{"id":406,"date":"2017-07-24T09:25:09","date_gmt":"2017-07-24T13:25:09","guid":{"rendered":"https:\/\/elearning.wfh.org\/resource\/mcmdm-1-mvw-condense\/"},"modified":"2022-09-21T15:14:18","modified_gmt":"2022-09-21T19:14:18","slug":"mcmdm-1-mw-condense","status":"publish","type":"resource","link":"https:\/\/elearning.wfh.org\/fr\/resource\/mcmdm-1-mw-condense\/","title":{"rendered":"MCMDM-1 mW condens\u00e9"},"content":{"rendered":"<h3>Condensed Molecular and Clinical Markers for the Diagnosis and Management of Type 1 (MCMDM-1) VWD Bleeding Questionnaire<\/h3>\n<p class=\"\"><strong>Authors\/developers<\/strong><br class=\"\" \/>Bowman M, Mundell G, Grabell J, Hopman WH, Rapson D, Lillicrap D, James PD<\/p>\n<p class=\"\"><a href=\"https:\/\/www1.wfh.org\/docs\/en\/Resources\/Assessment_Tools_CondensedMCMDM1VWD.pdf\" target=\"blank\" rel=\"noopener\">Questionnaire and scoring key<\/a><\/p>\n<h6><em>N.B.: These scores are posted with the permission of the developers.<\/em><\/h6>\n\t\t<div data-elementor-type=\"section\" data-elementor-id=\"16227\" class=\"elementor elementor-16227\" data-elementor-post-type=\"elementor_library\">\n\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-3d94eaa6 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"3d94eaa6\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-7664c4bf\" data-id=\"7664c4bf\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-e52896e elementor-widget elementor-widget-spacer\" data-id=\"e52896e\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c49f59e elementor-widget elementor-widget-html\" data-id=\"c49f59e\" data-element_type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\r\n\r\n\/* Style the tab *\/\r\n.popTab {\r\n  float: left;\r\n  border: 1px solid #ccc;\r\n  background-color: #f1f1f1;\r\n  width: 35%;\r\n  height: 500px;\r\n}\r\n\r\n\/* Style the buttons inside the tab *\/\r\n.popTab button {\r\n  display: block;\r\n  background-color: inherit;\r\n  color: black;\r\n  padding: 15px 10px;\r\n  width: 100%;\r\n  border: none;\r\n  border-radius: 0;\r\n  outline: none;\r\n  text-align: left;\r\n  cursor: pointer;\r\n  transition: 0.3s;\r\n  font-size: 1.3em;\r\n}\r\n\r\n\/* Change background color of buttons on hover *\/\r\n.popTab button:hover {\r\n  background-color: #ddd;\r\n}\r\n\r\n\/* Create an active\/current tablink class *\/\r\n.popTab button.active {\r\n  background-color: #ccc;\r\n  border: none!important;\r\n}\r\n\r\n\/* Style the tab content *\/\r\n.popContent {\r\n  float: left;\r\n  padding: 0px 1em;\r\n  border: 1px solid #ccc;\r\n  width: 65%;\r\n  border-left: none;\r\n  height: 500px;\r\n  overflow-y:auto;\r\n}\r\n\r\n.popContent table tr {\r\n    \/*pointer-events: none;*\/\r\n\r\n}\r\n\r\n.popContent table td {\r\n    border-top: none;\r\n    border-left: none;\r\n    border-right: none;\r\n    border-bottom: 1px solid #eee;\r\n    background-color: white!important;\r\n    padding-left: 0;\r\n}\r\n\r\n<\/style>\r\n\r\n\r\n<div class=\"popTab\">\r\n   <button class=\"popLinks active\" onclick=\"openTab(event, 'description')\">Description<\/button>    \r\n   <button class=\"popLinks\" onclick=\"openTab(event, 'utility')\">Utility<\/button>\r\n   <button class=\"popLinks\" onclick=\"openTab(event, 'administration')\">Administration<\/button>\r\n   <button class=\"popLinks\" onclick=\"openTab(event, 'psychometrics')\">Psychometrics<\/button>\r\n   <button class=\"popLinks\" onclick=\"openTab(event, 'references')\">References<\/button>\r\n \r\n  \r\n<\/div>\r\n\r\n<div id=\"description\" class=\"popContent\">\r\n  <h3>Description<\/h3>\r\n  <p>The condensed version of the MCMDM-1 VWD bleeding questionnaire can be used in the clinical setting to identify those with normal vs. abnormal bleeding symptoms and to determine the severity of bleeding. The target population includes patients with known VWD and those being evaluated for a possible bleeding disorder.