- Describe your topic.
- Platelets are transfused to prevent or treat bleeding in patients who are thrombocytopenic. The majority of these transfusions are given to cancer patients who are repeatedly transfused. Donor screening, improved collection methods, and laboratory testing are used to reduce the risk of transfusion-transmitted infection (TTI), but there is a small residual risk of viral, bacterial, or protozoal transmission with platelet and other blood products. Two pathogen-reduced platelet preparations (PR Platelets) are now available (currently only 1 in the US), and are being promoted as a means of further reducing the risk of TTI. Pathologists need guidance on whether or not to switch to these new products.
- Describe why this topic is important.
- Use of PR-Platelets promises to make blood transfusions less prone to transmitting infectious agents on top of interventions that have already been implemented. PR-platelets might in the future also not require irradiation for severely immunocompromised patients which might result in cost savings that would somewhat offset the cost of pathogen reductions.
- Tell us why you are suggesting this topic.
- Clinicians would have more confidence in the safety of blood transfusions if they knew that the decision to implement or not was based on sound scientific evidence and analysis. Pathologists are torn between issues of stewardship of health care resources and optimizing patient care and will need to make a decision if the costs outweigh the benefits. Without an EBG to back up their decision, pathologists and the specialty could come under serious criticism: If patients acquire a serious infection that could have been prevented by PR Platelets, pathologists who did not adopt will be criticized. Pathologists who adopt could be criticized if product risks outweigh the benefits (e.g. platelet refractoriness), or if the expense of implementation impairs adoption of more meritorious projects due to resource constraints. PR-platelets are more expensive and have lower effective platelet counts and require more units to support a patient resulting in higher costs. Less costly alternatives are being exp0lored (in England they're looking at culturing on 2nd day with a larger volume and extending outdate to 7 days) This strategy is likely to result in better stewardship of resources.
- Target Date.
- Describe what you are doing currently and what you are hoping will change because of a new evidence report.
- For this topic, we are seeking input from a cost-effectiveness or cost-analysis perspective. We are aware of a recent systematic review published however we are seeking additional documentation if available.
- How will you or your group use the information from a new evidence report?
- The College of American Pathologists (CAP) Pathology and Laboratory Quality Center, along with our professional partners, is advancing the practice of pathology and laboratory medicine by bringing evidence-based guidelines, and consensus recommendations to the forefront of clinical decision making. Adopting these guidelines helps pathologists and laboratory professionals to provide more effective testing with consistent, high-quality results, and expert interpretations.
- How would you or your group plan to disseminate information from the report? Who would you plan to disseminate it to?
- We would develop a guideline to address the topic. http://www.cap.org/web/home/protocols-and-guidelines/cap-guidelines/cap-guideline-principles?_afrLoop=27255191901283#!%40%40%3F_afrLoop%3D27255191901283%26_adf.ctrl-state%3D4s47gkzrs_38
- Do you know of organizations that could use an evidence report to change clinical practice? Are you a part of, or have you been in contact with, any organizations that might implement the research findings of an evidence report?
- The CAP has identified the following organizations as key stakeholders: American Society of Hematology American Society of Clinical Oncology AABB
- Information About You: (optional)
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- Provide a description of your role or perspective.
- The College of American Pathologists (CAP), the leading organization of board-certified pathologists, serves patients, pathologi
- If you are you making a suggestion on behalf of an organization, please state the name of the organization.
- The College of American Pathologists
- Please tell us how you heard about the Effective Health Care Program.
- email announcement
