The value of bleeding scores in the assessment of patients presenting with bleeding of unknown cause: Complex algorithms with little predictive value

      The evaluation of patients with mild to moderate bleeding disorder can be frustratingly unproductive. Patients frequently present with bothersome symptoms, such as recurrent epistaxis, easy bruising or menorrhagia, undergo a battery of investigations, only to reveal normal results. Such patients also may demonstrate a family history or have had abnormal bleeding after surgical procedures. Comprehensive laboratory-based bleeding evaluations of patients with suspected bleeding disorders are inconvenient for the patient, are expensive in some healthcare settings, may be difficult to access, and are extraordinarily complex to explain to patients. Availability of an easy to use clinically-based tool with high predictive value for the presence of a laboratory confirmed bleeding disorder would greatly simplify the evaluation of such patients and allow clinicians to prioritize those patients requiring laboratory investigation. This could further simplify clinical monitoring and, potentially, treatment of such patients.
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      1. Gebhart J, Hofer S, Kaider A, et. al. The discriminatory power of bleeding assessment tools in adult patients with a mild to moderate bleeding tendency. Eur J Internal Med, 10.1016/j.ejim.2020.04.023.

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