{"id":410,"date":"2017-10-24T08:30:23","date_gmt":"2017-10-24T12:30:23","guid":{"rendered":"https:\/\/elearning.wfh.org\/resource\/score-relatif-aux-saignements-de-sramek\/"},"modified":"2022-09-21T14:51:41","modified_gmt":"2022-09-21T18:51:41","slug":"score-relatif-aux-saignements-de-sramek","status":"publish","type":"resource","link":"https:\/\/elearning.wfh.org\/fr\/resource\/score-relatif-aux-saignements-de-sramek\/","title":{"rendered":"Score relatif aux saignements de \u0160r\u00e1mek"},"content":{"rendered":"<h3>\u0160r\u00e1mek Bleeding Score<\/h3>\n<p class=\"\"><strong>Authors\/developers<\/strong><br class=\"\" \/>\u0160r\u00e1mek A, Eikenboom JCJ, Briet E, Vandenbroucke JP, Rosendaal FR<\/p>\n<p class=\"\"><a href=\"https:\/\/www1.wfh.org\/docs\/en\/Resources\/Assessment_Tools_Sramek.pdf\" target=\"blank\" rel=\"noopener noreferrer\">Questionnaire and scoring key<\/a><\/p>\n<p class=\"\"><em>N.B.: These scores are posted with the permission of the developers.<\/em><\/p>\n\t\t<div data-elementor-type=\"section\" data-elementor-id=\"7945\" class=\"elementor elementor-7945\" data-elementor-post-type=\"elementor_library\">\n\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-6de6839e elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"6de6839e\" 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-25f3ea71\" data-id=\"25f3ea71\" 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-1adf1039 elementor-widget elementor-widget-spacer\" data-id=\"1adf1039\" 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-68aaf843 elementor-widget elementor-widget-html\" data-id=\"68aaf843\" 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 \u0160r\u00e1mek bleeding score is a short questionnaire that can either be self- or expert-administered. It is designed to assist in the clinical diagnosis of mild inherited bleeding disorders. The target population is people with mild inherited bleeding disorders.<\/p>\r\n\r\n\r\n  <p><strong>Contact person:<\/strong><br>\r\n  FR Rosendaal:\r\n<a href=\"mailto:f.r.rosendaal@lumc.nl\">f.r.rosendaal@lumc.nl<\/a>\r\n<\/p>\r\n\r\n<p class=\"\"><strong>Date of this review: <\/strong>August 27, 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><strong>Overall utility:<\/strong><\/p>\r\n  <ul style=\"margin-bottom: 1em\">\r\n  <li>Useful in the primary care clinical setting to screen for a bleeding disorder<\/li>\r\n \t<li>May be self-administered<\/li>\r\n  <\/ul>\r\n\r\n  <p><strong>Limitations:<\/strong><\/p>\r\n   <ul>\r\n    <li>Low discriminating power in a specialty referral setting (i.e. better for primary care)<\/li>\r\n \t<li>No validation against gold standard laboratory\/clinical diagnosis<\/li>\r\n \t<li>No specific assessment of sensitivity or specificity of abnormal bleeding score<\/li>\r\n \t<li>Time to complete not known<\/li>\r\n<\/ul>\r\n\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> Not identified<\/li>\r\n    <li><strong>Equipment\/space required:<\/strong> None<\/li>\r\n    <li><strong>Training required:<\/strong>\r\n      <ul>\r\n \t    <li>None for self-administered questionnaire<sup>1<\/sup><\/li>\r\n \t    <li>For expert-administered, no training specific to the administration of the scoring tool is required<sup>2,3<\/sup><\/li>\r\n      <\/ul>\r\n    <\/li>\r\n    <li><strong>Cost:<\/strong> None<\/li>\r\n    <li><strong>Scoring\/scaling\/interpretation of results:<\/strong>\r\n    <ul>\r\n \t  <li>Scale: 0\u20131 for each of 16 main bleeding symptoms or categories. For some categories the maximum score could be as high as 5 if sub-categories of that question were positive (e.g. severity)<sup>1<\/sup><\/li>\r\n \t<li>Possible range of total score 0\u201340<sup>1<\/sup> (Podda modification range 0\u201342 for 12 main bleeding symptoms)<sup>2<\/sup><\/li>\r\n \t<li>Abnormal if total score \u226512 (based on the Podda-modification of the score<sup>2<\/sup>)<\/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>PFA-100<sup>\u00ae<\/sup> Collagen-Epinephrine cartridge closure times progressively increased in association with higher bleeding score categories (four categories in this study: 0\u20133, 4\u20137, 8\u201311, \u226512), however bleeding time and PFA-100<sup>\u00ae<\/sup> Collagen-ADP cartridge closure times did not differ among groups.