<\/p>\r\n\r\n\r\n  <p><strong>Contact person:<\/strong><br>\r\n  PD James: <a title=\"[GMCP] Compose a new mail to jamesp@queensu.ca\" href=\"mailto:jamesp@queensu.ca\" rel=\"noreferrer\">jamesp@queensu.ca<\/a><\/p>\r\n\r\n<p class=\"\"><strong>Date of this review: <\/strong>August 19, 2013<br>\r\n<strong>Updated: <\/strong>April 2014<\/p>\r\n\r\n\r\n<\/div>\r\n\r\n\r\n<div id=\"utility\" class=\"popContent\" style=\"display:none\">\r\n  <h3>Utility<\/h3>\r\n  \r\n  <p style=\"margin-bottom: 0\"><strong>Overall utility:<\/strong><\/p>\r\n  <ul style=\"margin-bottom: 1em\">\r\n \t<li>Very useful in the clinical setting to distinguish between various bleeding disorders, severity of specific bleeding disorders, and ruling out a bleeding disorder, particularly VWD<\/li>\r\n \t<li>Quick and easy to use<\/li>\r\n<\/ul>\r\n\r\n<p><strong>Limitations:<\/strong> Requires a skilled professional to administer<\/p> \r\n\r\n<\/div>\r\n\r\n\r\n<div id=\"administration\" class=\"popContent\" style=\"display:none\">\r\n  <h3>Administration<\/h3>        \r\n   <ol style=\"margin-bottom:1em\">\r\n \t<li><strong>Time to complete:<\/strong> 5\u201310 minutes<\/li>\r\n    \t<li><strong>Equipment\/space required:<\/strong> None<\/li>\r\n    <li><strong>Training required:<\/strong> Expert-administered; no training specific to the administration of the scoring tool is required<\/li>\r\n \t<li><strong>Cost:<\/strong> None<\/li>\r\n    <li><strong>Scoring\/scaling\/interpretation of results:<\/strong>\r\n    <ul>\r\n \t  <li>Scale: 3 categories are scored \u20131 to 4 (dental extraction, post-op, and post-partum), 7 are scored 0 to 4, GI is scored 0 to 3 and bruising is scored 0 to 2 (details as for <a style=\"color: #e31837; text-decoration: none;\" href=\"https:\/\/elearning.wfh.org\/resource\/mcmdm-1-vwd\/\" target=\"_blank\" rel=\"noopener\">MCMDM-1 VWD Bleeding Questionnaire<\/a> score)<\/li>\r\n \t  <li>Possible range of total score: \u20133 to 45<\/li>\r\n \t  <li>Differentiating features as for <a style=\"color: #e31837; text-decoration: none;\" href=\"https:\/\/elearning.wfh.org\/resource\/mcmdm-1-vwd\/\" target=\"_blank\" rel=\"noopener\">MCMDM-1 VWD Bleeding Questionnaire<\/a> score<\/li>\r\n \t  <li>Abnormal bleeding score (BS): &gt;4<\/li>\r\n    <\/ul>\r\n  <\/ol>\r\n\r\n<\/div>\t\r\n\r\n<div id=\"psychometrics\" class=\"popContent\" style=\"display:none\">\r\n  <h3>Psychometrics<\/h3>        \r\n  \r\n  <p><strong>Psychometric properties:<\/strong><\/p>\r\n  \r\n  <ol style=\"margin-bottom:1em\">\r\n    <li>\r\n      Construct validity:<br>\r\n      <u>Convergent validity<\/u><br>\r\n \t  <ul>\r\n \t    <li>Higher bleeding score (BS) being inversely correlated to VWF:Ag, FVIII:C and VWF:RCo levels, bleeding time.<sup>1,2,3\u00a0<\/sup><\/li>\r\n \t    <li>Comparing the Condensed MCMDM-1 VWD Questionnaire to the full MCMDM-1VWD Questionnaire showed a Spearman\u2019s rho of 0.97 and an r<sup>2<\/sup> of 96.4.<sup>1<\/sup><\/li>\r\n      <\/ul>\r\n      <u>Divergent validity<\/u>\r\n      <ul>\r\n \t    <li>In those with a negative BS (i.e. &lt;4): when challenged with a surgical procedure, none had significant bleeding.<sup>1<\/sup><\/li>\r\n      <\/ul>\r\n      <u>Group differences<\/u>\r\n      <ul>\r\n \t    <li>With increased BS being associated with type 3 &gt; type 2 &gt; type 1 VWD.<sup>1\u00a0<\/sup><\/li>\r\n \t    <li>BS discriminated between cases with VWD, undefined bleeding disorders, or mild platelet dysfunction and controls.<sup>4\u00a0<\/sup><\/li>\r\n \t    <li>With increased BS being associated with type 3 as compared to type 1 VWD, obligate carriers, and unaffected family members.<sup>2<\/sup><\/li>\r\n      <\/ul>\r\n      <\/li>\r\n \t  <li>Criterion validity:\r\n \t    <ul>\r\n \t      <li>The BS was significantly different between those with laboratory confirmed VWD and those who bled without having VWD and those without bleeding.<sup>1<\/sup><\/li>\r\n        <\/ul>\r\n      <\/li>\r\n \t  <li>Reliability:\r\n \t    <ul>\r\n \t      <li>In the original study, 24 subjects (of the total 259) were administered the questionnaire by two different observers three months apart with an inter-observer Spearman\u2019s rho of 0.72 and an intra-class correlation (ICC) of 0.805 (reasonable inter-observer reliability).