重视输血医学中的参考间隔:当前实践中的创新和挑战
Paulo Pereira1, Alan Carvalho Dias2, Filipe Luig1
1Portuguese Institute of Blood and Transplantation, Lisbon, Portugal.
概括
参考间隔对于献血和输血安全至关重要. 像reflimR和refineR这样的新计算方法比标准的CLSI EP28方法提供了更准确的RI估计,改善了供体查和安全.
科学领域:
- 输血医学 输血医学
- 临床化学 临床化学
- 生物统计学 生物统计学
背景情况:
- 参考间隔 (RIs) 对供体选择,血液成分质量和输血后安全至关重要.
- 广泛使用的CLSI EP28非参数方法有异常值和偏差数据的局限性.
- 新兴的计算方法为RI估计提供了潜在的改进.
研究的目的:
- 评估CLSI EP28在输血医学中的局限性.
- 将EM,reflimR和refineR进行比较,以改进RI估计.
- 评估计算方法的有效性,以获得准确的RI.
主要方法:
- 对血红蛋白,血红素和血小板计数进行模拟的献血者数据集 (n=500).
- 我们比较了四种RI估计方法:CLSI EP28,预期最大化 (EM),reflimR和refineR.
- 分析了每个方法的异常值阻力和分布精度.
主要成果:
- 根据经验百分位数,CLSI EP28和EM产生了类似的RI.
- ReflimR和refineR产生了更广泛的RI,显示出更好的异常阻力.
- 与CLSI EP28和EM相比,ReflimR和RefineR的分布精度提高了.
结论:
- 虽然CLSI EP28是标准,但EM,reflimR和refineR等计算方法提供了更高的准确性和稳定性.
- 这些先进的方法可以提高监管合规性 (IVDR,FDA 510(k,ISO 15189).
- 实施EM,reflimR和refineR可以提高供体查和输血安全.
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