RESUMEN
Race and ethnicity are sociopolitical and not biological constructs, and assertions that these population descriptors have scientific meaning has caused significant harm. A critical assessment of the transfusion medicine literature is an important aspect of promoting race-conscious as opposed to race-based medicine. Utilizing current definitions and health equity frameworks, this review will provide a critical appraisal of transfusion medicine studies at the intersection of race and healthcare disparities, with a focus on larger methodological challenges facing the transfusion medicine community. Moving forward, risk modelling accounting for upstream factors, patient input, as well as an expert consensus on how to critically conduct and evaluate this type of literature are needed. Further, when using race and ethnicity in research contexts, investigators must be aware of existing guidelines for such reporting.
Asunto(s)
Disparidades en Atención de Salud , Grupos Raciales , Medicina Transfusional , Humanos , Medicina Transfusional/métodos , Medicina Transfusional/organización & administración , Medicina Transfusional/normas , Etnicidad , Transfusión Sanguínea/métodos , Transfusión Sanguínea/normasRESUMEN
BACKGROUND: Several studies have highlighted the disparities in gender equity that exist in different medical specialties. The COVID-19 pandemic has further heightened the inequity faced by female physicians as they are challenged by increasing household and childcare duties in addition to their professional responsibilities. Given these hurdles, fewer women than men have published in various medical disciplines. In this brief report, we wanted to determine the impact of the COVID-19 pandemic on the academic output of female physicians and researchers in transfusion medicine. STUDY DESIGN AND METHODS: We compared all articles in four transfusion medicine journals published from January 1 to July 31, 2019 with the same time period in 2020. Overall, 1024 articles were reviewed for whether they included women as first or senior authors. RESULTS: Overall, women were first authors in 45.9% (n = 458) of all publications and senior authors in 35% (n = 356) of all publications. There was a statistically significant decrease in the percentage of women as first authors between 2019 (49.1%) and 2020 (42.7%) (p = .04). There was no significant change in the percentage of women as senior authors between 2019 (35.4%) and 2020 (35.5%) (p = 0.99). CONCLUSIONS: Similar to other medical specialties, the COVID-19 pandemic has further increased the disparities faced by female researchers in transfusion medicine as evidenced by a decrease in publications with women as first authors.
Asunto(s)
Investigación Biomédica , COVID-19/epidemiología , Médicos Mujeres , Publicaciones/estadística & datos numéricos , Medicina Transfusional , Academias e Institutos/organización & administración , Academias e Institutos/estadística & datos numéricos , Bibliometría , Investigación Biomédica/organización & administración , Investigación Biomédica/estadística & datos numéricos , Investigación Biomédica/tendencias , Eficiencia , Femenino , Historia del Siglo XXI , Humanos , Masculino , Medicina , Pandemias , Médicos Mujeres/organización & administración , Médicos Mujeres/estadística & datos numéricos , Médicos Mujeres/tendencias , Publicaciones/tendencias , Investigadores/organización & administración , Investigadores/estadística & datos numéricos , Investigadores/tendencias , Factores Sexuales , Medicina Transfusional/organización & administración , Medicina Transfusional/estadística & datos numéricos , Medicina Transfusional/tendenciasRESUMEN
Heterogeneous practices exist across transplant centres regarding assessment prior to allogeneic haematopoietic cell transplantation (allo-HCT) for myelofibrosis, post-transplant monitoring and management of relapse. The 'Practice Harmonisation and Guidelines' and Myeloproliferative Neoplasms subcommittees of the Chronic Malignancies Working Party (CMWP) of the EBMT generated an electronic survey proposal to investigate approaches to the above aspects of myelofibrosis allo-HCT practice. This survey was sent to a total of 65 centres experienced in allo-HCT for myelofibrosis across Europe in February 2020. By time of survey closure, a total of 36 centres (55 %) had completed the survey. Responses were aggregated and reported in a comparative fashion. Marked variations in assessment prior to allo-HCT, JAK inhibitor management peri-transplant, molecular, histopathological and cytogenetic monitoring and approaches to the definition and management of relapse were apparent across surveyed centres. On the basis of these findings, future CMWP efforts will focus on defining guidelines for relapse definition in MF allo-HCT and also suggested optimal monitoring practices for the transplant community.