<sup>1<\/sup><\/li>\r\n        <\/ul>\r\n \t  <\/li>\r\n \t  \r\n \t<li>Responsiveness\/sensitivity:\r\n \t<ul>\r\n \t  <li>Responsiveness was excellent with an ROC-AUC of 0.96 for distinguishing affected and unaffected individuals based on having a positive BS (defined as \u22654).<sup>1<\/sup><\/li>\r\n \t<li>For type 1 VWD, the sensitivity was 100%, specificity was 87%, positive predictive value (PPV) was 0.20, and negative predictive value (NPV) was 1.<sup>1\u00a0<\/sup><\/li>\r\n \t<li>For the diagnosis of a mild bleeding disorder, the PPV was 0.71\u20130.78 and the NPV was 99%. The ROC-AUC was 0.63. Inclusion of positive BS with elevated aPTT (ratio &gt;1.2) improved the ROC-AUC to 0.74 (which is considered adequate).<sup>5\u00a0<\/sup><\/li>\r\n \t<li>In women with menorrhagia, using a BS cut-off of 3.5, the sensitivity was 85%, specificity was 90%, PPV was 0.88, and NPV was 0.89 with an ROC-AUC of 0.91.<sup>3<\/sup><\/li>\r\n    <\/ul>\r\n  <\/ol>\r\n  \r\n  <p><strong>Languages studied:<\/strong> English<\/p>\r\n\r\n  <p><strong>Groups tested with this measure:<\/strong><\/p>\r\n  <ul style=\"margin-bottom:1em\">\r\n \t<li>Community controls<sup>1,4<\/sup><\/li>\r\n \t<li>Type 1, 2A, 2B, 2M, 3 VWD<sup>1,2,4<\/sup><\/li>\r\n \t<li>Subjects being evaluated to rule out VWD<sup>1<\/sup><\/li>\r\n \t<li>Undefined bleeding disorders<sup>4,5<\/sup><\/li>\r\n \t<li>Mild platelet dysfunction disorders<sup>4\u00a0<\/sup><\/li>\r\n \t<li>Mild hemophilia<sup>5\u00a0<\/sup><\/li>\r\n \t<li>Factor XI deficiency<sup>5\u00a0<\/sup><\/li>\r\n \t<li>Women with menorrhagia<sup>3<\/sup><\/li>\r\n <\/ul>\r\n\r\n  <p><strong>Age: <\/strong>Children and adults<\/p>\r\n\r\n  <p><a href=\"\/resource\/glossary-of-psychometric-properties\/\" target=\"_blank\" rel=\"noopener\"><button>Glossary of Psychometric Properties<\/button><\/a><\/p>\r\n\r\n<\/div>\r\n\r\n\r\n<div id=\"references\" class=\"popContent\" style=\"display:none\">\r\n  <h3>References<\/h3>        \r\n  <ol>\r\n    <li>Bowman M et al. Generation and validation of the condensed MCMDM-1VWD bleeding questionnaire for von Willebrand disease. <em>J Thromb Haemost<\/em> 2008; 6: 2062-2066.<\/li>\r\n \t<li>Bowman M et al. The genetics of Canadian type 3 von Willebrand disease: further evidence for co-dominant inheritance of mutant alleles. <em>J Thromb Haemost<\/em> 2013; 11: 512-520.<\/li>\r\n \t<li>Azzam HAG et al. The condensed MCMDM-1 VWD bleeding questionnaire as a predictor of bleeding disorders in women with unexplained menorrhagia. <em>Blood Coagul Fibrinolysis<\/em> 2012; 23: 311-315.<\/li>\r\n \t<li>Jackson SC et al. Suspected collagen disorders in the bleeding disorder clinic: A case\u2013control study.<em>Haemophilia<\/em> 2013; 19: 246-250.<\/li>\r\n \t<li>Tosetto A et al. Prospective evaluation of the clinical utility of quantitative bleeding severity assessment in patients referred for hemostatic evaluation. <em>J Thromb Haemost<\/em> 2011; 9: 1143-1148.<\/li>\r\n \t<li>Rydz N, James P The evolution and value of bleeding assessment tools. <em>J Thromb Haemost<\/em> 2012; 10: 2223-2229.<\/li>\r\n  <\/ol>\r\n\r\n<\/div>\r\n\r\n\r\n\r\n\r\n\r\n\r\n<script>\r\nfunction openTab(evt, country) {\r\n  var i, popContent, popLinks;\r\n  popContent = document.getElementsByClassName(\"popContent\");\r\n  for (i = 0; i < popContent.length; i++) {\r\n    popContent[i].style.display = \"none\";\r\n  }\r\n  popLinks = document.getElementsByClassName(\"popLinks\");\r\n  for (i = 0; i < popLinks.length; i++) {\r\n    popLinks[i].className = popLinks[i].className.replace(\" active\", \"\");\r\n  }\r\n  document.getElementById(country).style.display = \"block\";\r\n  evt.currentTarget.className += \" active\";\r\n}\r\n<\/script>\r\n   \t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7a6970f4 elementor-widget elementor-widget-spacer\" data-id=\"7a6970f4\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t\n","protected":false},"featured_media":23007,"template":"","format":[],"old-keyword":[],"topic":[3994],"serie":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.4 - 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