Background: Blood transfusions are a vital component of modern healthcare, yet adverse reactions to blood product transfusions can cause morbidity, and rarely result in mortality. Therefore, accurate reporting of transfusion related adverse events (TRAEs) is paramount to improved transfusion practice. This study aims to investigate real-world data (RWD) on TRAEs by evaluating differences between ICD 9/10-based electronic health records (EHR) and blood bank-specific reporting.Study Design and Methods: TRAE data were retrospectively collected from a blood bank-specific database between Jan 2015 and June 2019 as the reference data source and compared it to ICD 9/10 diagnostic codes corresponding to various TRAEs. Seven reactions that have corresponding ICD 9/10 diagnostic codes were evaluated: Transfusion related circulatory overload (TACO), transfusion related acute lung injury (TRALI), febrile non-hemolytic reaction (FNHTR), transfusion-related anaphylactic reaction (TRA), acute hemolytic transfusion reaction (AHTR), delayed hemolytic transfusion reaction (DHTR), and delayed serologic reaction (DSTR). These accounted for 33% of the TRAEs at an academic institution during the study period.Results: Among 18637 adult blood transfusion recipients, there were 229 unique patients with 263 TRAE related ICD codes in the EHR, while there were 191 unique patients with 287 TRAEs identified in the blood bank database. None of the categories of reaction we investigated had perfect alignment between ICD 9/10 codes and blood bank specific diagnoses.Discussion: Multiple systemic challenges were identified that hinder effective reporting of TRAEs. Identifying factors causing inconsistent reporting between blood banks and EHRs is paramount to developing effective workability between these electronic systems, as well as across clinical and laboratory teams.blood transfusions, electronic health records, transfusion related adverse events This article's contents reflect the views of the authors and should not be construed to represent FDA's official views or policies.

further refined through a modified Delphi process. We developed n[20 quality indicators (QIs) targeting measure quality of AS at population level. AS-specific QIs were tested among low-risk PC who were managed with AS between 2002-2014 using population-level cancer registry databases. We assessed adherence to clinical guidelines using QIs, and compared with health care system-related characteristics.RESULTS: In this cohort study of 35,531 low risk PC men with a mean (SD) age at diagnosis of 64.9 (8.6) years. At diagnosis mean PSA level was 6.2 (IQR 4.7-8.6) ng/mL, mean positive core (SD) was 2.5 (1.9). Overall use of Initial AS was 40.5% in 35531 eligible men with low-risk disease. 82.3% of patients underwent at least 8 or more core diagnostic biopsy. 67.1% of low volume patients went on AS and 77.7% had regular follow up with urologist as per guidelines. Only 44.5% patients on AS underwent confirmatory biopsy within 6-12months from diagnosis, and 80.6% patients had biopsy prior to receiving definitive therapy. 91.0% of patients who eventually received definitive therapy did so after upgrade in Gleason score. Specific to outcomes indicators, 52.8% of patients discontinued AS within 5 years from diagnosis, the 5-and 10-year metastases free survival rates were 98.5% and 95.5% respectively. 5-and 10-year PC specific survival rates were 99.6% and 98.4% respectively. Overall survival at 10 years was 90.0% with median follow up 9 years.CONCLUSIONS: This study establishes a foundation on which to build quality of care assessment to monitor the quality of AS patients at population level. In this Canadian population based cohort study based on OCR database, although the use of AS increased, considerable quality of AS care variation appeared with QIs related to process of care and outcome of AS care.