Locke S E, Kowaloff H B, Hoff R G, Safran C, Popovsky M A, Cotton D J, Finkelstein D M, Page P L, Slack W V
Center for Clinical Computing, Boston, MA 02115.
JAMA. 1992 Sep 9;268(10):1301-5.
To test the ability of a computer-based interview to detect factors related to the risk of the human immunodeficiency virus (HIV) among potential blood donors and to determine donor reactions to the use of the interview.
A comparison of the rate of detection of HIV-related factors elicited by a computer interview with that obtained by standard American Red Cross procedures for assessment of donor suitability, including a randomized crossover trial in which the order of the two methods was reversed. Information obtained by the computer was not available to influence the use of blood components for transfusion.
The computer interview was administered to donors at an American Red Cross blood donor center and at a mobile blood drive at a hospital.
Consecutive sample of 294 male and female blood donors 18 to 75 years of age.
Subjects' responses to the computer-based interview as well as responses to the standard Red Cross written questionnaires and face-to-face interviews were used for donor assessment.
The interview took an average of 8 minutes to complete. From among 272 donors who provided complete data, the computer identified 12 donors who reported either behaviors associated with a risk of HIV acquisition or symptoms compatible with the acquired immunodeficiency syndrome; none of these donors had been so identified either by routine written questionnaires or by face-to-face interviews used to screen potential blood donors. Only one of the 12 identified donors used the confidential unit exclusion procedure to prevent use of his donated unit. The rate of elicitation of HIV-related factors by the computer interview was 12 (4.4%) of 272 (95% confidence interval [CI], 2.3% to 7.6%), compared with two (0.13%) of 1536 (95% confidence upper bound, 0.28%) using the standard Red Cross procedure (P less than .0001). Tests for antibodies to HIV were negative in blood samples from all of the 272 subjects studied. The subjects enjoyed the computer interview and judged it to be more private than the standard donor assessment method. They also predicted that donors would be more honest with the computer interview than with a human interviewer.
Computer-based screening elicits more HIV-related factors in the health histories of blood donors than do the standard questionnaire and interviewing methods currently in use. Computer-based screening is also acceptable to blood donors.
测试基于计算机的访谈在潜在献血者中检测与人类免疫缺陷病毒（HIV）风险相关因素的能力，并确定献血者对使用该访谈的反应。
将计算机访谈得出的HIV相关因素检出率与美国红十字会评估献血者适用性的标准程序得出的检出率进行比较，包括一项随机交叉试验，其中两种方法的顺序颠倒。计算机获取的信息不会影响输血用血液成分的使用。
在美国红十字会献血中心和一家医院的流动献血活动中，对献血者进行计算机访谈。
连续抽取的294名年龄在18至75岁之间的男性和女性献血者样本。
将受试者对基于计算机的访谈的回答以及对红十字会标准书面问卷和面对面访谈的回答用于献血者评估。
访谈平均耗时8分钟。在提供完整数据的272名献血者中，计算机识别出12名报告有与感染HIV风险相关行为或与获得性免疫缺陷综合征相符症状的献血者；这些献血者中没有一人通过常规书面问卷或用于筛查潜在献血者的面对面访谈被识别出来。在这12名被识别出的献血者中，只有一人使用了保密单位排除程序来阻止使用其捐献的单位。计算机访谈得出的HIV相关因素引出率为272人中的12人（4.4%）（95%置信区间[CI]，2.3%至7.6%），而使用红十字会标准程序的引出率为1536人中的2人（0.13%）（95%置信上限，0.28%）（P<0.0001）。对所有272名研究对象的血样进行HIV抗体检测均为阴性。受试者喜欢计算机访谈，并认为它比标准的献血者评估方法更私密。他们还预测，献血者对计算机访谈会比对人工访谈者更诚实。
与目前使用的标准问卷和访谈方法相比，基于计算机的筛查在献血者健康史中引出的HIV相关因素更多。基于计算机的筛查也为献血者所接受。
