mBAT: a newly developed mobile application for self-screening of pediatric bleeding disorders - a multi-center study

Bleeding assessment tools (BATs) are used by trained medical personnel for screening bleeding disorders on a one-to-one basis with patients; hence, they are time-consuming and limited in use for large-population screening. The aims of the study were to develop, validate, and demonstrate a Thai BAT mobile application (mBAT) for self-screening of bleeding disorders. mBAT was developed and validated using the paper-based Thai version of pediatric bleeding questionnaire (TPBQ). Then, mBAT was applied to 916 subjects from communities and hematology clinics. Those with scores of ≥3 consented to further investigation of bleeding disorders. mBAT was developed for Thai children using simple sentences, a video introduction, pictures, and auto-calculation. It showed a high correlation with the TPBQ: r = 0.96 and 0.97 in the PBQ and ISTH scoring systems, respectively (P<0.01). A score ≥3 was considered abnormal. The mBAT was applied to 916 subjects, with a mean (range) age of 10.5 (0.07-18.0) years. Most subjects (97.3%) were from the community, and the rest (2.7%) were from hematology clinics. The results showed 41 subjects had abnormal scores, and 35 (16 from the community and 19 from clinics) consented to diagnostic investigation. Eleven subjects (31.4%) were found to have bleeding disorders, including four with VWD, two each with hemophilia A and thrombocytopenia, and one each with factor VII deficiency, platelet dysfunction, and MYH9-related disorder. Thus, the prevalence rates of bleeding disorders in the subjects whose scores ≥3 from community and hematology clinics were 6.25% and 52.6%, respectively. In conclusions, the mBAT had a high correlation with the TPBQ. As a self-screening tool, it could enhance the diagnosis of bleeding disorders.