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Increasing observation rates in low‐risk pediatric immune thrombocytopenia using a standardized clinical assessment and management plan (SCAMP®)
Authors:Michelle L Schoettler  Dionne Graham  Wen Tao  Margaret Stack  Elaine Shu  Lauren Kerr  Ellis J Neufeld  Rachael F Grace
Institution:1. Pediatric Hematology/Oncology, Dana‐Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts;2. Institute for Relevant Clinical Data Analytics, Boston, Massachusetts;3. Program for Patient Safety and Quality, Boston Children's Hospital, Boston, Massachusetts
Abstract:An observational approach is recommended in newly diagnosed children with immune thrombocytopenia (ITP) at low risk of bleeding; however, there is no standard definition of risk. A standardized clinical assessment and management plan (SCAMP®), a modifiable practice guideline, was implemented and revised (SCAMP‐1 and SCAMP‐2) and applied to 71 newly diagnosed patients with ITP. The Buchanan and Adix bleeding score guided treatment and was modified by stratifying by low‐ and high‐risk grade 3 bleeding in SCAMP‐2. Observation rates increased from 40% to 74% from SCAMP‐1 to SCAMP‐2 (P < 0.05) with no bleeding complications. We propose a modified bleeding score that increased observation rates in low‐risk patients with ITP.
Keywords:bleeding  guideline  immune thrombocytopenia  pediatrics  treatment
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