A Comparison of Administration Time between Red Blood Cell Transfusion and Chemotherapy.
Bibliographic record
Abstract
Abstract In oncology patients, the majority of chemotherapy and red blood cell (RBC) transfusions occur in outpatient ‘chemotherapy’ units, where they compete for resources such as nursing time and “chair-time”. This study was to accurately assess the “chair-time” consumed by transfusion patients, in order to estimate the chemotherapy administration opportunities lost to RBC transfusions. Over four weeks, “chair-time”, defined as the time difference between the admission of each patient into care to their time of discharge, was prospectively evaluated in a tertiary-care outpatient cancer clinic with a referral population base of 2 million. Chair-times were then grouped into three types of care - RBC transfusions, chemotherapy administrations, and “other” (phlebotomy, central line catheter care, etc.) - to enable comparison. Chair-time is reported as a mean (+/− SD). Patient demographics (age, sex, diagnosis, chemotherapy regimen, pre-transfusion hemoglobin) were also recorded. A total of 1354 visits to the chemotherapy suite were captured over one month. Of these, 1279 visits had evaluable data for further analysis, and can be divided as follows: 1023 (80%) chemotherapy administrations, 44 (3.4%) RBC transfusions, and 212 (16.6%) “other”. 38 patients accounted for the 44 RBC transfusions. Of those, 14 were hematological malignancy patients (ALL, AML, CLL, HD, Myeloma, Lymphoma), 12 were solid tumor patients and the remaining 12 had other hematological disorders (Aplastic Anaemia, Myelodysplasia, Myelofibrosis). Among the malignant patients, 20 were receiving chemotherapy during the study period. The mean chair-time for all accurately recorded events was 1 hr 49 min (+/− 1 hr 39 min). Divided into types of care, the mean chair times were: 1 hr 59 min (+/− 1 hr 40 min) for chemotherapy, 3 hr 51 min (+/− 47 min) for RBC transfusion, and 34 min (+/− 43 min) for “other” care. The average time per RBC unit transfused was 1 hr 49 min (+/− 19 min) and the average number of units per transfusion was 2.2 units. When chemotherapy chair-times were examined, and patients were grouped by diagnoses, it was found that patients with lymphoma (most commonly treated with R-CHOP, or other Rituximab containing regimens), and gynecological cancers (most commonly treated with regimens containing carboplatin) had the longest chair-times, at 4 hr 20 min (+/− 1 hr 24 min) and 3 hr 50 min (+/− 2 hr 11 min) respectively. Although RBC transfusions make up only 3.4% of all events in our chemotherapy suite, they occupy almost twice as much chair-time as compared to chemotherapy. Depending on the patient population, clinics with a high rate of RBC transfusions might consider transfusion alternatives, as emerging monoclonal antibody chemotherapies augment the time necessary for administering chemotherapy, and chair-time becomes an increasingly valuable resource.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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 source (direct Gemma or distilled Codex), 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".