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Systematic reviews on platelet transfusions: Is there unnecessary duplication of effort? A scoping review

Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium. South Danish Transfusion Service & Tissue Center, Department of Clinical Immunology, Odense University Hospital, Odense, Denmark. Faculty of Medicine, University of Alberta, Edmonton, Canada. Transfusion and Transplantation Medicine, Alberta Precision Laboratories, Calgary, Alberta, Canada. Departments of Medicine, Laboratory Medicine and Pathobiology, Institute of Health Policy Management and Evaluation, University of Toronto, Mount Sinai Hospital, Toronto, Canada. Transfusion Medicine, NHS Blood and Transplant, Oxford, UK. Radcliffe Department of Medicine, University of Oxford, and NIHR Oxford Biomedical Research Centre, Oxford, UK. Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. Department of Public Health and Primary Care, Leuven Institute for Healthcare Policy, KU Leuven, Leuven, Belgium. Blood Services, Belgian Red Cross, Mechelen, Belgium. Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. Belgian Red Cross, Mechelen, Belgium. Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

Vox sanguinis. 2022
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PICO Summary

Population

Patients of any age eligible for platelet transfusion (110 systematic reviews (SRs)).

Intervention

Scoping review to develop an evidence map in the field of platelet transfusion.

Comparison

Outcome

The majority of the SRs focused on clinical effectiveness, including prophylactic or therapeutic transfusions compared to no platelet transfusion (34 SRs), prophylactic compared to therapeutic-only transfusion (8 SRs), dose, timing (11 SRs) and threshold for platelet transfusion (15 SRs) and the ratio of platelet transfusion to other blood products in massive transfusion (14 SRs). 34 SRs were included on decision support, of which 26 evaluated viscoelastic testing. 22 SRs were identified on platelet production modalities, including derivation (4 SRs), pathogen inactivation (6 SRs), leucodepletion (4 SRs) and ABO/human leucocyte antigen matching (5 SRs).
Abstract
BACKGROUND AND OBJECTIVES Platelet transfusions are used across multiple patient populations to prevent and correct bleeding. This scoping review aimed to map the currently available systematic reviews (SRs) and evidence-based guidelines in the field of platelet transfusion. MATERIALS AND METHODS A systematic literature search was conducted in seven databases for SRs on effectiveness (including dose and timing, transfusion trigger and ratio to other blood products), production modalities and decision support related to platelet transfusion. The following data were charted: methodological features of the SR, population, concept and context features, outcomes reported, study design and number of studies included. Results were synthesized in interactive evidence maps. RESULTS We identified 110 SRs. The majority focused on clinical effectiveness, including prophylactic or therapeutic transfusions compared to no platelet transfusion (34 SRs), prophylactic compared to therapeutic-only transfusion (8 SRs), dose, timing (11 SRs) and threshold for platelet transfusion (15 SRs) and the ratio of platelet transfusion to other blood products in massive transfusion (14 SRs). Furthermore, we included 34 SRs on decision support, of which 26 evaluated viscoelastic testing. Finally, we identified 22 SRs on platelet production modalities, including derivation (4 SRs), pathogen inactivation (6 SRs), leucodepletion (4 SRs) and ABO/human leucocyte antigen matching (5 SRs). The SRs were mapped according to concept and clinical context. CONCLUSION An interactive evidence map of SRs and evidence-based guidelines in the field of platelet transfusion has been developed and identified multiple reviews. This work serves as a tool for researchers looking for evidence gaps, thereby both supporting research and avoiding unnecessary duplication.
Study details
Study Design : Systematic Review
Language : eng
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine