{"id":"https://openalex.org/W2531841707","doi":"https://doi.org/10.1182/blood.v124.21.4835.4835","title":"Referral Practices in Management of Heavy Menstrual Bleeding in Adolescents","display_name":"Referral Practices in Management of Heavy Menstrual Bleeding in Adolescents","publication_year":2014,"publication_date":"2014-12-06","ids":{"openalex":"https://openalex.org/W2531841707","doi":"https://doi.org/10.1182/blood.v124.21.4835.4835","mag":"2531841707"},"language":"en","primary_location":{"id":"doi:10.1182/blood.v124.21.4835.4835","doi":"https://doi.org/10.1182/blood.v124.21.4835.4835","is_oa":false,"landing_page_url":"https://doi.org/10.1182/blood.v124.21.4835.4835","pdf_url":null,"source":{"id":"https://openalex.org/S200071133","display_name":"Blood","issn_l":"0006-4971","issn":["0006-4971","1528-0020"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Blood","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5060538814","display_name":"Katherine I. Foster","orcid":"https://orcid.org/0000-0001-7714-246X","observed_orcids":["https://orcid.org/0000-0001-7714-246X"]},"institutions":[{"id":"https://openalex.org/I52357470","display_name":"The Ohio State University","ror":"https://ror.org/00rs6vg23","country_code":"US","type":"education","lineage":["https://openalex.org/I52357470"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Katherine I Foster","raw_affiliation_strings":["The Ohio State University College of Medicine, Columbus, OH"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The Ohio State University College of Medicine, Columbus, OH","institution_ids":["https://openalex.org/I52357470"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5084260560","display_name":"Terah L. Koch","orcid":"https://orcid.org/0000-0003-4010-8190","observed_orcids":["https://orcid.org/0000-0003-4010-8190"]},"institutions":[{"id":"https://openalex.org/I1314135232","display_name":"Nationwide Children's Hospital","ror":"https://ror.org/003rfsp33","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1314135232"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Terah L Koch","raw_affiliation_strings":["Nationwide Children's Hospital, Columbus, OH"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Nationwide Children's Hospital, Columbus, OH","institution_ids":["https://openalex.org/I1314135232"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5050829820","display_name":"Sarah H. O\u2019Brien","orcid":"https://orcid.org/0000-0001-8855-9746","observed_orcids":["https://orcid.org/0000-0001-8855-9746","https://orcid.org/0000-0001-9939-6292"]},"institutions":[{"id":"https://openalex.org/I1314135232","display_name":"Nationwide Children's Hospital","ror":"https://ror.org/003rfsp33","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1314135232"]},{"id":"https://openalex.org/I52357470","display_name":"The Ohio State University","ror":"https://ror.org/00rs6vg23","country_code":"US","type":"education","lineage":["https://openalex.org/I52357470"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Sarah H O'Brien","raw_affiliation_strings":["Nationwide Children's Hospital, Columbus, OH","The Ohio State University College of Medicine, Columbus, OH"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Nationwide Children's Hospital, Columbus, OH","institution_ids":["https://openalex.org/I1314135232"]},{"raw_affiliation_string":"The Ohio State University College of Medicine, Columbus, OH","institution_ids":["https://openalex.org/I52357470"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5060538814","https://openalex.org/A5084260560"],"corresponding_institution_ids":["https://openalex.org/I1314135232","https://openalex.org/I52357470"],"apc_list":{"value":5500,"currency":"USD","value_usd":5500},"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.34957605,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"124","issue":"21","first_page":"4835","last_page":"4835"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12054","display_name":"Menstrual Health and Disorders","score":0.7851999998092651,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T12054","display_name":"Menstrual Health and Disorders","score":0.7851999998092651,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10746","display_name":"Platelet Disorders and Treatments","score":0.1031000018119812,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11280","display_name":"Hemophilia Treatment and Research","score":0.04839999973773956,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/menorrhagia","display_name":"menorrhagia","score":0.996999979019165},{"id":"https://openalex.org/keywords/adolescents","display_name":"adolescents","score":0.9729999899864197},{"id":"https://openalex.org/keywords/referral-patterns","display_name":"referral