<sup>2<\/sup><\/li>\r\n \t    <li>A significant correlation between <a style=\"color: #e31837; text-decoration: none;\" href=\"https:\/\/elearning.wfh.org\/resource\/pictorial-blood-loss-assessment-chart\/\" target=\"_blank\" rel=\"noopener\">PBAC score<\/a> and Podda-modified bleeding score<sup>2<\/sup> was observed in women with and without underlying bleeding disorders (Spearman\u2019s rho 0.44, p&lt;0.001)<sup>3<\/sup><\/li>\r\n \t    <li>Median bleeding score increased in mild to moderate forms of rare bleeding disorders and VWD (although the trend was not statistically significant). A similar non-significant trend was seen in female hemophilia carriers with factor levels ranging from normal to mild to moderate deficiencies having proportional increases in bleeding score.<sup>3<\/sup><\/li>\r\n      <\/ul>\r\n      <u>Group differences<\/u>\r\n      <ul>\r\n \t    <li>Presence of certain symptoms (e.g. bleeding post tonsillectomy and adenoidectomy) was most informative at differentiating controls from those with bleeding disorders.<sup>1<\/sup><\/li>\r\n \t    <li>Abnormal bleeding score (Podda-modified)<sup>2<\/sup> was observed in 49% of women with a bleeding disorder and no women without an underlying bleeding disorder.<sup>3<\/sup><\/li>\r\n      <\/ul>\r\n      <\/li>\r\n \t  <li>Criterion validity:\r\n \t    <ul>\r\n \t       \t<li>No studies identified<\/li>\r\n        <\/ul>\r\n      <\/li>\r\n \t  <li>Reliability:\r\n \t    <ul>\r\n \t     <li>No studies identified<\/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>ROC-AUC for interview (using only presence or absence of symptoms rather than actual bleeding score) in a screening situation had high discriminating power (AUC not recorded), and in a referral clinic (hematology) setting of minimal discriminating power (AUC not recorded).<sup>1<\/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:<\/strong><\/p>\r\n  <ul style=\"margin-bottom:1em\">\r\n \t<li>Healthy controls<sup>1<\/sup><\/li>\r\n \t<li>Adults with mild hemophilia A\/B<sup>1<\/sup><\/li>\r\n \t<li>Adults with mild VWD<sup>1<\/sup><\/li>\r\n \t<li>Adults with platelet dysfunction<sup>1<\/sup><\/li>\r\n \t<li>Adults and children being evaluated for a possible bleeding disorder<sup>2<\/sup><\/li>\r\n \t<li>Women with rare bleeding disorders, VWD, and hemophilia carriers<sup>3,4<\/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>\u0160r\u00e1mek A et al. Usefulness of patient interview in bleeding disorders. <em>Arch Intern Med<\/em> 1995; 155: 1409-1415.<\/li>\r\n \t<li>Podda GM et al. Usefulness of PFA-100<sup>\u00ae<\/sup> testing in the diagnostic screening of patients with suspected abnormalities of hemostasis: comparison with bleeding time. <em>J Thromb Haemost<\/em> 2007; 5: 2393-2398.<\/li>\r\n \t<li>Siboni SM et al. Gynaecological and obstetrical problems in women with different bleeding disorders.<em>Haemophilia<\/em> 2009; 15: 1291-1299.<\/li>\r\n \t<li>Plug I et al. Bleeding in carriers of hemophilia. <em>Blood<\/em> 2006; 108: 52-56.<\/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-33d04cff elementor-widget elementor-widget-spacer\" data-id=\"33d04cff\" 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":23273,"template":"","format":[],"old-keyword":[],"topic":[3994],"serie":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.4 - 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