{"id":409,"date":"2017-10-24T08:35:28","date_gmt":"2017-10-24T12:35:28","guid":{"rendered":"https:\/\/elearning.wfh.org\/resource\/questionnaire-sur-les-saignements-chez-les-enfants\/"},"modified":"2022-09-21T15:21:09","modified_gmt":"2022-09-21T19:21:09","slug":"questionnaire-sur-les-saignements-chez-les-enfants","status":"publish","type":"resource","link":"https:\/\/elearning.wfh.org\/fr\/resource\/questionnaire-sur-les-saignements-chez-les-enfants\/","title":{"rendered":"Questionnaire sur les saignements chez les enfants"},"content":{"rendered":"<h3>Pediatric Bleeding Questionnaire (PBQ)<\/h3>\n<p class=\"\"><strong>Authors\/developers<\/strong><br class=\"\" \/>Bowman M, Riddel J, Rand ML, Tosetto A, Silva M, James PD<\/p>\n<p class=\"\"><a href=\"https:\/\/www1.wfh.org\/docs\/en\/Publications\/Assessment_Tools\/PB_Questionnaire.pdf\" target=\"blank\" rel=\"noopener\">Questionnaire<\/a> and <a href=\"https:\/\/www1.wfh.org\/docs\/en\/Publications\/Assessment_Tools\/PBQ_Scoring_Key.pdf\" target=\"blank\" rel=\"noopener\">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=\"16166\" class=\"elementor elementor-16166\" data-elementor-post-type=\"elementor_library\">\n\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-11d6927f elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"11d6927f\" 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-3ab6a954\" data-id=\"3ab6a954\" 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-cde5dd6 elementor-widget elementor-widget-spacer\" data-id=\"cde5dd6\" 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-33e15f94 elementor-widget elementor-widget-html\" data-id=\"33e15f94\" 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>A pediatric-specific bleeding questionnaire used as a screening tool for VWD.The target population is children with VWD.<\/p>\r\n\r\n  <p><strong>Contact person(s):<\/strong><br>\r\n   PD James: <a href=\"mailto:jamesp@queensu.ca\">jamesp@queensu.ca<\/a><\/p>\r\n\r\n<p class=\"\"><strong>Date of this review: <\/strong>August 25, 2013<br class=\"\"><strong>Updated:<\/strong> April  2014<\/p>\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:2em;\">\r\n      <li>Most useful in the pediatric clinical setting to assess which children should be further evaluated for VWD<\/li>\r\n \t  <li>May also be useful in platelet function disorders<\/li>\r\n \t  <li>May be used as a self-administered tool once validated appropriately<\/li>\r\n \t  <li>Quick and easy to use<\/li>\r\n    <\/ul>\r\n\r\n  <p style=\"margin-bottom:0\"><strong>Limitations:<\/strong><\/p>\r\n    <p>\r\n      Very few studies documented a need for the pediatric specific bleeding symptoms in the \u201cother\u201d category, therefore the need for them is unclear.\r\n \t<\/p>\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>\r\n    <li><strong>Time to complete:<\/strong> 20 minutes<\/li>\r\n    <li><strong>Equipment\/space required:<\/strong> None<\/li>\r\n \t<li><strong>Training required:<\/strong> Physician, research nurse or research associate (\u201ctrained expert\u201d) administered. One study utilized a self-administered version of the PBQ.<sup>5<\/sup><\/li>\r\n \t<li><strong>Cost:<\/strong> None<\/li>\r\n \t<li><strong>Scoring\/scaling\/interpretation of results:<\/strong> \r\n \t  <ul>\r\n \t    <li>Scale \u20131 to 4 for 2 categories of the 13 symptoms tested: dental extraction and surgery. Maximum score for cutaneous bleeding is 2; maximum score for gastrointestinal tract or post-partum bleeding is 3; score of \u20131 is assigned for lack of bleeding on 2 or more challenges for each of post-surgery bleeding, post-partum hemorrhage, and bleeding post-tooth extraction.<\/li>\r\n \t    <li>Possible range: \u20133 to 48<\/li>\r\n \t    <li>Differential features include modification to include pediatric-specific bleeding symptoms in the \u201cother category\u201d (post-circumcision bleeding, umbilical stump bleeding, cephalohematoma, macroscopic hematuria, post-venipuncture bleeding, conjunctival hemorrhage)<\/li>\r\n \t    <li>Abnormal bleeding score (BS) \u22652<\/li>\r\n     <\/ul>  \r\n   <\/li>\r\n\r\n  <\/ol>\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>Construct validity:<br>\r\n      <u>Convergent validity<\/u>\r\n      <ul>\r\n       <li>32% of boys with VWD scored a clinically significant bleeding score (BS) with post-circumcision bleeding.<sup>2<\/sup><\/li>\r\n \t   <li>96% of children with a platelet function disorder scored a positive BS.<sup>4<\/sup><\/li>\r\n \t   <li>BS was inversely related to VWF:Ag and VWF:RCo when using a self-administered version of the PBQ.<sup>5<\/sup><\/li>\r\n \t   <li>BS was significantly higher in affected vs. unaffected family members with VWD.<sup>6<\/sup><\/li>\r\n      <\/ul>\r\n      \r\n      <u>Group differences<\/u>\r\n      <ul>\r\n        <li>Abnormal BS was derived from assessment of questionnaire in a general control population of children attending school association meetings. The normal range of BS was between \u20131.5 to 2.5 and only 13% had a score \u22652.