{"id":"https://openalex.org/W785668702","doi":"https://doi.org/10.1182/blood.v122.21.772.772","title":"Influence Of Updated ASH Guidelines On Practice Patterns In Management Of Newly Diagnosed Childhood ITP, 2007-2012","display_name":"Influence Of Updated ASH Guidelines On Practice Patterns In Management Of Newly Diagnosed Childhood ITP, 2007-2012","publication_year":2013,"publication_date":"2013-11-15","ids":{"openalex":"https://openalex.org/W785668702","doi":"https://doi.org/10.1182/blood.v122.21.772.772","mag":"785668702"},"language":"en","primary_location":{"id":"doi:10.1182/blood.v122.21.772.772","doi":"https://doi.org/10.1182/blood.v122.21.772.772","is_oa":false,"landing_page_url":"https://doi.org/10.1182/blood.v122.21.772.772","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/A5035555205","display_name":"Corinna L. Schultz","orcid":"https://orcid.org/0000-0001-7620-1819","observed_orcids":["https://orcid.org/0000-0001-7620-1819"]},"institutions":[{"id":"https://openalex.org/I1335321130","display_name":"Children's Hospital of Philadelphia","ror":"https://ror.org/01z7r7q48","country_code":"US","type":"funder","lineage":["https://openalex.org/I1335321130"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Corinna L. Schultz","raw_affiliation_strings":["The Children's Hospital of Philadelphia, Philadelphia, PA, USA,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The Children's Hospital of Philadelphia, Philadelphia, PA, USA,","institution_ids":["https://openalex.org/I1335321130"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5034517358","display_name":"Michele P. Lambert","orcid":"https://orcid.org/0000-0003-0439-402X","observed_orcids":["https://orcid.org/0000-0003-0439-402X"]},"institutions":[{"id":"https://openalex.org/I1335321130","display_name":"Children's Hospital of Philadelphia","ror":"https://ror.org/01z7r7q48","country_code":"US","type":"funder","lineage":["https://openalex.org/I1335321130"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Michele P Lambert","raw_affiliation_strings":["Division of Hematology, Children's Hospital of Philadelphia, Philadelphia, PA, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Division of Hematology, Children's Hospital of Philadelphia, Philadelphia, PA, USA","institution_ids":["https://openalex.org/I1335321130"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":["https://openalex.org/I1335321130"],"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":0.04226749,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"122","issue":"21","first_page":"772","last_page":"772"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10746","display_name":"Platelet Disorders and Treatments","score":0.9980000257492065,"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"}},"topics":[{"id":"https://openalex.org/T10746","display_name":"Platelet Disorders and Treatments","score":0.9980000257492065,"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/T11064","display_name":"Antiplatelet Therapy and Cardiovascular Diseases","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"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/T11725","display_name":"Immunodeficiency and Autoimmune Disorders","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2403","display_name":"Immunology"},"field":{"id":"https://openalex.org/fields/24","display_name":"Immunology and Microbiology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/practice-patterns","display_name":"clinical practice patterns","score":0.6489999890327454},{"id":"https://openalex.org/keywords/platelet-count","display_name":"platelet count","score":0.4269999861717224},{"id":"https://openalex.org/keywords/bleeding-manifestations","display_name":"bleeding manifestations","score":0.9539999961853027},{"id":"https://openalex.org/keywords/retreatment","display_name":"retreatment","score":0.4740000069141388},{"id":"https://openalex.org/keywords/hospitalization","display_name":"hospitalization","score":0.42399999499320984},{"id":"https://openalex.org/keywords/corticosteroids","display_name":"corticosteroids","score":0.5910000205039978},{"id":"https://openalex.org/keywords/intravenous-immunoglobulin","display_name":"intravenous immunoglobulin","score":0.9269999861717224},{"id":"https://openalex.org/keywords/rituximab","display_name":"rituximab","score":0.7080000042915344},{"id":"https://openalex.org/keywords/pediatric-hematology","display_name":"pediatric