Construction of a decision model for donor testing in cases of suspected antibody-mediated transfusion-related-acute-lung-injury.
Transfus Med
; 34(5): 405-412, 2024 Oct.
Article
em En
| MEDLINE
| ID: mdl-39187261
ABSTRACT
OBJECTIVE:
To propose a rational basis for donor testing in cases of suspected antibody-mediated transfusion-related lung injury (AMT).BACKGROUND:
Anti-leukocyte antibodies in donated blood are established causes of transfusion-related lung injury (TRALI). However, the question of whether to test donors for antibodies is not identical to whether the case meets definition criteria for TRALI. There is a balance between the potential benefits of testing and the costs of donor deferral and investigation. We propose that a decision-making process based on optimising the balance between risk and benefit requires a subjective choice of the relative value of different outcomes of testing.METHODS:
We have developed a formal decision model to illustrate how these choices affect testing decisions.RESULTS:
Using a Bayesian probability model, we show that the diagnostic benefit and TRALI prevention benefit of testing donors have a complex interrelationship with the number of implicated donors and clinical suspicion of antibody-mediated TRALI (AMT) and that rational testing choices vary according to value assigned to outcomes.CONCLUSIONS:
The challenges to the use of a formal decision model for clinical testing are discussed and conclude that a formal model is a useful consensus-building tool for improving consistency and openness in decision making.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doadores de Sangue
/
Lesão Pulmonar Aguda Relacionada à Transfusão
Limite:
Female
/
Humans
/
Male
Idioma:
En
Revista:
Transfus Med
Assunto da revista:
HEMATOLOGIA
Ano de publicação:
2024
Tipo de documento:
Article
País de publicação:
Reino Unido