Asunto(s)
Trasplante de Células Madre Hematopoyéticas , Pautas de la Práctica en Medicina/estadística & datos numéricos , Mielofibrosis Primaria/terapia , Transfusión Sanguínea/normas , Trasplante de Médula Ósea/normas , Enfermedad Crónica , Europa (Continente)/epidemiología , Enfermedad Injerto contra Huésped/epidemiología , Adhesión a Directriz/normas , Adhesión a Directriz/estadística & datos numéricos , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Trasplante de Células Madre Hematopoyéticas/métodos , Trasplante de Células Madre Hematopoyéticas/normas , Trasplante de Células Madre Hematopoyéticas/estadística & datos numéricos , Humanos , Neoplasias/terapia , Guías de Práctica Clínica como Asunto , Pautas de la Práctica en Medicina/normas , Mielofibrosis Primaria/epidemiología , Mielofibrosis Primaria/patología , Recurrencia , Estudios Retrospectivos , Sociedades Médicas/organización & administración , Sociedades Médicas/normas , Encuestas y Cuestionarios , Medicina Transfusional/organización & administración , Medicina Transfusional/normas , Medicina Transfusional/estadística & datos numéricos , Trasplante Homólogo/efectos adversos , Trasplante Homólogo/estadística & datos numéricosRESUMEN
BACKGROUND: The availability of a safe blood supply is a key component of transfusion medicine. A decade of decreased blood use, decreased payment for products, and a dwindling donor base have placed the sustainability of the US blood supply at risk. STUDY DESIGN AND METHODS: A literature review was performed for blood center (BC) and hospital disaster management, chronically transfusion-dependent diseases, and appropriate use of group O-negative red blood cells (RBCs), and the Choosing Wisely campaign. The aim was to identify current practice and to make recommendations for BC and hospital actions. RESULTS: While BCs are better prepared to handle disasters than after the 9/11 attacks, messaging to the public remains difficult, as donors often do not realize that blood transfused during a disaster was likely collected before the event. BCs and transfusion services should participate in drafting disaster response plans. Hospitals should maintain inventories adequate for patients in the event supply is disrupted. Providing specialty products for transfusion-dependent patients can strain collections, lead to increased use of group O RBCs, and create logistical inventory challenges for hospitals. The AABB Choosing Wisely initiative addresses overuse of blood components to optimally use this precious resource. Group O-negative RBCs should be transfused only to patients who truly need them. CONCLUSIONS: Collecting and maintaining a blood supply robust enough to handle disasters and transfusion-dependent patients in need of specialty products is challenging. Collaboration of all parties should help to optimize resources, ensure appropriate collections, improve patient care, and ultimately result in a robust, sustainable blood supply.