patterns","score":0.6069999933242798},{"id":"https://openalex.org/keywords/mild-bleeding-disorders","display_name":"mild bleeding disorders","score":0.8730000257492065},{"id":"https://openalex.org/keywords/von-willebrand-disease","display_name":"von Willebrand disease","score":0.9589999914169312},{"id":"https://openalex.org/keywords/platelet-function-defects","display_name":"platelet function defects","score":0.9169999957084656},{"id":"https://openalex.org/keywords/adolescent-medicine","display_name":"adolescent medicine","score":0.847000002861023},{"id":"https://openalex.org/keywords/medicaid-claims-data","display_name":"Medicaid claims data","score":0.5730000138282776},{"id":"https://openalex.org/keywords/hormonal-contraception","display_name":"hormonal contraception","score":0.7860000133514404},{"id":"https://openalex.org/keywords/iron-deficiency-anemia","display_name":"iron deficiency anemia","score":0.8069999814033508},{"id":"https://openalex.org/keywords/blood-transfusion","display_name":"blood transfusion","score":0.6759999990463257},{"id":"https://openalex.org/keywords/pediatric-hospital-care","display_name":"pediatric hospital care","score":0.6209999918937683},{"id":"https://openalex.org/keywords/fragmentation-of-care","display_name":"care fragmentation","score":0.3089999854564667},{"id":"https://openalex.org/keywords/medicaid-enrollees","display_name":"Medicaid enrollees","score":0.3440000116825104},{"id":"https://openalex.org/keywords/ohio","display_name":"Ohio","score":0.7590000033378601},{"id":"https://openalex.org/keywords/southeastern-ohio","display_name":"southeastern Ohio","score":0.3630000054836273},{"id":"https://openalex.org/keywords/electronic-health-records","display_name":"electronic health records","score":0.746999979019165}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8869346976280212},{"id":"https://openalex.org/C2908580079","wikidata":"https://www.wikidata.org/wiki/Q103824","display_name":"Hematologist","level":3,"score":0.8001993894577026},{"id":"https://openalex.org/C2776135927","wikidata":"https://www.wikidata.org/wiki/Q5242559","display_name":"Referral","level":2,"score":0.6626331806182861},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.65119868516922},{"id":"https://openalex.org/C2776534028","wikidata":"https://www.wikidata.org/wiki/Q1141363","display_name":"Medicaid","level":3,"score":0.5547312498092651},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.4753841161727905},{"id":"https://openalex.org/C2778248108","wikidata":"https://www.wikidata.org/wiki/Q5445","display_name":"Anemia","level":2,"score":0.4463995099067688},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.30006635189056396},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.20471352338790894},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.11533430218696594},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.0},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.0},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.0},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.0}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1182/blood.v124.21.4835.4835","doi":"https://doi.org/10.1182/blood.v124.21.4835.4835","is_oa":false,"landing_page_url":"https://doi.org/10.1182/blood.v124.21.4835.4835","pdf_url":null,"source":{"id":"https://openalex.org/S200071133","display_name":"Blood","issn_l":"0006-4971","issn":["0006-4971","1528-0020"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Blood","raw_type":"journal-article"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":0.9940000176429749}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W4387640725","https://openalex.org/W4405039634","https://openalex.org/W4393429204","https://openalex.org/W2572522119","https://openalex.org/W4414104820","https://openalex.org/W2049169470","https://openalex.org/W2901103382","https://openalex.org/W2912860210","https://openalex.org/W2604861014","https://openalex.org/W2740711114"],"abstract_inverted_index":{"Abstract":[0],"Background:":[1],"Due":[2],"to":[3,58,66,122,179,191,220,226,232,349,421,429,453,482,494],"the":[4,19,28,47,172,235,375,445],"prevalence":[5],"of":[6,22,31,49,62,111,118,133,198,201,208,216,256,268,282,301,313,347,367,390,415,439,447,492],"mild":[7,42],"bleeding":[8,17,43],"disorders":[9,44],"(MBDs)":[10,45],"among":[11,80],"adolescent":[12,37,221,272,327],"females":[13,96],"with":[14,39,72,105,140,188,203,210,287,303,308,315,320,417],"heavy":[15],"menstrual":[16],"(HMB),":[18],"American":[20,29],"College":