Von Willebrand Disease (VWD)
Part 3: VWF Activity Assay

ROC Analysis of VWF:Lx/Ag and VWF:RCo/Ag for Detecting AVWA with Loss of HMWMs

June 2011

We also performed the ROC curve analysis of VWF latex activity over antigen ratio to determine its optimal cutoff. It has area under the curve AUC of 0.97 which is significantly better that of the VWF ristocetin cofactor activity ratios. When sensitivity and specificity are equally weighted, the optimal cutoff of VWF latex activity over antigen ratio for detecting such an acquired VWF abnormality is 0.8, where both sensitivity and specificity are close to 90%.

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ROC Analysis of VWF

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Jump to section:

• Introduction
• Objectives
• History of VWF Ristocetin Cofactor Activity (VWF:RCo) Assay
• Problems with VWF:RCo Assay
• Summary of External Quality Assessment of VWF:RCo
• von Willebrand Disease(VWD) Diagnostic Error Rates Due to Erroneous VWF:RCo Results⁵
• VWF:RCo/Ag Ratio is Insensitive for Aquired von Willebrand Abnormalities (AVWA)
• VWF:RCo is Inadequate for Detecting AVW Abnormality
• The New Automated VWF Activity by Latex-Immunoturbidity Assay (VWF:Lx)
• VWF Activity Assay by an A1 Domain Conformation-Sensitive Antibody⁶
• Performance Characteristics of VWF:Lx
• VWF:Lx and VWF:RCo Method Comparison
• VWF:Lx and VWF:RCo Bias Analysis
• Sample Categorization
• Comparison of VWF:Lx/Ag and VWF:RCo/Ag Ratios
• VWF:Lx and VWF:RCo Errors
• Severe Type 1 vs 2M⁷
• VWF:Lx and RCo Errors
• VWF:Lx/Ag is Sensitive to AVWA with Subtle Loss of Highest HMWM
• ROC Analysis of VWF:Lx/Ag and VWF:RCo/Ag for Detecting AVWA with Loss of HMWMs
• VWF:Lx/Ag vs VWF:RCo/Ag Ratios
• VWF Laboratory Testing Strategy
• Sensitivity and Specificity of the Screening Panel
• von Willebrand Disease Profile
• von Willebrand Disease Profile
• von Willebrand Disease Profile
• von Willebrand Disease Profile
• Limitations of VWF:Lx
• Summary
• References
• Questions?