使用常规医疗保健数据来搜索未知的输血传播疾病:全国性的,不可知论的回顾性队列研究
Torsten Dahlén1, Jingcheng Zhao2, Michael P Busch3
1Department of Medicine, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden; Department of Haematology, Karolinska University Hospital, Stockholm, Sweden.
The Lancet. Digital health
|January 26, 2024
概括
这项研究开发了一种新的数据驱动方法来检测输血传播疾病,没有发现血液安全存在广泛的意外威胁. 这种方法增强了对未知的病原体的监测,并提高了输血安全.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 传染病监测 传染病监测 传染病
背景情况:
- 目前的输血安全依赖于哨兵事件报告,这可能会错过新型或长期潜伏的病原体.
- 需要一种不可知论的,数据驱动的方法来识别对血液供应的未知威胁.
研究的目的:
- 开发和验证一种全现象的不可知算法,用于检测潜在的输血传播疾病.
- 通过全国卫生登记册和血液银行数据,识别对血液安全的未知威胁.
主要方法:
- 一个回顾性队列研究使用瑞典全国数据 (SCANDAT-3S) 从1968-2017.
- 开发了一种系统算法,用于对1155种疾病实体进行全现象搜索,以进行输血传播.
- 使用考克斯回归和错误发现率调整分析了捐赠者-接受者疾病一致性和共同增加的疾病风险.
主要成果:
- 分析了从104万名献血者到172万名接受者的1897万次输血.
- 确定了15种疾病的输血传播证据,其中13种疾病通过第二种方法得到验证.
- 检测到病毒性肝炎和其他疾病的传播;在调整后,艾滋病毒和异常生殖器发现没有统计学意义.
结论:
- 没有发现出乎意料的,广泛传播的输血传播疾病的有力证据.
- 这种新的方法证明了对输血传播疾病的不可知,数据驱动的监测的概念验证.
- 可以利用常规医疗保健和血液银行数据来提高血液供应的安全性.
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