<sup>1<\/sup><\/li>\r\n \t    <li>Median BS was significantly different between children with VWD &gt; positive BS without VWD &gt; negative BS without VWD.<sup>1<\/sup><\/li>\r\n \t    <li>Median BS was significantly higher in all forms of VWD vs. controls as well as all forms of definite VWD vs. possible VWD.<sup>2<\/sup><\/li>\r\n      <\/ul>\r\n    <\/li>\r\n    \r\n \t<li>Criterion validity:\r\n \t  <ul>\r\n \t    <li>For the laboratory diagnosis of VWD, the BS was able to accurately differentiate between those affected and unaffected with VWD.<sup>1<\/sup><\/li>\r\n \t <\/ul>\r\n \t<li>Reliability:\r\n \t  <ul>\r\n \t    <li>Repeat testing was performed in one study but results were not recorded.<sup>2<\/sup><\/li>\r\n \t  <\/ul> \r\n \t<li>Responsiveness\/sensitivity:\r\n \t<ul>\r\n \t  <li>Responsiveness by means of ROC analysis had an AUC of 0.88.<sup>1<\/sup><\/li>\r\n \t<li>Responsiveness of tool to increased BS with increasing age was shown (Spearman\u2019s correlation coefficient was 0.35, p=0.0004).<sup>2<\/sup><\/li>\r\n \t<li>The sensitivity of an abnormal BS for diagnosis of VWD was 83%, with a specificity of 79%, positive predictive value (PPV) of 0.14, and negative predictive value (NPV) of 0.99.<sup>1<\/sup><\/li>\r\n \t<li>When using a screening question of \u201cDoes your child have a problem with bleeding or bruising?\u201d the sensitivity and specificity for a positive BS and diagnostically proven VWD was similar (sensitivity of 94% vs. 91% and specificity of 94% vs. 95%, respectively).<\/li>\r\n \t<li>Internal consistency of questions within one version of the self-PBQ was good, with a Crohnbach\u2019s alpha of 0.88.<sup>5<\/sup><\/li>\r\n \t<li>PBQ ROC-AUC was 0.768, similar to the ISTH BAT ROC-AUC of 0.764.<sup>8<\/sup><\/li>\r\n \t<li>However, in a tertiary care setting when evaluating for a mild bleeding disorder, the PBQ was found to have an ROC-AUC&lt;0.6 for qualitative BS cut off of 2:\r\n \t  <ul>\r\n        <li>Using a cut off of &gt;2, hemorrhagic symptoms sensitivity was 60.5%, and specificity was 50.8%<\/li>\r\n        <li>Using a cut off of BS &gt;3 in males and &gt;5 in females, sensitivity was 41.9%, and specificity was 82%.<sup>7<\/sup><\/li>\r\n      <\/ul>\r\n      <\/li>\r\n    <\/ul>\r\n    <\/li>\r\n  <\/ol>\r\n  \r\n  <p><strong>Languages studied: <\/strong>English, German <sup>8<\/sup><\/p>\r\n \r\n  <p><strong>Groups tested with this measure: <\/strong><\/p>\r\n  <ul style=\"margin-bottom: 2em\">\r\n    <li>Controls<sup>1,2<\/sup><\/li>\r\n \t<li>Children being evaluated for VWD because of personal or family history of bleeding<sup>1,6<\/sup><\/li>\r\n \t<li>Children with known diagnosis of VWD (type 1\u20133)<sup>2,3,6,7<\/sup><\/li>\r\n \t<li>Children with a known diagnosis of a platelet function disorder<sup>4<\/sup><\/li>\r\n \t<li>Hemophilia A<sup>5<\/sup><\/li>\r\n  <\/ul>\r\n  \r\n\r\n  <p><strong>Age: <\/strong>Children and some adults<\/p>\r\n  \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. Evaluation of the diagnostic utility for von Willebrand disease of a pediatric bleeding questionnaire. <em>J Thromb Haemost<\/em> 2009; 7: 1418-1421.<\/li>\r\n \t<li>Biss T et al. Quantitation of bleeding symptoms in children with von Willebrand disease: use of a standardized pediatric bleeding questionnaire. <em>J Thromb Haemost<\/em> 2010; 8: 950-956.<\/li>\r\n \t<li>Bowman M et al. A Prospective Evaluation of the Prevalence of Symptomatic von Willebrand Disease (VWD) in a Pediatric Primary Care Population. <em>Pediatr Blood Cancer<\/em> 2010; 55: 171-173.<\/li>\r\n \t<li>Biss T et al. Use of a quantitative pediatric bleeding questionnaire to assess mucocutaneous bleeding symptoms in children with a platelet function disorder. <em>J Thromb Haemost<\/em> 2010; 8: 1416-1419.<\/li>\r\n \t<li>Boelaars MFP et al. Evaluation of a self-administrated pediatric bleeding questionnaire measuring bleeding severity in children. <em>Thromb Haemost<\/em> 2012; 108: 1006-1007.<\/li>\r\n \t<li>Robertson J et al. Expanded phenotype\u2013genotype correlations in a pediatric population with type 1 von Willebrand disease. <em>J Thromb Haemost<\/em> 2011; 9: 1752-60.<\/li>\r\n \t<li>Marcus PD et al. The power of a standardized bleeding score in diagnosing paediatric type 1 von Willebrand\u2019s disease and platelet function defects. <em>Haemophilia<\/em> 2011; 17: 223-227.<\/li>\r\n \t<li>Bidlingmaier C et al. Prospective evaluation of a pediatric bleeding questionnaire and the ISTH bleeding assessment tool in children and parents in routine clinical practice. <em>J Thromb Haemost<\/em> 2012; 10: 1335-1341.<\/li>\r\n<\/ol>\r\n\r\n<\/div>\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-a47704e elementor-widget elementor-widget-spacer\" data-id=\"a47704e\" 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":23196,"template":"","format":[],"old-keyword":[],"topic":[3994],"serie":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.4 - 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