PB0666 - Comparison Of Interobserver Agreement Between The 4T And The HIT Expert Probability (HEP) Scores

Monday, June 24, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Co-Author(s)

abdulrahman al raizah, thrombosis fellowship from ottawa

consultant hematology
Oncology department, Ministry of National Guard Health Affairs, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University of Health Sciences, Saudi society of bone marrow transplant, Riyadh, Saudi Arabia
Riyadh, Ar Riyad, Saudi Arabia

Co-Author(s)

RA

Rawan Almohamdy

hematology
Oncology department, Ministry of National Guard Health Affairs, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University of Health Sciences, Saudi society of bone marrow transplant, Riyadh, Saudi Arabia
riyadh, Ar Riyad, Saudi Arabia
KA

Khalid Alharbi

hematology
Oncology department, Ministry of National Guard Health Affairs, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University of Health Sciences, Saudi society of bone marrow transplant, Riyadh, Saudi Arabia
riyadh, Ar Riyad, Saudi Arabia

Presenting Author(s)

AM

Albarra Madkhali

hematology
Oncology department, Ministry of National Guard Health Affairs, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University of Health Sciences, Saudi society of bone marrow transplant, Riyadh, Saudi Arabia
riyadh, Ar Riyad, Saudi Arabia

Co-Author(s)

RS

Rahaf Salem

hematology
Oncology department, Ministry of National Guard Health Affairs, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University of Health Sciences, Saudi society of bone marrow transplant, Riyadh, Saudi Arabia
riyadh, Ar Riyad, Saudi Arabia
MA

Mohammed Alshuaibi

hematology
Internal medicine, King Abdulaziz hospital, Ministry of National Guard Health Affairs, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University of Health Sciences, Alahsa, Saudi Arabia
riyadh, Ash Sharqiyah, Saudi Arabia

Background: The 4T score and The HIT Expert Probability (HEP) score are scores for calculating the pre-test probability of HIT . Inter-observer agreement (IOA) of HEP score compared to 4T score is uncertain.

Aims: 1-Comparison of IOA between 4T and HEP score
2-Identify which item have the lowest IOA

Methods: This is a retrospective study at a single tertiary hospital. All inpatients 16 years or older who have been tested for HIT between June 2019 to end of June 2021 were included.

Two hematologists rated the HEP score and 4Ts score independently. They were blinded to the HIT Eliza result. Low 4Ts score is defined as score less than 4 and for HEP score if less than 3

The Kappa coefficient (к) with was used to assess the IOA

Results: We included 302 patients.
In all patients, We found similar IOA between 4T and HEP scores к (95 % CI) of 4T score was .14(-0.13-0.41), compared 0.17(-0.16-0.5) in the HEP score (P = 0.83).
Non-ICU :
The IOA was similar between the 4T score and the HEP score, к of 4T score was 0.24 (0.11-0.38) compared 0.17 (0.03-0.31) in the HEP score (P = 0.86).
ICU :
The IOA of 4Tscore was lower than HEP score к of 4T score was -020(-0.20.16) compared 0.16(-0.037-0.37) in the HEP score( P < 0.01).
existence of other causes of thrombocytopenia” achieved the lowest к with 0.03 and 0.1 in 4Tscore and HEP score respectively.

Conclusion(s): We found a lower IOA of the 4T score compared to the HEP score in ICU patients. The poor IOA of the 4T score in ICU patients is attributed to worse agreement in (existence of other causes of thrombocytopenia item). Our data suggests that the HEP score is the preferred score in in patients with critical illness.