Utilizing a PLASMIC score‐based approach in the management of suspected immune thrombotic thrombocytopenic purpura: a cost minimization analysis within the Harvard TMA Research Collaborative
Summary The PLASMIC score is a recently described clinical scoring algorithm that rapidly assesses the probability of severe ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13) deficiency among patients presenting with microangiopathic haemolytic anaemia. Usi...
Gespeichert in:
| Veröffentlicht in: | British journal of haematology 2019-08, Vol.186 (3), p.490-498 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 498 |
|---|---|
| container_issue | 3 |
| container_start_page | 490 |
| container_title | British journal of haematology |
| container_volume | 186 |
| creator | Upadhyay, Vivek A. Geisler, Benjamin P. Sun, Lova Uhl, Lynne Kaufman, Richard M. Stowell, Christopher Makar, Robert S. Bendapudi, Pavan K. |
| description | Summary
The PLASMIC score is a recently described clinical scoring algorithm that rapidly assesses the probability of severe ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13) deficiency among patients presenting with microangiopathic haemolytic anaemia. Using a large multi‐institutional cohort, we explored whether an approach utilizing the PLASMIC score to risk‐stratify patients with suspected immune thrombotic thrombocytopenic purpura (iTTP) could lead to significant cost savings. Our consortium consists of institutions with an unrestricted approach to ADAMTS13 testing (Group A) and those that require pre‐approval by the transfusion medicine service (Group B). Institutions in Group A tested more patients than those in Group B (P |
| doi_str_mv | 10.1111/bjh.15932 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6642029</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2232106845</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5092-3cdf596c28a7c271491e817a076470f9807c9ad615b541ba5a51a9c417a8f6a03</originalsourceid><addsrcrecordid>eNp1ktFu0zAUhiMEYmVwwQsgS9zARTbbsZOYC6RSDTrUCQTbtXXiOK2rJA6206m72iPwSDwLT4JLuwmQsCzZsj__5z_WnyTPCT4hcZxW69UJ4SKjD5IJyXKeUsLIw2SCMS5Sgll5lDzxfo0xyTAnj5OjjJCMMEYnyY-rYFpzY_olAvR5Mf16cT5DXlmnf95-r8DrGsEwOAtqhUyPwkqjDnpY6k73AdkG-dEPWoXIma4bex0RZ7vKBqPutmob7KD7eDCMLk54E2sp6wPqTG86cwPB2B5F2XbrjUfXJqwOtebgNuBqdHkxRV-01-Cij5ltW6isi882-mnyqIHW62eH9Ti5en92OZuni08fzmfTRao4FjTNVN1wkStaQqFoQZgguiQF4CJnBW5EiQsloM4JrzgjFXDgBIRiESmbHHB2nLzd6w5j1elaxfYdtHJwpgO3lRaM_PumNyu5tBuZ54xiKqLAq4OAs99G7YPsjFc6ttJrO3pJaUYJzkvGI_ryH3RtRxe_Z0dxwUVR8J2j13tKOeu90829GYLlLhcy5kL-zkVkX_zp_p68C0IETvfAtWn19v9K8t3H-V7yF-TAxwA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2259597750</pqid></control><display><type>article</type><title>Utilizing a PLASMIC score‐based approach in the management of suspected immune thrombotic thrombocytopenic purpura: a cost minimization analysis within the Harvard TMA Research Collaborative</title><source>Wiley Online Library Journals Frontfile Complete</source><source>Wiley Free Content</source><creator>Upadhyay, Vivek A. ; Geisler, Benjamin P. ; Sun, Lova ; Uhl, Lynne ; Kaufman, Richard M. ; Stowell, Christopher ; Makar, Robert S. ; Bendapudi, Pavan K.</creator><creatorcontrib>Upadhyay, Vivek A. ; Geisler, Benjamin P. ; Sun, Lova ; Uhl, Lynne ; Kaufman, Richard M. ; Stowell, Christopher ; Makar, Robert S. ; Bendapudi, Pavan K.</creatorcontrib><description>Summary
The PLASMIC score is a recently described clinical scoring algorithm that rapidly assesses the probability of severe ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13) deficiency among patients presenting with microangiopathic haemolytic anaemia. Using a large multi‐institutional cohort, we explored whether an approach utilizing the PLASMIC score to risk‐stratify patients with suspected immune thrombotic thrombocytopenic purpura (iTTP) could lead to significant cost savings. Our consortium consists of institutions with an unrestricted approach to ADAMTS13 testing (Group A) and those that require pre‐approval by the transfusion medicine service (Group B). Institutions in Group A tested more patients than those in Group B (P < 0·001) but did not identify more cases of iTTP (P = 0·29) or have lower iTTP‐related mortality (P = 0·84). Decision tree cost analysis showed that applying a PLASMIC score‐based strategy to screen patients for ADAMTS13 testing in Group A would have reduced costs by approximately 27% over the 12‐year period of our study compared to the current approach. Savings were primarily driven by a reduction in unnecessary therapeutic plasma exchanges, but lower utilization of ADAMTS13 testing and subspecialty consultations also contributed. Our data indicate that using the PLASMIC score to guide ADAMTS13 testing and the management of patients with suspected iTTP could be associated with significant cost savings.</description><identifier>ISSN: 0007-1048</identifier><identifier>EISSN: 1365-2141</identifier><identifier>DOI: 10.1111/bjh.15932</identifier><identifier>PMID: 31131442</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>ADAM protein ; ADAMTS13 ; Cost control ; cost savings/effectiveness ; Hematology ; Hemolytic anemia ; PLASMIC ; Purpura ; Thrombocytopenic purpura ; Thrombospondin ; Thrombotic thrombocytopenic purpura ; Transfusion ; TTP</subject><ispartof>British journal of haematology, 2019-08, Vol.186 (3), p.490-498</ispartof><rights>2019 British Society for Haematology and John Wiley & Sons Ltd</rights><rights>2019 British Society for Haematology and John Wiley & Sons Ltd.</rights><rights>Copyright © 2019 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5092-3cdf596c28a7c271491e817a076470f9807c9ad615b541ba5a51a9c417a8f6a03</citedby><cites>FETCH-LOGICAL-c5092-3cdf596c28a7c271491e817a076470f9807c9ad615b541ba5a51a9c417a8f6a03</cites><orcidid>0000-0002-0754-7688</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fbjh.15932$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fbjh.15932$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,1427,27903,27904,45553,45554,46388,46812</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31131442$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Upadhyay, Vivek A.</creatorcontrib><creatorcontrib>Geisler, Benjamin P.</creatorcontrib><creatorcontrib>Sun, Lova</creatorcontrib><creatorcontrib>Uhl, Lynne</creatorcontrib><creatorcontrib>Kaufman, Richard M.</creatorcontrib><creatorcontrib>Stowell, Christopher</creatorcontrib><creatorcontrib>Makar, Robert S.</creatorcontrib><creatorcontrib>Bendapudi, Pavan K.</creatorcontrib><title>Utilizing a PLASMIC score‐based approach in the management of suspected immune thrombotic thrombocytopenic purpura: a cost minimization analysis within the Harvard TMA Research Collaborative</title><title>British journal of haematology</title><addtitle>Br J Haematol</addtitle><description>Summary
The PLASMIC score is a recently described clinical scoring algorithm that rapidly assesses the probability of severe ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13) deficiency among patients presenting with microangiopathic haemolytic anaemia. Using a large multi‐institutional cohort, we explored whether an approach utilizing the PLASMIC score to risk‐stratify patients with suspected immune thrombotic thrombocytopenic purpura (iTTP) could lead to significant cost savings. Our consortium consists of institutions with an unrestricted approach to ADAMTS13 testing (Group A) and those that require pre‐approval by the transfusion medicine service (Group B). Institutions in Group A tested more patients than those in Group B (P < 0·001) but did