bleeding score for inherited bleeding disorders. J Thromb Haemost. 2010 Sep;8(9):2063–5. Elbatarny M, Mollah S, Grabell J, et al. Normal range of bleeding scores for the ISTH-BAT: adult and pediatric data from the merging project. Haemophilia. 2014 Nov;20(6):831–5. Borhany M, Fatima N, Abid M, Shamsi T, Othman M. Application of the ISTH bleeding score in hemophilia. Transfus Apher Sci. 2018 Aug;57(4):556–60. Gresele P, Orsini S, Noris P, et al. Validation of the ISTH/SCC bleeding assessment tool for inherited platelet disorders: a communication from the Platelet Physiology SCC. J Thromb Haemost. 2020 Mar;18(3):732–9. Kalot MA, Husainat N, Tayiem S, et al. Bleeding assessment tools in the diagnosis of VWD in adults and children: a systematic review and meta-analysis of test accuracy. Blood Adv. 2021 Dec 14;5(23):5023–31. Rezende SM, Neumann I, Angchaisuksiri P, et al. International Society on Thrombosis and Haemostasis clinical practice guideline for treatment of congenital hemophilia A and B based on the Grading of Recommendations Assessment, Development, and Evaluation methodology. J Thromb Haemost. 2024 Sep;22(9):2629–52.
openEHR-EHR-EVALUATION.health_risk, openEHR-EHR-OBSERVATION.isth_scc_bleeding_assessment
