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The systematic use of evidence-based methodologies and technologies enhances shared decision-making in the 2018 International Consensus Conference on Patient Blood Management

Centre for Evidence-Based Practice (CEBaP), Belgian Red Cross, Mechelen, Belgium. European Blood Alliance (EBA), Amsterdam, The Netherlands. Finnish Red Cross Blood Service, Helsinki, Finland. German Red Cross Blood Transfusion Service, Frankfurt/Main, Germany. Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Leuven, Belgium. Canadian Blood Services, Ottawa, ON, Canada. Societe Francaise de Transfusion Sanguine (SFTS), Paris, France. Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt/Main, Germany. Etablissement Francais du Sang (EFS), Saint-Denis, France. International Society of Blood Transfusion (ISBT), Amsterdam, The Netherlands. Transfusion Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic, Australia. Belgian Red Cross, Mechelen, Belgium.

Vox sanguinis. 2019
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Abstract
BACKGROUND AND OBJECTIVES Patient Blood Management (PBM) aims to optimize the care of patients who might need a blood transfusion. The International Consensus Conference on PBM (ICC-PBM) aimed to develop evidence-based recommendations on three topics: preoperative anaemia, red blood cell transfusion thresholds and implementation of PBM programmes. This paper reports how evidence-based methodologies and technologies were used to enhance shared decision-making in formulating recommendations during the ICC-PBM. MATERIALS & METHODS Systematic reviews on 17 PICO (Population, Intervention, Comparison, Outcomes) questions were conducted by a Scientific Committee (22 international topic experts and one methodologist) according to GRADE (Grades of Recommendation, Assessment, Development and Evaluation) methodology. Evidence-based recommendations were formulated using Consensus Development Conference methodology. RESULTS We screened 17 607 references and included 145 studies. The overall certainty in the evidence of effect estimates was generally low or very low. During the ICC, plenary sessions (100-200 stakeholders from a range of clinical disciplines and community representatives) were followed by closed sessions where multidisciplinary decision-making panels (>50 experts and patient organizations) formulated recommendations. Two chairs (content-expert and methodologist) moderated each session and two rapporteurs documented the discussions. The Evidence-to-Decision template (GRADEpro software) was used as the central basis in the process of formulating recommendations. CONCLUSION This ICC-PBM resulted in 10 clinical and 12 research recommendations supported by an international stakeholder group of experts in blood transfusion. Systematic, rigorous and transparent evidence-based methodology in a formal consensus format should be the new standard to evaluate (cost-) effectiveness of medical treatments, such as blood transfusion.
Study details
Study Design : Systematic Review
Language : eng
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine