A randomized trial to evaluate the use of text messaging, letter, and telephone call reminders to improve return of blood donors with reactive serologic tests
BACKGROUND Low return rates for notification and counseling among donors with reactive serologic screening tests have been reported worldwide. A randomized trial to test the effectiveness of text message, letter, or telephone call reminders to improve return among nonresponding first-time blood donors with reactive serologic tests was conducted. STUDY DESIGN AND METHODS Donors with serologically reactive screening test results who had a cell phone and resided in the metropolitan telephone area code of Sao Paulo in the period from August 2013 through July 2014 were eligible. A consecutive sample of first-time donors with reactive screening tests who had not responded to a standard letter requesting the donor return to the blood center were randomly assigned to receive a text, a new letter, or a telephone call requesting return for notification and counseling. Return rates were measured over the subsequent 30 days. RESULTS The return rate after a phone call reminder was better than that for a text message (39.8% vs. 28.4%; odds ratio [OR], 1.66; 95% confidence interval [CI], 1.05-2.64) but not better than that for a letter (39.8% vs. 34.4%; OR, 1.26; 95% CI, 0.80-1.99). Older age was a predictor of higher rate of return with each year increase in age associated with a 2% increase in the odds of return (OR, 1.02; 95% CI, 1.01-1.04). CONCLUSION In nonresponding serologic reactive donors, telephone call led to a higher return rate than text message. The results of this study suggest that use of text messages, while attractive for its simplicity, will not lead to increased donor notification success after serologically reactive marker results from blood donation in Brazil.
A randomized trial to evaluate the use of SMS text messaging, letter and telephone call reminders to improve return of blood donors with reactive serologic tests
Transfusion. 2016;56((S4)):92A-93A.. sp137.
Impact of increasing sample volume from 4 ml to 8 ml on bacterial detection rates in apheresis platelets: a meta-analysis
Vox Sanguinis. 2015;108((3):):318-20.
Some blood centres have increased sample volume of in-process cultures to improve detection of bacterial contamination when screening apheresis platelet units. We performed a meta-analysis to evaluate extant published North American data comparing apheresis platelet bacterial contamination rates from 4 ml and 8 ml sample volume. Pooled results indicate an 8 ml sample volume yields higher true-positive rates than 4 ml resulting in a significant increase in the detection rate and interdiction of contaminated units, which should contribute to reduced risk of adverse transfusion outcomes. Copyright 2014 International Society of Blood Transfusion.
Greater culture volume improves bacterial detection in apheresis platelets: a meta-analysis
Transfusion. 2014;54((S2):):204A.. Abstract No. SP370.
Risk perception and its role in attitudes toward blood transfusion: a qualitative systematic review
Transfusion Medicine Reviews. 2013;27((2):):119-28.
Despite improvements in blood safety making transfusion a much safer clinical procedure, the general public still perceives it as risky. We systematically reviewed available literature to examine evidence regarding the reasons and causes behind this perception. Electronic databases including PubMed, Cochrane Library, and EMBASE for literature dating back to the 1980s were searched. Eligible studies collected information on blood recipients' demographics, measures of risk domains (sets of values that risks encompass), and general knowledge of blood transfusion in terms of risks and benefits. Each study was assessed for quality of data, research method, and relevant findings. A scoring system was used to subjectively rate the overall quality of each study. Each study was reviewed for its method of data collection and information abstracted on hazards and conceptual dimensions used to measure risk. Risk perception between blood transfusion and other hazards including alternatives to transfusion were compared. Fifteen studies met the inclusion criteria, all of which were conducted outside the United States, with most of the studies published more than 10 years ago and conducted by only 3 research groups. Five studies were rated as being very good, four good, five fair, and one of poor quality. The finding of the studies consistently show that objective or raw knowledge is not correlated with risk perception, but subjective or calibrated knowledge is. Thus, it is what people think they know rather than what they actually do know that influences risk perception of transfusion. Of the 3 common conceptual domains-dread, unknown risk, and benefits-blood transfusion was found to be of intermediate dread, intermediate unknown risk, and most beneficial compared with other hazards. Donated blood was found to have lower perceived risk than all other alternatives to transfusion, except for use of autologous blood. There is a lack of recent studies on allogeneic transfusion. However, the more recent studies show that perceived high risk is still prevalent in the general public. The available risk perception studies suggest that although blood transfusion is safe, elevated risk perception of infections persists. Studies of the US population are needed to better understand the influence of both psychological and scientific factors. Copyright 2013 Elsevier Inc. All rights reserved.