not identify more cases of iTTP (P = 0·29) or have lower iTTP‐related mortality (P = 0·84). Decision tree cost analysis showed that applying a PLASMIC score‐based strategy to screen patients for ADAMTS13 testing in Group A would have reduced costs by approximately 27% over the 12‐year period of our study compared to the current approach. Savings were primarily driven by a reduction in unnecessary therapeutic plasma exchanges, but lower utilization of ADAMTS13 testing and subspecialty consultations also contributed. Our data indicate that using the PLASMIC score to guide ADAMTS13 testing and the management of patients with suspected iTTP could be associated with significant cost savings.</description><subject>ADAM protein</subject><subject>ADAMTS13</subject><subject>Cost control</subject><subject>cost savings/effectiveness</subject><subject>Hematology</subject><subject>Hemolytic anemia</subject><subject>PLASMIC</subject><subject>Purpura</subject><subject>Thrombocytopenic purpura</subject><subject>Thrombospondin</subject><subject>Thrombotic thrombocytopenic purpura</subject><subject>Transfusion</subject><subject>TTP</subject><issn>0007-1048</issn><issn>1365-2141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp1ktFu0zAUhiMEYmVwwQsgS9zARTbbsZOYC6RSDTrUCQTbtXXiOK2rJA6206m72iPwSDwLT4JLuwmQsCzZsj__5z_WnyTPCT4hcZxW69UJ4SKjD5IJyXKeUsLIw2SCMS5Sgll5lDzxfo0xyTAnj5OjjJCMMEYnyY-rYFpzY_olAvR5Mf16cT5DXlmnf95-r8DrGsEwOAtqhUyPwkqjDnpY6k73AdkG-dEPWoXIma4bex0RZ7vKBqPutmob7KD7eDCMLk54E2sp6wPqTG86cwPB2B5F2XbrjUfXJqwOtebgNuBqdHkxRV-01-Cij5ltW6isi882-mnyqIHW62eH9Ti5en92OZuni08fzmfTRao4FjTNVN1wkStaQqFoQZgguiQF4CJnBW5EiQsloM4JrzgjFXDgBIRiESmbHHB2nLzd6w5j1elaxfYdtHJwpgO3lRaM_PumNyu5tBuZ54xiKqLAq4OAs99G7YPsjFc6ttJrO3pJaUYJzkvGI_ryH3RtRxe_Z0dxwUVR8J2j13tKOeu90829GYLlLhcy5kL-zkVkX_zp_p68C0IETvfAtWn19v9K8t3H-V7yF-TAxwA</recordid><startdate>201908</startdate><enddate>201908</enddate><creator>Upadhyay, Vivek A.</creator><creator>Geisler, Benjamin P.</creator><creator>Sun, Lova</creator><creator>Uhl, Lynne</creator><creator>Kaufman, Richard M.</creator><creator>Stowell, Christopher</creator><creator>Makar, Robert S.</creator><creator>Bendapudi, Pavan K.</creator><general>Blackwell Publishing Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-0754-7688</orcidid></search><sort><creationdate>201908</creationdate><title>Utilizing a PLASMIC score‐based approach in the management of suspected immune thrombotic thrombocytopenic purpura: a cost minimization analysis within the Harvard TMA Research Collaborative</title><author>Upadhyay, Vivek A. ; Geisler, Benjamin P. ; Sun, Lova ; Uhl, Lynne ; Kaufman, Richard M. ; Stowell, Christopher ; Makar, Robert S. ; Bendapudi, Pavan K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5092-3cdf596c28a7c271491e817a076470f9807c9ad615b541ba5a51a9c417a8f6a03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>ADAM protein</topic><topic>ADAMTS13</topic><topic>Cost control</topic><topic>cost savings/effectiveness</topic><topic>Hematology</topic><topic>Hemolytic anemia</topic><topic>PLASMIC</topic><topic>Purpura</topic><topic>Thrombocytopenic purpura</topic><topic>Thrombospondin</topic><topic>Thrombotic thrombocytopenic purpura</topic><topic>Transfusion</topic><topic>TTP</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Upadhyay, Vivek A.</creatorcontrib><creatorcontrib>Geisler, Benjamin P.</creatorcontrib><creatorcontrib>Sun, Lova</creatorcontrib><creatorcontrib>Uhl, Lynne</creatorcontrib><creatorcontrib>Kaufman, Richard M.</creatorcontrib><creatorcontrib>Stowell, Christopher</creatorcontrib><creatorcontrib>Makar, Robert S.</creatorcontrib><creatorcontrib>Bendapudi, Pavan K.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>British journal of haematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Upadhyay, Vivek A.