[21],"Obstetricians":[23],"and":[24,27,74,77,102,113,164,206,228,295,326,405,443,463],"Gynecologists":[25],"(ACOG)":[26],"Academy":[30],"Pediatrics":[32],"(AAP)":[33],"recommend":[34],"screening":[35],"select":[36],"patients":[38,139,187,217,236,257,269,284,302,314,393,434,472],"HMB":[40,73,112,125,205,212,305,317,357,418],"for":[41,70,136,148,248,263,276,335],"under":[46],"guidance":[48],"a":[50,192,239,242,249,264,277,288,309,321,350,412,422,486],"hematologist,":[51],"as":[52,157],"coagulation":[53,457],"labs":[54],"can":[55,460],"be":[56,427,461,469],"difficult":[57],"interpret.":[59],"The":[60],"goal":[61],"this":[63,137,477],"study":[64,181],"was":[65,384,479],"describe":[67],"referral":[68,348,368,391],"patterns":[69],"adolescents":[71,416,449],"compare":[75],"evaluation":[76],"management":[78],"practices":[79],"different":[81],"pediatric":[82,193,351,423],"specialties":[83],"using":[84],"Medicaid":[85,99,161],"claims":[86,162],"data.":[87,182],"Methods:":[88],"Our":[89],"patient":[90],"population":[91,478],"comprised":[92],"10-17":[93],"year":[94],"old":[95],"enrolled":[97],"in":[98,100,196,388,473],"central":[101],"southeastern":[103],"Ohio":[104],"at":[106,114,241,436,471],"least":[107,115],"2":[108],"separate":[109],"diagnoses":[110],"12":[116],"months":[117],"continuous":[119],"enrollment":[120],"prior":[121],"their":[123],"first":[124],"diagnosis.":[126],"While":[127],"there":[128],"is":[129],"no":[130,385],"standard":[131],"definition":[132],"\u201csevere\u201d":[134],"HMB,":[135,149,336],"study,":[138],"iron":[141],"deficiency":[142],"anemia,":[143],"an":[144,151,440],"inpatient":[145],"hospital":[146,378],"stay":[147],"or":[150,400],"outpatient":[152],"blood":[153],"transfusion":[154],"were":[155,177,213,218,224,230,246,261,274,285,306,318],"defined":[156],"having":[158],"severe":[159,204,304,356],"HMB.":[160,189],"data":[163],"electronic":[165],"medical":[166],"records":[167],"from":[168,374,485],"Nationwide":[169],"Children\u2019s":[170],"Hospital,":[171],"region\u2019s":[173,376],"only":[174,411],"children\u2019s":[175,243,377],"hospital,":[176,244],"linked":[178],"collect":[180],"Results:":[183],"We":[184],"identified":[185],"509":[186],"Referral":[190],"specialist":[194,240,352],"occurred":[195],"17.9%":[197],"patients;":[199],"39.5%":[200],"those":[202,209],"13.8%":[207],"non-severe":[211,316],"referred.":[214],"10.8%":[215],"referred":[219,225,231,283,420,452],"med,":[222],"6.7%":[223],"hematology,":[227],"0.4%":[229],"endocrinology.":[233],"Of":[234],"seen":[237,258,270],"by":[238,253,259,271,396],"69%":[245],"screened":[247,262,275],"MBD.":[250,278,322],"When":[251],"stratified":[252],"specialty,":[254],"100.0%":[255],"hematology":[260,454],"MBD":[265],"while":[266,311],"51.0%":[267],"medicine":[273,328],"Approximately":[279],"one-third":[280],"(35.7%)":[281],"diagnosed":[286,307,319,395],"MBD,":[289,310,442],"most":[290,337],"commonly":[291,338],"platelet":[292],"function":[293],"defects":[294],"von":[296],"Willebrand":[297],"disease":[298],"(VWD).":[299],"48.3%":[300],"29.1%":[312],"Both":[323],"hematologists":[324],"(100.0%)":[325],"doctors":[329],"(97.0%)":[330],"almost":[331],"uniformly":[332],"prescribed":[333],"treatment":[334],"hormonal":[339],"contraception":[340],"(95.2%).":[341],"Patients":[342,362],"had":[343,355,363],"significantly":[344,364],"higher":[345,437],"odds":[346,366],"if":[353,369],"they":[354,370],"[2.3,":[358],"95%":[359,380],"CI":[360],"(1.42-3.71)].":[361],"lower":[365],"lived":[371],"farther":[372],"away":[373],"[0.16,":[379],"CI:":[381],"(0.09-0.29)].":[382],"There":[383],"significant":[386],"difference":[387],"frequency":[389],"between":[392],"initially":[394],"family":[397],"practitioners,":[398],"pediatricians,":[399],"gynecologists.":[401],"Conclusions:":[402],"Despite":[403],"ACOG":[404],"AAP":[406],"recommendations,":[407],"we":[408],"found":[409],"that":[410,456],"small":[413],"percentage":[414],"are":[419,435,451],"specialist.":[424],"Efforts":[425],"should":[426,468],"made":[428],"increase":[430],"education":[431],"regarding":[432],"which":[433],"risk":[438],"underlying":[441],"increasing":[444],"number":[446],"these":[448],"who":[450],"so":[455],"lab":[458],"studies":[459],"ordered":[462],"interpreted":[464],"appropriately.":[465],"Such":[466],"efforts":[467],"targeted":[470],"rural":[474],"areas,":[475],"since":[476],"particularly":[480],"unlikely":[481],"receive":[483],"care":[484],"hematologist.":[487],"Disclosures":[488],"No":[489],"relevant":[490],"conflicts":[491],"interest":[493],"declare.":[495]},"counts_by_year":[],"updated_date":"2026-10-01T08:54:57.152042","created_date":"2016-10-21T00:00:00"}
