Translation, validation, and usability of the International Society on Thrombosis and Haemostasis Bleeding Assessment Tool (Self‐ISTH‐BAT)

Background Bleeding questionnaires are effective and recommended screening tools for potential bleeding disorder, but healthcare practitioner–administered bleeding assessment tools (expert‐ISTH‐BATs) are time‐consuming. A patient‐administered ISTH‐BAT (self‐ISTH‐BAT) has been developed and validated. We translated, validated, and evaluated the usability of self‐ISTH‐BAT. Methods We conducted a forward–backward translation of self‐ISTH‐BAT from English to Danish. Expert‐ISTH‐BAT and Danish self‐ISTH‐BAT were administered to 106 random individuals aged ≥18 years attending Odense University Hospital between August and November 2020 for elective blood sampling. Results comprise a score of bleeding symptoms. Results Mean age of included individuals were 49 years (range: 18‐83), and 59% were female. Median self‐ISTH‐BAT score was 2 (range: 0‐18) and 1 (range: 0‐22) for expert‐ISTH‐BAT ( P  = .09). All organ systems had ≥90% exact score agreement between expert‐ISTH‐BAT and self‐ISTH‐BAT, except gastrointestinal bleeding (77%) and other bleedings (72%). We found an acceptable correlation ( r 2  = .80) between expert‐ISTH‐BAT and self‐ISTH‐BAT. The self‐ISTH‐BAT had 82% sensitivity and 89% specificity at the recommended cutoff for expert‐BAT (female:<6; male:<4). At this cutoff, 10 had abnormal self‐ISTH‐BAT scores with normal expert‐ISTH‐BAT. Three (3%) had normal self‐ISTH‐BAT with abnormal expert‐ISTH‐BAT. Conclusion Self‐ISTH‐BAT can replace expert‐ISTH‐BAT as a screening tool for bleeding disorders in Danish individuals as only 3% were not identified with the self‐ISTH‐BAT tool.