The role of hemovigilance as a mechanism to increase transfusion safety
Bibliographic record
Abstract
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)
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".