The role of hemovigilance as a mechanism to increase transfusion safety
Notice bibliographique
Résumé
The complexity of healthcare organizations involves interdisciplinary professional practice, whose common goal is to provide quality products and services that satisfy the customer's and society's expectations.One of the services that comprise this structure is transfusion medicine, which is an essential specialty in the treatment of hematologic malignancies and numerous other clinical and surgical conditions. (1)n transfusion medicine, quality starts with the process of attracting donors and extends to the transfused patient, by ensuring traceability of blood components and derivatives.Despite major advances, transfusion, even with precise indication and correct administration, involves risk to health with the potential of transfusion incidents (TI), whether immediate or delayed.TI are defined as injuries occurring during or after and related to blood transfusion. (2)he professionals involved in prescribing and administrating blood products must be trained to identify signs and symptoms of TI, to manage them and to establish measures to prevent future incidents.Thus, the notification of immediate and delayed TI is essential to minimize these risks. (3)mmediate TI (within 24 hours of transfusion) are the most commonly observed, with an overall occurrence which varies in different services and countries of between 0.5 and 3%; febrile non-hemolytic and allergic reactions are the most frequent.However, health risks, in order of severity, are: acute hemolytic reaction, TRALI, bacterial contamination and volumetric overload. (4)emovigilance, developed in the early 1990s in France, has emerged as a tool to improve transfusion safety.In Brazil, a blood-surveillance system was implanted during the restructuring of the National Health Service in 1999 and the goal of the project: "Blood with a guaranteed quality in all its process until 2003" became a reality in 2001. (5)esolution number 57 of the Agência Nacional de Vigilância Sanitária (ANVISA) defines hemovigilance as "a set of surveillance procedures covering the cycle of blood, from the donation to the transfusion, generating information about adverse events resulting from the donation and the therapeutic use of blood and blood components.This information is used to identify risks, improve the quality of products and processes and increase the donor and patient safety by preventing the occurrence or reoccurrence of these events."Article # 152 stipulates that "Any adverse event that occurs in recipients of blood and blood products should be investigated and reported officially to the responsible authorities using the NOTIVISA system." (6)owever, on analyzing the annex of decree 1353 of 13/06/2011 of the Brazilian Ministry of Health, we found that only Article 137, when it addresses late complications, in section IV of the 3 rd paragraph, determines that adverse events must be reported to the appropriate health authority, not including early ones. (7)e believe that the two laws should be standardized urgently if we are to move forward with the system of national hemovigilance improving transfusion safety.Even because, as recorded in the Hemovigilance Bulletin number 3 in 2009 the rate of underreporting for all TI in the country is extremely high (69.5%),ranging between 60.5% in the southeast to 99.2% in the Midwest; of the 3348 TI that were documented (0.9 per 1000 transfusions when 10,975 or 3/1000 TI were expected) only 1.5% were delayed reactions with no record of transmissible disease and only 199 TI classified in the group of severe reactions (0.054/1000). (8)espite the large difference to developed countries, such as France, United Kingdom, Netherlands, Switzerland, the United States and Canada, where hemovigilance has been consolidated for several years, underreporting is still a common problem.In France and the Netherlands, where all TI must be reported, the rates are 2.8 and 2.9 per 1000 transfusions, respectively (3 times the rate of Brazil).In the UK, where only the serious TI are reported, 0.2 events per 1000 transfusions are recorded which is also 3.7 times higher than in Brazil. (9)
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,018 | 0,041 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,003 | 0,001 |
| Études des sciences et des technologies | 0,002 | 0,005 |
| Communication savante | 0,010 | 0,005 |
| Science ouverte | 0,002 | 0,008 |
| Intégrité de la recherche | 0,006 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,013 | 0,003 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».