Questionnaire helps predict bleeding risk from von Willebrand disease

Abstract

The objective of this study was to use a questionnaire 1) for characterization of hemorrhagic signs; 2) to assess its value as a predictor of von Willebrand Disease (vWD) status; and 3) for evaluation of the vWD diagnostic profile [platelet function analysis using the PFA-100, Collagen binding assay (vWF:CBA), and vWF antigen ELISA (vWF:Ag)], partial thromboplastin time (PTT) and Factor VIII activity (FVIII) as predictors of hemorrhagic risk. von Willebrand factor (vWF) concentration and function was assessed for each of the 165 canine participants using the vWD diagnostic profile. Hemorrhagic signs for each dog were obtained using a standardized questionnaire. Questionnaires were scored according to a previously prepared scoring key. Of the 165 dogs in the study, 43.6% had a low vWF concentration, with only 48.6% of dogs in this group having reports of hemorrhagic signs. Oral bleeding was the most commonly reported sign. The questionnaire had a sensitivity of 48.6% and a specificity of 78.5% for the prediction of vWD status. Using the Spearman correlation coefficient, a statistical association was found between the questionnaire and the vWD diagnostic profile components. However, this could not be translated into an ability to predict hemorrhage. The questionnaire allowed characterization of hemorrhagic signs in a large population of dogs over a range of vWF:Ag concentrations, and demonstrated that the vWD diagnostic profile was unsuccessful in the prediction of hemorrhagic risk. Although the sensitivity was insufficient for a screening tool, the questionnaire did have some discriminatory power in the prediction of vWD status.