Custer Brian, Johnson Eric S, Sullivan Sean D, Hazlet Tom K, Ramsey Scott D, Murphy Edward L, Busch Michael P
Pharmaceutical Outcomes Research and Policy Program, University of Washington, Seattle, USA.
Med Decis Making. 2005 Sep-Oct;25(5):571-82. doi: 10.1177/0272989X05280557.
Through a combination of predonation donor screening and donated unit testing, the blood supply is safer than ever. However, as a result of increasingly stringent screening measures, one of the greatest threats may be an insufficient supply. The balance between safety and adequacy of the blood supply has not received enough attention.
The authors developed a model to allow for empirical investigation of the determinants of a safe and sufficient supply. The model is a cohort simulation of allogeneic whole-blood donation, with the population of presenting donors stratified into 8 age and gender groups because the probability of donor and donation deferral varies by these characteristics. Parameters are estimated from year 2000 Blood Centers of Pacific (BCP) data. The model includes cost parameters, which were estimated using BCP expenditure data. The main outcomes are the number of transfusable units of blood and the unit cost of procurement.
The model tracks the production of a supply of blood, highlighting the influence of demographic characteristics, predonation deferral, underweight collection of blood units, and associated costs. The authors sought to establish model validity by showing that modeled results closely mimic the outcomes and costs observed by blood bank administrators.
The model was developed to evaluate blood safety and policy decisions; it can be used to assess the impact of predonation deferrals, such as expanded European travel deferral for variant Creutzfeldt-Jakob disease, or the impact of new testing strategies, such as nucleic acid testing for West Nile virus.
通过对预先献血者的筛选和对所捐献血液单位的检测相结合,血液供应比以往任何时候都更安全。然而,由于筛选措施日益严格,最大的威胁之一可能是供应不足。血液供应的安全性和充足性之间的平衡尚未得到足够的关注。
作者开发了一个模型,以便对安全充足供应的决定因素进行实证研究。该模型是对异体全血捐献的队列模拟,将前来献血者的人群按年龄和性别分为8组,因为献血者和延期献血的概率因这些特征而异。参数是根据2000年太平洋血液中心(BCP)的数据估算的。该模型包括成本参数,这些参数是使用BCP的支出数据估算的。主要结果是可用于输血的血液单位数量和采购单位成本。
该模型跟踪血液供应的生产情况,突出了人口统计学特征、预先献血延期、血液单位采集量不足以及相关成本的影响。作者试图通过表明模型结果与血库管理人员观察到的结果和成本密切相似来确立模型的有效性。
开发该模型是为了评估血液安全性和政策决策;它可用于评估预先献血延期的影响,例如因变异型克雅氏病扩大欧洲旅行延期的影响,或新检测策略的影响,例如对西尼罗河病毒进行核酸检测的影响。