hematology","score":0.49900001287460327},{"id":"https://openalex.org/keywords/guideline-implementation","display_name":"guideline implementation","score":0.44600000977516174},{"id":"https://openalex.org/keywords/evans-syndrome","display_name":"Evans syndrome","score":0.5379999876022339},{"id":"https://openalex.org/keywords/alps","display_name":"Alps","score":0.8980000019073486},{"id":"https://openalex.org/keywords/children-s-hospital-of-philadelphia","display_name":"Children's Hospital of Philadelphia","score":0.7570000290870667}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.898734450340271},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.6413374543190002},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.5923702716827393},{"id":"https://openalex.org/C151956035","wikidata":"https://www.wikidata.org/wiki/Q1132755","display_name":"Logistic regression","level":2,"score":0.4950794279575348},{"id":"https://openalex.org/C45827449","wikidata":"https://www.wikidata.org/wiki/Q5270338","display_name":"Diagnosis code","level":3,"score":0.4155215322971344},{"id":"https://openalex.org/C2993327898","wikidata":"https://www.wikidata.org/wiki/Q638729","display_name":"Immune thrombocytopenia","level":3,"score":0.4149532616138458},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.2694701552391052},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.1374090015888214},{"id":"https://openalex.org/C89560881","wikidata":"https://www.wikidata.org/wiki/Q101026","display_name":"Platelet","level":2,"score":0.10814237594604492},{"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.v122.21.772.772","doi":"https://doi.org/10.1182/blood.v122.21.772.772","is_oa":false,"landing_page_url":"https://doi.org/10.1182/blood.v122.21.772.772","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":[{"score":1.0,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"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/W1965178255","https://openalex.org/W4310120231","https://openalex.org/W2557670995","https://openalex.org/W3216302394","https://openalex.org/W7127981609","https://openalex.org/W4405043002","https://openalex.org/W7045268808","https://openalex.org/W2127160844","https://openalex.org/W3087222797","https://openalex.org/W2288365573"],"abstract_inverted_index":{"Abstract":[0],"Background":[1],"Treatment":[2],"recommendations":[3,76,506],"for":[4,59,137,146,159,229,266,564],"childhood":[5],"Immune":[6],"Thrombocytopenia":[7],"(ITP)":[8],"in":[9,90,107,181,237,275,279,386,390,395,509,529,542,592,603,630],"the":[10,23,73,91,113,133,143,164,182,187,262,369,515,530,543,581,626],"United":[11,92],"States":[12],"have":[13,77,314],"been":[14],"a":[15,83,238,481,499,573],"subject":[16],"of":[17,26,51,66,116,166,217,309,351,371,384,408,416,422,485,504,517,532,552,566,583,597,637],"much":[18],"debate.":[19],"In":[20],"early":[21],"2011,":[22],"American":[24],"Society":[25],"Hematology":[27],"(ASH)":[28],"updated":[29],"their":[30],"guidelines,":[31],"recommending":[32],"that":[33,550],"children":[34,518,533],"with":[35,39,61,102,156,220,251,355,366,413,432,466,469,538,580],"ITP":[36,105,147,223],"be":[37,601,622],"managed":[38,354],"observation":[40,510],"alone":[41,607],"when":[42,613],"there":[43,571],"is":[44,572,616,640],"mild":[45],"or":[46,319,438,457,536],"no":[47,433],"bleeding":[48,315,324,335,341,540],"symptoms":[49,316,325,541],"regardless":[50],"platelet":[52,283,302,404,451],"count,":[53,405],"reserving":[54],"hospitalization":[55],"and":[56,109,123,168,178,201,242,258,277,285,292,304,339,393,406,507,632,634],"pharmacologic":[57,356,417],"treatment":[58,170,244,357,535],"those":[60,250,361,537],"significant":[62,434,539],"bleeding.":[63],"The":[64,190,225,281,321,442],"objective":[65],"this":[67,379,496],"study":[68],"was":[69,129,151,196,298,345],"to":[70,153,163,313,388,449,472,576,594,608,624],"better":[71],"understand":[72],"impact":[74],"these":[75],"had":[78],"on":[79],"practice":[80],"patterns":[81],"at":[82,112,176,194,245,287,326,358,374,489,521],"large,":[84],"urban,":[85],"pediatric":[86],"tertiary":[87],"care":[88],"hospital":[89,134,247],"States.":[93],"Methods":[94],"We":[95,172],"examined":[96],"data":[97,135],"from":[98,273,382],"patients":[99,139,155,208,219,310,352,372,385,423,486,553],"aged":[100],"0-17":[101],"newly":[103,221],"diagnosed":[104,222,568],"seen":[106],"inpatient":[108,587],"outpatient":[110,584],"locations":[111],"Children's":[114],"Hospital":[115],"Philadelphia":[117],"(CHOP)":[118],"between":[119,502],"January":[120],"1,":[121],"2007":[122],"December":[