Related Experiment Videos
Comparison of PFA-100 and bleeding time testing in pediatric patients with suspected hemorrhagic problems
Rohit Cariappa1, Timothy R Wilhite, Curtis A Parvin
1Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Insights
The PFA-100 test demonstrates superior sensitivity and specificity compared to the bleeding time test for diagnosing bleeding disorders in children. This makes the PFA-100 a more efficient and reliable diagnostic tool for pediatric hemostasis evaluation.
Area of Science:
- Pediatric Hematology
- Diagnostic Laboratory Medicine
- Hemostasis and Thrombosis
Background:
- The bleeding time test is challenging to perform, standardize, and interpret in pediatric populations.
- Children with potential bleeding problems require accurate and efficient diagnostic methods.
Purpose of the Study:
- To evaluate the diagnostic performance of the PFA-100 compared to the bleeding time test in children.
- To determine the sensitivity, specificity, and efficiency of both tests for identifying bleeding disorders.
Main Methods:
- A cohort of 52 children (aged >6 months and <18 years) referred for hemostatic evaluation were included.
- Standard hemostatic tests, bleeding time, and PFA-100 (using Col/Epi and Col/ADP cartridges) were performed.
- All patients underwent evaluation by a hematologist.
Main Results:
- The PFA-100 with the Col/Epi cartridge showed 100% sensitivity and 97% specificity for qualitative platelet abnormalities, outperforming the bleeding time test (37% sensitivity, 88% specificity).
- For pediatric von Willebrand disease, PFA-100 sensitivity was 100% (Col/Epi) versus 17% for bleeding time.
- Combined sensitivities for platelet defects and von Willebrand disease were 100% (Col/Epi) and 87% (Col/ADP) for PFA-100, compared to 37% for bleeding time.
Conclusions:
- The PFA-100 test is a more efficient and accurate diagnostic tool for evaluating children with potential bleeding issues.
- The PFA-100 can effectively replace the bleeding time test in the laboratory assessment of pediatric bleeding disorders.
Background:
The bleeding time test is difficult to perform, standardize, and interpret in children. In this study the authors evaluated the sensitivity, specificity, and efficiency of the bleeding time test and the PFA-100 in a series of children referred for possible bleeding problems.
Patients And Methods:
Between February 2000 and August 2001 patients aged more than 6 months and less than 18 years of age who were referred to the authors' institution for a hemostatic evaluation were included in the study if residual blood was available for testing on the PFA-100 instrument. Fifty-two children had platelet count, prothrombin time, partial thromboplastin time, bleeding time, and PFA-100 testing performed as well as an evaluation by a hematologist. For PFA-100 testing, 52 patients had Col/Epi measurements; adequate sample remained for Col/ADP testing on 32. Additional testing for diagnostic purposes was at the discretion of the treating physician.
Results:
Use of the Col/Epi cartridge in the PFA-100 instrument offered 100% sensitivity and 97% specificity for detection of qualitative platelet abnormalities, compared with 37% and 88%, respectively, for bleeding time testing. For pediatric patients with von Willebrand disease, the sensitivity was 100% using the Col/Epi cartridge, compared with 17% for the bleeding time test. The sensitivities for combined qualitative platelet defects and von Willebrand disease using the Col/Epi or Col/ADP cartridges were 100% and 87%, respectively, compared with 37% for the bleeding time test.
Conclusions:
The PFA-100 is a more efficient test; it can replace the bleeding time test as a component of the laboratory evaluation of children with a potential bleeding problem.