Given the commonality of
bleeding symptoms in the general population and the diagnostic limitations of available laboratory testing for mild
bleeding disorders, there has been increasing interest in a more precise quantification of
bleeding symptoms. The Vicenza
bleeding score (and its successor, Molecular and
Clinical Markers for the Diagnosis and Management of
Type 1 von Willebrand disease [MCMDM-1 VWD]) and its pediatric counterpart, the Pediatric
Bleeding Questionnaire, are validated research tools that have demonstrated their ability to discriminate between healthy subjects and those with VWD. These instruments collect data regarding both the presence and severity of a variety of
bleeding symptoms and generate a
bleeding score by summing the severity of all symptoms reported by a subject. More recent work demonstrates the promise of these tools as a diagnostic aid in the evaluation of patients with a suspected inherited mild
bleeding disorder, as well as the development of a condensed score with increased clinical applicability. This review focuses on the development of these
bleeding assessment tools, recent publications applying and refining these instruments, and current limitations of
bleeding scores. Needed research studies and potential clinical applications of
bleeding scores are also discussed. The ultimate goal would be for
bleeding scores to be integrated with the results of standardized laboratory testing to allow for a universal diagnostic approach to patients with suspected
bleeding disorders.