</au><au>Geisler, Benjamin P.</au><au>Sun, Lova</au><au>Uhl, Lynne</au><au>Kaufman, Richard M.</au><au>Stowell, Christopher</au><au>Makar, Robert S.</au><au>Bendapudi, Pavan K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Utilizing a PLASMIC score‐based approach in the management of suspected immune thrombotic thrombocytopenic purpura: a cost minimization analysis within the Harvard TMA Research Collaborative</atitle><jtitle>British journal of haematology</jtitle><addtitle>Br J Haematol</addtitle><date>2019-08</date><risdate>2019</risdate><volume>186</volume><issue>3</issue><spage>490</spage><epage>498</epage><pages>490-498</pages><issn>0007-1048</issn><eissn>1365-2141</eissn><abstract>Summary
The PLASMIC score is a recently described clinical scoring algorithm that rapidly assesses the probability of severe ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13) deficiency among patients presenting with microangiopathic haemolytic anaemia. Using a large multi‐institutional cohort, we explored whether an approach utilizing the PLASMIC score to risk‐stratify patients with suspected immune thrombotic thrombocytopenic purpura (iTTP) could lead to significant cost savings. Our consortium consists of institutions with an unrestricted approach to ADAMTS13 testing (Group A) and those that require pre‐approval by the transfusion medicine service (Group B). Institutions in Group A tested more patients than those in Group B (P < 0·001) but did not identify more cases of iTTP (P = 0·29) or have lower iTTP‐related mortality (P = 0·84). Decision tree cost analysis showed that applying a PLASMIC score‐based strategy to screen patients for ADAMTS13 testing in Group A would have reduced costs by approximately 27% over the 12‐year period of our study compared to the current approach. Savings were primarily driven by a reduction in unnecessary therapeutic plasma exchanges, but lower utilization of ADAMTS13 testing and subspecialty consultations also contributed. Our data indicate that using the PLASMIC score to guide ADAMTS13 testing and the management of patients with suspected iTTP could be associated with significant cost savings.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>31131442</pmid><doi>10.1111/bjh.15932</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-0754-7688</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0007-1048 |
| ispartof | British journal of haematology, 2019-08, Vol.186 (3), p.490-498 |
| issn | 0007-1048 1365-2141 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6642029 |
| source | Wiley Online Library Journals Frontfile Complete; Wiley Free Content |
| subjects | ADAM protein ADAMTS13 Cost control cost savings/effectiveness Hematology Hemolytic anemia PLASMIC Purpura Thrombocytopenic purpura Thrombospondin Thrombotic thrombocytopenic purpura Transfusion TTP |
| title | Utilizing a PLASMIC score‐based approach in the management of suspected immune thrombotic thrombocytopenic purpura: a cost minimization analysis within the Harvard TMA Research Collaborative |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-23T04%3A25%3A24IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Utilizing%20a%20PLASMIC%20score%E2%80%90based%20approach%20in%20the%20management%20of%20suspected%20immune%20thrombotic%20thrombocytopenic%20purpura:%20a%20cost%20minimization%20analysis%20within%20the%20Harvard%20TMA%20Research%20Collaborative&rft.jtitle=British%20journal%20of%20haematology&rft.au=Upadhyay,%20Vivek%20A.&rft.date=2019-08&rft.volume=186&rft.issue=3&rft.spage=490&rft.epage=498&rft.pages=490-498&rft.issn=0007-1048&rft.eissn=1365-2141&rft_id=info:doi/10.1111/bjh.15932&rft_dat=%3Cproquest_pubme%3E2232106845%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2259597750&rft_id=info:pmid/31131442&rfr_iscdi=true |