Development of permanent national register of blood component use utilizing electronic hospital information systems

Palo, Riikka; Ali‐Melkkilä, T.; Hanhela, R; Jäntti, V.; Krusius, Tom; Leppänen, Esa; Mahlamäki, Eija K.; Perhoniemi, Vesa; Rajamäki, Allan; Rautonen, Jukka; Salmenperä, Markku; Salo, Hanna; Salonen, Iiris; Savolainen, E.–R.; Sjövall, S.; Suistomaa, M.; Syrjälä, Martti; Tienhaara, Anri; Vähämurto, M; Mäki, Tiina

doi:10.1111/j.1423-0410.2006.00814.x

Cited by 23 publications

(24 citation statements)

References 6 publications

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“…The data are collected on all potentially transfused patients using computer programs designed for data collection (VOK data extraction system, MediWare Corporation Oy, Helsinki, Finland; and Oulu data extraction system, Oulu, Finland). The validation of data has been described previously 1 . Currently 10 hospital districts provide data to the registry.…”

Section: Methodsmentioning

confidence: 99%

BLOOD DONORS AND BLOOD COLLECTION: The aging population poses a global challenge for blood services

2010

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A large part of the variation in RBC use per capita can be explained by the age distribution of the different populations and not by the different national and regional treatment policies and protocols used. If current efforts are not enough to serve the changing population demographic and if increasing demands for blood products cannot be met, there is need to consider unprecedented measures such as reversing certain donor deferrals or even exporting blood from country to country.

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Section: Methodsmentioning

confidence: 99%

BLOOD DONORS AND BLOOD COLLECTION: The aging population poses a global challenge for blood services

2010

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“…The significant decrease seen during the relatively short 6‐year study period was evident both in the rate of transfusions per population and in the amount of RBC units per patient. The number of single‐unit transfusions was significantly higher than before (Palo et al, ) and increased, showing growing adherence to evidence‐based practice. Nevertheless, 34% of transfusions were still double‐unit, and 58% of multiple‐unit transfusions were given in even numbers.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown variations in blood use among hospitals and clinicians (Palo et al, 2006;Abdelsattar et al, 2015), indicating inappropriate blood use. The objective of RBC transfusion is to maintain adequate oxygen delivery to tissues, and the decision to transfuse cannot be based solely on laboratory parameters (Nielsen et al, 2017).…”

mentioning

confidence: 99%

Red blood cell transfusion in southern Finland from 2011 to 2016: a quality audit

Laurén

Vikatmaa

Kerkelä

et al. 2018

Transfusion Medicine

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SUMMARY Objectives The current trends in RBC use and pre‐ and post‐transfusion Hb levels were analysed to improve practice and to provide international comparison. Background Indications for RBC transfusion have changed with growing scientific evidence. The lowest acceptable haemoglobin (Hb) level has decreased, and transfusing single units instead of pairs has become the new standard. Evidence‐based guidelines and patient blood management (PBM) programmes increase clinician awareness of rational RBC use. In Finland, however, no formal PBM programme has been established to date. Methods The study was registry‐based, retrospective and observational. All RBC transfusions for adult patients from 2011 to 2016 in the southern region of Finland were analysed. Results RBC usage decreased from 34·9 to 27·5 units per 1000 population (P < 0·001). The percentage of single‐unit transfusions increased from 57·9 to 66·7%, and the median pre‐ and post‐transfusion Hb levels decreased from 8·4 to 8·2 g dL−1 (P < 0·001) and 9·9 to 9·6 g dL−1 (P < 0·001), respectively. The proportion of transfusions with pre‐transfusion Hb ≥ 9·0 g dL−1 decreased during the study period but remained high, being 29·5% in 2011 and still 25·2% in 2016. Conclusions Consumption of RBCs has decreased despite aging population and increasing healthcare performance demands. The results indicate more rational and evidence‐based RBC use. Nevertheless, the transfusion rate and pre‐ and post‐transfusion Hb are still sufficiently high to enable more restrictive transfusion practice.

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“…Validation outcomes reported by previous transfusion data warehouse studies are sparse and vary greatly. Most often reported was the linkage rate of transfusions to donors, varying between 92%–99% [20, 22–25] and, vice versa, estimates of wastage of blood products (i.e., issued but not transfused) of 1.3% and 7.7% [22, 23]. The percentage missing values was also reported by some studies: clinical variables were missing for 13% (post-transfusion Hb), 14% (ASA code) [26], and 20% (specialty), with the degree of missingness varying between specialties from 2% to 47% [21] (a more extensive overview per transfusion database is provided in Additional file 1: Table S3).…”

Section: Discussionmentioning

confidence: 99%

Validation of multisource electronic health record data: an application to blood transfusion data

Hoeven

Bruijne

Kemper

et al. 2017

BMC Med Inform Decis Mak

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BackgroundAlthough data from electronic health records (EHR) are often used for research purposes, systematic validation of these data prior to their use is not standard practice. Existing validation frameworks discuss validity concepts without translating these into practical implementation steps or addressing the potential influence of linking multiple sources. Therefore we developed a practical approach for validating routinely collected data from multiple sources and to apply it to a blood transfusion data warehouse to evaluate the usability in practice.MethodsThe approach consists of identifying existing validation frameworks for EHR data or linked data, selecting validity concepts from these frameworks and establishing quantifiable validity outcomes for each concept. The approach distinguishes external validation concepts (e.g. concordance with external reports, previous literature and expert feedback) and internal consistency concepts which use expected associations within the dataset itself (e.g. completeness, uniformity and plausibility). In an example case, the selected concepts were applied to a transfusion dataset and specified in more detail.ResultsApplication of the approach to a transfusion dataset resulted in a structured overview of data validity aspects. This allowed improvement of these aspects through further processing of the data and in some cases adjustment of the data extraction. For example, the proportion of transfused products that could not be linked to the corresponding issued products initially was 2.2% but could be improved by adjusting data extraction criteria to 0.17%.ConclusionsThis stepwise approach for validating linked multisource data provides a basis for evaluating data quality and enhancing interpretation. When the process of data validation is adopted more broadly, this contributes to increased transparency and greater reliability of research based on routinely collected electronic health records.Electronic supplementary materialThe online version of this article (doi:10.1186/s12911-017-0504-7) contains supplementary material, which is available to authorized users.

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Development of permanent national register of blood component use utilizing electronic hospital information systems

Cited by 23 publications

References 6 publications

BLOOD DONORS AND BLOOD COLLECTION: The aging population poses a global challenge for blood services

BLOOD DONORS AND BLOOD COLLECTION: The aging population poses a global challenge for blood services

Red blood cell transfusion in southern Finland from 2011 to 2016: a quality audit

Validation of multisource electronic health record data: an application to blood transfusion data

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