Notice bibliographique
Résumé
Platelet transfusions are a commonly used medical therapy to prevent bleeding (prophylactic use), or to treat patients who are actively bleeding (therapeutic use). The most frequent use of prophylactic platelet transfusions occurs in patients with chemotherapy induced thrombocytopenia, although prophylactic platelet transfusions are also used in other thrombocytopenic patient populations prior to a surgical intervention. Therapeutic platelet transfusions used by many different patient populations with acute hemorrhage including: medical and surgical patients; trauma patients, patients with intraventricular hemorrhage and gastrointestinal bleeds. Randomized controlled trials designed to determine the optimal trigger, optimal dose, efficacy of a therapeutic only platelet transfusion strategy, and efficacy of pathogen reduced platelets have contributed to an evidence based approach for platelet transfusions over the past 15 years. Although we have learned a lot from these clinical trials, generalizability is limited with most trials have been conducted in adults with chemotherapy induced thrombocytopenia. There is a paucity of evidence to inform transfusion therapy in other patient populations. Methodological challenges associated with many of these studies have hampered the overall acceptance of the results; hence, knowledge uptake has been slow raising the question: why evidence based platelet transfusion changes occur so slowing even when RCT data are available? The answer to this question is complex but may include: research design limitations; the lack of generalizability of data from hematology/oncology patients to other patient populations; and, methodological limitations including clinical relevance and/or challenges with measuring the outcome. Information generated through clinical research related to platelet transfusion has provided some guidance to inform the practice of evidence based platelet transfusion therapy; however, along that path we have also recognized the flaws and limitations of the clinical research methodology used which has limited practice change. The question for transfusion researchers today is –how do we move forward from here to ensure that research resources are best spent to inform evidence based practices that will benefit our patients? In this presentation what we know about evidence based transfusion practices will be reviewed with emphasis on the potential limitations associated with clinical research as explanations for the lack of practice change. Activities underway to overcome some of these limitations will also be discussed.
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 distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
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 tête enseignante, 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 ».