A data-informed system to manage scarce blood product allocation in a randomized controlled trial of convalescent plasma.
Transfusion
; 62(12): 2525-2538, 2022 12.
Article
en En
| MEDLINE
| ID: mdl-36285763
ABSTRACT
BACKGROUND:
Equitable allocation of scarce blood products needed for a randomized controlled trial (RCT) is a complex decision-making process within the blood supply chain. Strategies to improve resource allocation in this setting are lacking.METHODS:
We designed a custom-made, computerized system to manage the inventory and allocation of COVID-19 convalescent plasma (CCP) in a multi-site RCT, CONCOR-1. A hub-and-spoke distribution model enabled real-time inventory monitoring and assignment for randomization. A live CCP inventory system using REDCap was programmed for spoke sites to reserve, assign, and order CCP from hospital hubs. A data-driven mixed-integer programming model with supply and demand forecasting was developed to guide the equitable allocation of CCP at hubs across Canada (excluding Québec).RESULTS:
18/38 hospital study sites were hubs with a median of 2 spoke sites per hub. A total of 394.5 500-ml doses of CCP were distributed; 349.5 (88.6%) doses were transfused; 9.5 (2.4%) were wasted due to mechanical damage sustained to the blood bags; 35.5 (9.0%) were unused at the end of the trial. Due to supply shortages, 53/394.5 (13.4%) doses were imported from Héma-Québec to Canadian Blood Services (CBS), and 125 (31.7%) were transferred between CBS regional distribution centers to meet demand. 137/349.5 (39.2%) and 212.5 (60.8%) doses were transfused at hubs and spoke sites, respectively. The mean percentages of total unmet demand were similar across the hubs, indicating equitable allocation, using our model.CONCLUSION:
Computerized tools can provide efficient and immediate solutions for equitable allocation decisions of scarce blood products in RCTs.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
COVID-19
Tipo de estudio:
Clinical_trials
/
Prognostic_studies
Límite:
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Transfusion
Año:
2022
Tipo del documento:
Article
País de afiliación:
Canadá