{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:11:18Z","timestamp":1791357078238,"version":"4.3.1"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,11,28]],"date-time":"2022-11-28T00:00:00Z","timestamp":1669593600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>The diagnostic work\u2010up of patients referred to the haematologist for bleeding evaluation is performed in a stepwise way: bleeding history and results of screening laboratory tests guide further diagnostic evaluation. This can be ineffective, time\u2010consuming and burdensome for patients. To improve this strategy, the initial laboratory investigation can be extended. In a model\u2010based approach, effectiveness and costs of a conventional stepwise versus a newly proposed all\u2010in\u2010one diagnostic approach for bleeding evaluation were evaluated and compared, using data from an observational patient cohort study, including\u00a0adult patients referred for bleeding evaluation. In the all\u2010in\u2010one approach, specialized platelet function tests, coagulation factors, and fibrinolysis tests were included in the initial investigation. Final diagnosis, hospital resource use and costs and patient burden were compared. A total of 150 patients were included. Compared to the stepwise approach, in the all\u2010in\u2010one approach, 19 additional patients reached a diagnosis and patient burden was lower, but total costs per patient were higher [\u20ac359, 95% bootstrapped confidence interval (BCI) 283\u2013518, <jats:italic>p<\/jats:italic>\u00a0=\u20090.001]. For bleeding evaluation of patients referred to the haematologist, an all\u2010in\u2010one diagnostic approach has a higher diagnostic yield and reduces patient burden, at a higher cost. This raises the question what costs justify the diagnosis of a bleeding disorder and a less burdensome diagnostic strategy.<\/jats:p>","DOI":"10.1111\/bjh.18570","type":"journal-article","created":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T08:51:38Z","timestamp":1669711898000},"page":"792-801","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effectiveness and costs of a stepwise versus an all\u2010in\u2010one approach to diagnose mild bleeding disorders"],"prefix":"10.1111","volume":"200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3281-926X","authenticated-orcid":false,"given":"Floor C. J. 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