124],"31,":[125],"2012.":[126],"A":[127],"cohort":[128,216],"developed":[130],"by":[131,198,436],"querying":[132],"system":[136],"all":[138],"treated":[140,365,426,444,465],"2007-2012":[141],"using":[142,604],"ICD-9":[144,557,605],"code":[145,558,606],"(287.31).":[148],"Chart":[149],"review":[150,615],"used":[152],"exclude":[154],"alternative":[157,233,253],"diagnosis":[158,161,177,234,236,288,375,409,446,522],"thrombocytopenia,":[160],"prior":[162],"time":[165,380],"interest,":[167],"initial":[169,188,243,439],"elsewhere.":[171],"compared":[173],"management":[174,193,440,633],"strategies":[175],"retreatment":[179],"rates":[180],"first":[183],"6":[184,545],"months":[185,429,475],"after":[186,430,445,476],"diagnosis.":[189,359,477,490],"primary":[191],"outcome,":[192],"diagnosis,":[195,254,431],"analyzed":[197],"logistic":[199,399],"regression":[200],"chi":[202],"square":[203],"analysis.":[204],"Results":[205],"502":[206],"unique":[207],"were":[209,231,261,289,311,328,353,364,410,424,447,487],"identified.":[210],"After":[211],"chart":[212,614],"review,":[213],"an":[214,232,252,527],"evaluable":[215],"313":[218],"remained.":[224],"most":[226,263,322],"common":[227,264,323],"reasons":[228,265],"elimination":[230],"(n=41),":[235],"previous":[239],"year":[240,271,407,437],"(n=68),":[241],"another":[246],"(n=69).":[248],"Of":[249,360],"Evan's":[255],"syndrome":[256],"(n=8)":[257],"ALPS":[259],"(n=5)":[260],"elimination.":[267],"New":[268],"diagnoses":[269],"per":[270],"ranged":[272],"34-51":[274],"2007-2009":[276],"60-63":[278],"2010-2012.":[280],"mean":[282],"count":[284,303],"age":[286],"16.9":[290],"x10^9/l":[291],"6.22":[293],"years":[294],"old,":[295],"respectively.":[296],"Distribution":[297],"skewed":[299,591],"toward":[300],"lower":[301,403],"younger":[305,401],"age.":[306],"Overall,":[307,349],"19.5%":[308],"noted":[312],"beyond":[317],"bruising":[318],"petechiae.":[320],"presentation":[327],"epistaxis":[329],"(n=25),":[330],"wet":[331],"purpura":[332,455],"(n=20),":[333],"gastrointestinal":[334],"(n=5),":[336],"hematuria":[337],"(n=4),":[338],"menstrual":[340],"(n=4).":[342],"Intracranial":[343],"hemorrhage":[344],"rare":[346],"(n=2,":[347],"0.6%).":[348],"55%":[350],"treated,":[362],"98%":[363],"IVIG.":[367],"Additionally,":[368,547],"proportion":[370,484,516,531],"observed":[373,488,520],"rose":[376],"significantly":[377,411,482],"during":[378],"period":[381],"34%":[383],"2007-2010":[387],"49.2%":[389],"2011":[391],"(p<.02)":[392],"72%":[394],"2012":[396],"(p<0.001).":[397],"Via":[398],"regression,":[400],"age,":[402],"associated":[412],"increased":[414,483,514],"odds":[415],"treatment.":[418],"During":[419],"2010-2012,":[420],"21%":[421],"also":[425],"within":[427],"0.25-6":[428],"difference":[435],"(p>0.5).":[441],"majority":[443],"due":[448],"\u201clow":[450],"counts\u201d":[452],"(n=14),":[453],"bruising/wet":[454],"(n=6),":[456],"parental":[458],"anxiety/activity":[459],"level":[460],"(n=3).":[461],"One":[462],"child,":[463],"initially":[464],"IVIG,":[467],"presented":[468],"ICH":[470],"secondary":[471],"trauma":[473],"1.5":[474],"Conclusions":[478],"Over":[479],"time,":[480],"Though":[491],"we":[492,513,523,548],"cannot":[493],"prove":[494],"causation,":[495],"change":[497],"demonstrates":[498],"strong":[500],"association":[501],"timing":[503],"ASH":[505,638],"increase":[508,528],"rates.":[511],"As":[512,570],"being":[519],"did":[524,559],"not":[525,560,617],"see":[526],"receiving":[534],"following":[544],"months.":[546],"found":[549],"37%":[551],"originally":[554],"identified":[555],"via":[556],"meet":[561],"our":[562],"criteria":[563],"evaluation":[565],"\u2018newly":[567],"ITP'.":[569],"greater":[574],"shift":[575],"observing":[577],"patients,":[578],"along":[579],"development":[582],"infusion":[585],"services,":[586],"databases":[588],"could":[589],"become":[590],"regard":[593],"ITP.":[595],"Because":[596],"this,":[598],"caution":[599],"should":[600],"utilized":[602],"identify":[609,625],"new":[610],"diagnoses,":[611],"especially":[612],"accessible.":[618],"Future":[619],"studies":[620],"will":[621],"able":[623],"changing":[627],"national":[628],"trend":[629],"admission":[631],"whether":[635],"adoption":[636],"guidelines":[639],"widespread.":[641],"Disclosures:":[642],"Lambert:":[643],"Amgen:":[644],"Research":[645,650],"Funding;":[646],"Nestle:":[647],"Consultancy;":[648],"GSK:":[649],"Funding.":[651]},"counts_by_year":[],"updated_date":"2026-09-26T08:19:03.415552","created_date":"2016-06-24T00:00:00"}
