EVALUATION OF THE SENSITIVITY AND SPECIFICITY OF THE PEDIATRIC BLEEDING QUESTIONNAIRE IN VARIOUS HEMORRHAGIC DISORDERS

Abstract

Determination of significant bleeding in the anamnesis is quite difficult, since mild mucocutaneous bleeding can occur both in patients with hereditary bleeding disorders and in healthy people. As a result, there is a growing interest among researchers and clinicians in accurate and objective quantification of hemorrhage symptoms. Objective of the study: to evaluate the effectiveness of the Pediatric bleeding questionnaire as a tool for identifying a group of children requiring further laboratory examination. Materials and methods of research: the study was a retrospective, uncontrolled, comparative, nonrandomized, single-center study. Based on the analysis of the database of the Consultive department of the Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology from January 2017 to December 2019, out of the total number of visits to doctors, patients under 18 years old who complained of increased bleeding were selected. The manifestations of hemorrhagic syndrome were evaluated using the pediatric bleeding scale – PBQ (Pediatric Bleeding Questionnaire), followed by a series of laboratory examinations to verify the diagnosis in all children. The sensitivity and specificity of this questionnaire was assessed at various threshold values using the ROC AUC curve, and a comparison of the scores on the scale in patients with different nosologies was made. Results: the study included 346 people, 174 were diagnosed, 172 had no data for coagulopathy/thrombocytopathy found – the patients were considered healthy. The discriminatory ability of the scale under study, studied using the ROC-AUC, was 0,815 (95% CI 0,772–0,858) – satisfactory. With a threshold value of pathological bleeding of 2 points, the sensitivity of the method was 98%, specificity – 12%. The best ratio of sensitivity and specificity (69% and 79%, respectively) was achieved when the threshold value was increased to 4 points. Conclusion: this questionnaire is a convenient addition, with the help of which it is easy to collect a history of bleeding, to assess the severity of bleeding, but it cannot be used as a screening method due to the large number of falsepositive results.