{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T17:22:30Z","timestamp":1783358550541,"version":"3.54.6"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,10,26]],"date-time":"2016-10-26T00:00:00Z","timestamp":1477440000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004350","name":"Studienstiftung des Deutschen Volkes","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004350","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008322","name":"CSL Behring","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Rotational thromboelastometry (<jats:styled-content style=\"fixed-case\">ROTEM<\/jats:styled-content><jats:sup><jats:bold>\u00ae<\/jats:bold><\/jats:sup>) and thromboelastography (<jats:styled-content style=\"fixed-case\">TEG<\/jats:styled-content><jats:sup><jats:bold>\u00ae<\/jats:bold><\/jats:sup>) are increasingly used in the perioperative and emergency assessment of bleeding tendencies. The diagnostic value of<jats:styled-content style=\"fixed-case\">ROTEM<\/jats:styled-content>and<jats:styled-content style=\"fixed-case\">TEG<\/jats:styled-content>for von Willebrand disease (<jats:styled-content style=\"fixed-case\">VWD<\/jats:styled-content>) remains to be established.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To investigate whether<jats:styled-content style=\"fixed-case\">ROTEM<\/jats:styled-content>and<jats:styled-content style=\"fixed-case\">TEG<\/jats:styled-content>can discriminate patients with<jats:styled-content style=\"fixed-case\">VWD<\/jats:styled-content>from healthy controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Rotational thromboelastometry and<jats:styled-content style=\"fixed-case\">TEG<\/jats:styled-content>whole blood coagulation profiles were compared between<jats:styled-content style=\"fixed-case\">VWD<\/jats:styled-content>patients (<jats:italic>n<\/jats:italic>= 100) and healthy controls (<jats:italic>n<\/jats:italic>= 89). Measures of diagnostic accuracy were calculated, including sensitivity, specificity and receiver operating characteristic (<jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content>) curve.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Prolonged<jats:styled-content style=\"fixed-case\">TEG<\/jats:styled-content>R\u2010time had a positive and negative predictive value (<jats:styled-content style=\"fixed-case\">PPV<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\">NPV<\/jats:styled-content>) of 0.84 and 0.68 respectively.<jats:styled-content style=\"fixed-case\">TEG<\/jats:styled-content>clotting index (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) had a<jats:styled-content style=\"fixed-case\">PPV<\/jats:styled-content>of 1.00 and an<jats:styled-content style=\"fixed-case\">NPV<\/jats:styled-content>of 0.60. Both R\u2010time and<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>had a high specificity and accurately discriminated<jats:styled-content style=\"fixed-case\">VWD<\/jats:styled-content>patients from healthy controls, with an<jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content>area under the curve of 0.85 and 0.99 respectively. In multivariate analysis, low<jats:styled-content style=\"fixed-case\">FVIII<\/jats:styled-content>levels, but not von Willebrand factor (<jats:styled-content style=\"fixed-case\">VWF<\/jats:styled-content>) antigen or activity, determined hypocoagulable<jats:styled-content style=\"fixed-case\">TEG<\/jats:styled-content>R (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>= 0.35) and<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>levels (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>= 0.51). The<jats:styled-content style=\"fixed-case\">ROTEM<\/jats:styled-content>coagulation profiles of<jats:styled-content style=\"fixed-case\">VWD<\/jats:styled-content>patients did not differ from healthy controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Thromboelastography R and<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>accurately discriminated<jats:styled-content style=\"fixed-case\">VWD<\/jats:styled-content>patients from healthy controls, partly through the detection of low<jats:styled-content style=\"fixed-case\">FVIII<\/jats:styled-content>levels. The test's performance may be improved through adjustment of the test thresholds to a local reference population. Both intrinsic pathway\u2010activated (<jats:styled-content style=\"fixed-case\">INTEM<\/jats:styled-content>) and tissue factor pathway\u2010activated (<jats:styled-content style=\"fixed-case\">EXTEM<\/jats:styled-content>)<jats:styled-content style=\"fixed-case\">ROTEM<\/jats:styled-content>were of limited diagnostic value in<jats:styled-content style=\"fixed-case\">VWD<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hae.13121","type":"journal-article","created":{"date-parts":[[2016,10,27]],"date-time":"2016-10-27T01:06:42Z","timestamp":1477530402000},"page":"309-318","source":"Crossref","is-referenced-by-count":30,"title":["A prospective diagnostic accuracy study evaluating rotational thromboelastometry and thromboelastography in 100 patients with von Willebrand disease"],"prefix":"10.1111","volume":"23","author":[{"given":"D. E.","family":"Schmidt","sequence":"first","affiliation":[{"name":"Division of Haematology Department of Medicine Coagulation Unit Karolinska University Hospital and Karolinska Institutet Stockholm Sweden"},{"name":"University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Majeed","sequence":"additional","affiliation":[{"name":"Division of Haematology Department of Medicine Coagulation Unit Karolinska University Hospital and Karolinska Institutet Stockholm Sweden"},{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Bruzelius","sequence":"additional","affiliation":[{"name":"Division of Haematology Department of Medicine Coagulation Unit Karolinska University Hospital and Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Odeberg","sequence":"additional","affiliation":[{"name":"Division of Haematology Department of Medicine Coagulation Unit Karolinska University Hospital and Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Holmstr\u00f6m","sequence":"additional","affiliation":[{"name":"Division of Haematology Department of Medicine Coagulation Unit Karolinska University Hospital and Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"\u00c5gren","sequence":"additional","affiliation":[{"name":"Division of Haematology Department of Medicine Coagulation Unit Karolinska University Hospital and Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,10,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781444329926.ch7"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2002-27820"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.13243"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.23599"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1532\/IJH97.06214"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2010.12.019"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0952-8180(03)00022-9"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h5527"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1281034"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2015.02.022"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-9560-7-14"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mbc.0000169225.31173.19"},{"key":"e_1_2_8_14_1","doi-asserted-by":"crossref","unstructured":"PohlertT.The pairwise multiple comparison of mean ranks package (PMCMR). 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