Asunto(s)
Transfusión de Componentes Sanguíneos/ética , Donantes de Sangre/estadística & datos numéricos , Seguridad de la Sangre/métodos , Medicina Transfusional/organización & administración , Sistema del Grupo Sanguíneo ABO/clasificación , Sistema del Grupo Sanguíneo ABO/inmunología , Transfusión de Componentes Sanguíneos/estadística & datos numéricos , Donantes de Sangre/provisión & distribución , Seguridad de la Sangre/estadística & datos numéricos , Conducta Cooperativa , Planificación en Desastres/legislación & jurisprudencia , Eritrocitos/inmunología , Femenino , Hospitales/normas , Hospitales/estadística & datos numéricos , Humanos , Satisfacción del Paciente/estadística & datos numéricosAsunto(s)
Bancos de Sangre/organización & administración , Donantes de Sangre/provisión & distribución , Transfusión Sanguínea , COVID-19/epidemiología , Pandemias , Bancos de Sangre/normas , Bancos de Sangre/provisión & distribución , Donantes de Sangre/estadística & datos numéricos , Transfusión Sanguínea/métodos , Transfusión Sanguínea/normas , Transfusión Sanguínea/estadística & datos numéricos , COVID-19/sangre , COVID-19/terapia , Participación de la Comunidad/estadística & datos numéricos , Procedimientos Quirúrgicos Electivos/estadística & datos numéricos , Historia del Siglo XXI , Humanos , Inmunización Pasiva , Admisión y Programación de Personal/organización & administración , Admisión y Programación de Personal/normas , SARS-CoV-2/aislamiento & purificación , SARS-CoV-2/fisiología , Sociedades Hospitalarias/organización & administración , Encuestas y Cuestionarios , Medicina Transfusional/organización & administración , Medicina Transfusional/normas , Medicina Transfusional/estadística & datos numéricos , Estados Unidos/epidemiología , Sueroterapia para COVID-19 , Almacenamiento de Sangre/métodosAsunto(s)
COVID-19/epidemiología , COVID-19/terapia , Transfusión de Eritrocitos/estadística & datos numéricos , Necesidades y Demandas de Servicios de Salud/organización & administración , Pandemias , Medicina Transfusional/organización & administración , Adulto , Anciano , Anciano de 80 o más Años , Bancos de Sangre/organización & administración , Bancos de Sangre/estadística & datos numéricos , Bancos de Sangre/provisión & distribución , Donantes de Sangre/estadística & datos numéricos , Donantes de Sangre/provisión & distribución , COVID-19/sangre , Punto Alto de Contagio de Enfermedades , Brotes de Enfermedades , Femenino , Necesidades y Demandas de Servicios de Salud/estadística & datos numéricos , Humanos , Inmunización Pasiva , Masculino , Persona de Mediana Edad , SARS-CoV-2/fisiología , España/epidemiología , Medicina Transfusional/normas , Medicina Transfusional/estadística & datos numéricos , Adulto Joven , Sueroterapia para COVID-19Asunto(s)
Bancos de Sangre/organización & administración , Bancos de Sangre/tendencias , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Medicina Transfusional/organización & administración , Medicina Transfusional/tendencias , Bancos de Sangre/normas , Bancos de Sangre/estadística & datos numéricos , Donantes de Sangre/estadística & datos numéricos , COVID-19 , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/terapia , Selección de Donante/normas , Selección de Donante/estadística & datos numéricos , Selección de Donante/tendencias , Historia del Siglo XXI , Humanos , Inmunización Pasiva , Massachusetts/epidemiología , Neumonía Viral/sangre , Neumonía Viral/epidemiología , Neumonía Viral/terapia , Medicina Transfusional/métodos , Medicina Transfusional/normas , Sueroterapia para COVID-19RESUMEN
OBJECTIVES: Increasingly complex medical care requires specialized transfusion support close at hand. Hospital growth can necessitate expansion of blood bank services to new locations to ensure rapid delivery of blood products. We describe the opening of a new satellite transfusion service designed to serve the needs of a pediatric hospital. METHODS: Institutional transition teams and stakeholders collaborated to discuss options for providing blood at a new pediatric hospital. A staffed satellite transfusion service met the diverse needs of multiple services and was considered a compromise between a full new transfusion service and automated solutions. RESULTS: Initial challenges in establishing the laboratory included regulatory uncertainty and interactions between two hospitals' information technology services. Laboratory scientist staffing and actual use required adapting the satellite service to an emergency release-only model. CONCLUSIONS: A flexibly staffed satellite transfusion service met the most urgent needs of a pediatric hospital expansion. Review of implementation revealed potential process improvements for future expansions, including comprehensive routine and massive transfusion simulations. The challenges experienced in supplying staff and specialized blood products track with national trends. Other institutions may consider establishing a satellite transfusion service in the context of both increasingly sophisticated automated solutions and complex blood needs.