Water administration and the risk of syncope and presyncope during blood donation: a randomized clinical trial
BACKGROUND Blood centers rely heavily on adolescent donors to meet blood demand, but presyncope and syncope are more frequent in younger donors. Studies have suggested administration of water before donation may reduce syncope and/or presyncope in this group. STUDY DESIGN AND METHODS We conducted a randomized, controlled trial to establish the effect of preloading with 500mL of water on the rate of syncope and presyncope in adolescent donors. School collection sites in Eastern Cape Province of South Africa were randomized to receive water or not. Incidence of syncope and presyncope was compared between randomization groups using multivariable logistic regression. RESULTS Of 2464 study participants, 1337 received water and 1127 did not; groups differed slightly by sex and race. Syncope or presyncope was seen in 23 (1.7%) of the treatment and 18 (1.6%) of the control arm subjects. After adjusting for race, sex, age, and donation history, there was no difference in outcome between the water versus no water arms (adjusted odds ratio [OR],0.80; 95% confidence interval [CI], 0.42-1.53). Black donors had sevenfold lower odds of syncope or presyncope than their white counterparts (adjusted OR, 0.14; 95% CI, 0.04-0.47). CONCLUSION Preloading adolescent donors with 500mL of water did not have a major effect in reducing syncope and presyncope in South African adolescent donors. Our adolescent donors had lower overall syncope and presyncope rates than similar populations in the United States, limiting the statistical power of the study. We confirmed much lower rates of syncope and presyncope among young black donors. 2012 American Association of Blood Banks.
Needle-fear as independent predictor of syncope and presyncopal reactions in whole blood donors
Transfusion. 2011;51((Suppl 3):):33A.. Abstract No. S73-030J.
Cost-effectiveness analysis: what it really means for transfusion medicine decision making
Transfusion Medicine Reviews. 2009;23((1):):1-12.
Some have suggested that blood is different,and the role for cost-effectiveness is thus circumscribed. In this article, the authors start by reviewing key concepts in health economics and economic analysis methods. Examples are drawn from published blood safety studies. After explaining the underlying reasoning behind cost-effectiveness analysis, the authors point out how economic thinking is evident in some aspects of transfusion medicine. Some cost-effectiveness study results for blood safety are discussed to provide context, followed by consideration of prominent decisions that have been made in transfusion medicine field. In the last section, the authors conjecture as to why in some cases cost-effectiveness analysis appears to have greater impact than in others, noting the terrible price that is paid in mortality and morbidity when cost-effectiveness analysis is ignored. In this context, the implications of opportunity cost are discussed, and it is noted that opportunity cost should not be viewed as benefits forgone by concentrating on one aspect of blood safety and instead should be viewed as our societal willingness to misallocate resources to achieve less health for the same cost.
Economic analyses of blood safety and transfusion medicine interventions: a systematic review
Transfusion Medicine Reviews. 2004;18((2):):127-143.
Economic evaluations are increasingly common in blood safety and transfusion medicine. We sought to summarize and review economic evaluations of donated blood interventions conducted in the United States. By using computer database searches, we identified 19 studies that reported both cost and health benefit results, and relative to each other, we rated the quality of their design and reporting. We classified 6 of the studies as having high quality, 10 as having fair quality, and 3 as having poor quality. Several strengths and limitations in economic evaluations of blood safety and transfusion medicine interventions were identified. Four key improvements can increase the quality of literature in this discipline. We believe researchers should (1) provide more explicit detail on cost parameters in each study and the methods used to obtain them; (2) adopt a clear analysis perspective relevant to decision makers that captures all key costs and consequences, such as the societal perspective; (3) use a consistent approach to reporting sensitivity analyses; and (4) place greater reliance on graphical presentation of results including sensitivity analyses because a large amount of information can be conveyed in relatively simple figures, leaving space to discuss the impact of important analysis assumptions and applicability of the results to other settings.