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The PLASMIC Score was derived by Bendapudi et al and externally validated in a study with an independent cohort of 112 consecutive hospitalized patients with suspected thrombotic microangiopathy and appropriate ADAMTS-13 testing (including 21 patients with TTP diagnosis). The PLASMIC model predicted severe ADAMTS-13 deficiency with a c statistic of 0.94 (0.88-0.98). When dichotomized at high (scores 6-7) vs. low-intermediate risk (scores 0-5), the model predicted severe ADAMTS-13 deficiency with positive predictive value 72%, negative predictive value 98%, sensitivity 90% and specificity 92%.
In the low-intermediate risk group (scores 0-5), there was no significant improvement in overall survival associated with plasma exchange. The PLASMIC Score had excellent applicability, discrimination and calibration for predicting severe ADAMTS-13 deficiency. The clinical algorithm allowed identification of a subgroup of patients who lacked a significant response to empiric treatment.
Reference
Bendapudi PK, Hurwitz S, Fry A et al
Derivation and external validation of the PLASMIC score for rapid assessment of adults with thrombotic microangiopathies: a cohort study.
Lancet Haematol. 2017 Apr;4(4):e157-e164. doi: 10.1016/S2352-3026(17)30026-1. Epub 2017 Mar 2.
Li A, Khalighi PR, Wu Q, Garcia DA.
External validation of the PLASMIC score: a clinical prediction tool for thrombotic thrombocytopenic purpura diagnosis and treatment.
J Thromb Haemost. 2018 Jan;16(1):164-169. doi: 10.1111/jth.13882. Epub 2017 Nov 16.
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