Evidence map›Paper›PMID 25495497›Full record

SynthesisJournal of thrombosis and haemostasis : JTH2015

Severe bleeding events in adults and children with primary immune thrombocytopenia: a systematic review.

C Neunert, N Noroozi, G Norman, G R Buchanan, J Goy, I Nazi, J G Kelton, D M Arnold

Open access · bronzeAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of thrombosis and haemostasis : JTH, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 114 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
114citing papers in PubMed, 7 pooled it
10.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

114 citing papers in PubMed, 7 syntheses or guidelines pooled it, 333 citations in OpenAlex.

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  20. Haemostasis alterations in immune thrombocytopenia and their clinical significance.Research and practice in thrombosis and haemostasis · 2025
    Article

54 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 2 countries.

C NeunertDepartment of Pediatrics and Cancer Center, Georgia Regents University, Augusta, GA, USA.
N Noroozi
G Norman
G R Buchanan
J Goy
I Nazi
J G Kelton
D M Arnold
McMaster University · CAGeorgia Regents Medical Center · USThe University of Texas Southwestern Medical Center · US

Funding

CIHR 102446CIHR 102446-1
6 · The paper itself

Abstract

backgroundThe burden of severe bleeding in adults and children with immune thrombocytopenia (ITP) has not been established.

objectivesTo describe the frequency and severity of bleeding events in patients with ITP, and the methods used to measure bleeding in ITP studies. PATIENTS/

methodsWe performed a systematic review of all prospective ITP studies that enrolled 20 or more patients. Two reviewers searched Medline, Embase, CINAHL and the Cochrane registry up to May 2014. Overall weighted proportions were estimated using a random effects model. Measurement properties of bleeding assessment tools were evaluated.

resultsWe identified 118 studies that reported bleeding (n = 10 908 patients). Weighted proportions for intracerebral hemorrhage (ICH) were 1.4% for adults (95% confidence interval [CI], 0.9-2.1%) and 0.4% for children (95% CI, 0.2-0.7%; P < 0.01), most of whom had chronic ITP. The weighted proportion for severe (non-ICH) bleeding was 9.6% for adults (95% CI, 4.1-17.1%) and 20.2% for children (95% CI, 10.0-32.9%; P < 0.01) with newly-diagnosed or chronic ITP. Methods of reporting and definitions of severe bleeding were highly variable in primary studies. Two bleeding assessment tools (Buchanan 2002 for children; Page 2007 for adults) demonstrated adequate inter-rater reliability and validity in independent assessments.

conclusionsICH was more common in adults and tended to occur during chronic ITP; other severe bleeds were more common in children and occurred at all stages of disease. Reporting of non-ICH bleeding was variable across studies. Further attention to ITP-specific bleeding measurement in clinical trials is needed to improve standardization of this important outcome for patients.

Indexed as

AdultAge FactorsCerebral HemorrhageChildHemorrhageHumansPlatelet CountPredictive Value of TestsPrognosisPurpura, Thrombocytopenic, IdiopathicRisk AssessmentRisk FactorsSeverity of Illness Indexbleedingintracranial hemorrhagesoutcome assessment health careplateletspurpura, thrombocytopenic

Identifiers

PMID25495497
PMCPMC4991942
OpenAlexW2122735473

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.