Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
Are individuals presenting 
with hypotension eligible 
as whole blood donors? 
A systematic review 
Nele Pauwels 
Centre f...
Introduction 
 Donor selection prior to donation to protect the 
health of donor and recipient 
− E.g. blood pressure mea...
 How to collect the evidence behind our donor 
health decisions? 
Introduction 
Systematic review 
Methodology according ...
Systematic review 
1. Formulation of the research question 
2. Development of the search strategy and search in 
multiple ...
1. Research question 
 In blood donors presenting for whole blood 
donation, does hypotension increase the risk of 
donor...
2. Search strategy 
 Systematic search in 5 databases 
− from inception date until 12th April 2013
2. Search strategy 
 Systematic search in 5 databases 
− using highly sensitive search strings 
(“Blood Donors”[Mesh] OR ...
3. Evidence selection 
8305 potentially relevant records 
53 records 
(i.e. 45 peer-reviewed 
publications and 
9 conferen...
4. Extract and synthesize data
4. Extract and synthesise data 
 Out of 8305 records, 10 observational studies 
were identified that addressed the questi...
5. Quality assessment 
 Overall quality of body of evidence 
INITIAL QUALITY LEVEL 
RELATED TO STUDY DESIGN 
LOW 
Limitat...
Publication
From evidence to recommendation: 
the Evidence-Based Practice approach
From evidence to recommendation: 
the Evidence-Based Practice approach 
 Discussion with team of experts and representati...
Thank you 
Contact: 
Nele.Pauwels@rodekruis.be 
Cebap@rodekruis.be
Upcoming SlideShare
Loading in …5
×

Are individuals presenting with hypotension eligible as whole blood donors? A systematic review

232 views

Published on

.

Published in: Science
  • Login to see the comments

  • Be the first to like this

Are individuals presenting with hypotension eligible as whole blood donors? A systematic review

  1. 1. Are individuals presenting with hypotension eligible as whole blood donors? A systematic review Nele Pauwels Centre for Evidence-Based Practice
  2. 2. Introduction  Donor selection prior to donation to protect the health of donor and recipient − E.g. blood pressure measurement  No uniform donor selection criteria − E.g. hemochromatosis patients − E.g. individuals presenting with hypotension  Belgian Red Cross-Flanders: donor management based on the best available scientific evidence Pauwels NS, De Buck E, Compernolle V, Vandekerckhove P. Worldwide policies on haemochromatosis and blood donation: a survey among blood services. Vox Sang. 2013, 105(2):121-128.
  3. 3.  How to collect the evidence behind our donor health decisions? Introduction Systematic review Methodology according to The Cochrane Collaboration De Buck E, Pauwels NS, Dieltjens T, Vandekerckhove P. Use of evidence-based practice in an aid organisation: a proposal to deal with the variety in terminology and methodology. Int J Evid Based Healthc. 2014, 12(1):39-49.
  4. 4. Systematic review 1. Formulation of the research question 2. Development of the search strategy and search in multiple databases 3. Evidence selection 4. Extraction and synthesis of the data 5. Quality assessment of the included studies and assignment of the levels of evidence (i.e. determination of bias, using the GRADE approach)
  5. 5. 1. Research question  In blood donors presenting for whole blood donation, does hypotension increase the risk of donor adverse events when compared with normotension?
  6. 6. 2. Search strategy  Systematic search in 5 databases − from inception date until 12th April 2013
  7. 7. 2. Search strategy  Systematic search in 5 databases − using highly sensitive search strings (“Blood Donors”[Mesh] OR blood don*[TIAB] OR “Blood Banks”[Mesh] OR blood bank*[TIAB] OR blood centre*[TIAB] OR blood center*[TIAB] OR blood service*[TIAB]) AND (“Hypotension”[Mesh:NoExp] OR hypotens*[TIAB] OR “Arterial Pressure”[Mesh] OR “blood pressure”[TIAB] OR “systolic pressure”[TIAB] OR “diastolic pressure”[TIAB] OR “Risk”[Mesh:NoExp] OR “Risk Factors"[Mesh] OR risk factor*[TIAB] OR “Risk Assessment”[Mesh:NoExp] OR “predonation”[TIAB] or “pre donation”[TIAB] OR “predictive”[TIAB] OR deferral*[TIAB] OR referral*[TIAB] OR inclusion*[TIAB] OR exclusion*[TIAB] OR “retention”[TIAB] OR retain*[TIAB] OR return*[TIAB] OR “first time”[TIAB] OR “Blood Volume”[Mesh:NoExp] OR “blood volume”[TIAB] OR “donor selection”[Mesh] OR “donation history”[TIAB] OR “donation status”[TIAB] OR “body weight”[Mesh:NoExp] OR “weight”[TIAB] OR “body mass index”[Mesh] OR “body mass index”[TIAB] OR “BMI”[TIAB]) AND (“Syncope”[Mesh] OR syncop*[TIAB] OR “vasovagal”[TIAB] OR “vaso vagal”[TIAB] OR “Unconsciousness”[Mesh:NoExp] OR unconscious*[TIAB] OR conscious*[TIAB] OR “Hypotension, Orthostatic”[Mesh] OR collaps*[TIAB] OR faint*[TIAB] OR convuls*[TIAB] OR "Bradycardia"[Mesh] OR “bradycardia”[TIAB] OR “Urinary Incontinence”[Mesh:NoExp] OR “Fecal Incontinence”[Mesh] OR “incontinence”[TIAB] OR “Sweating”[Mesh] OR “diaphoresis”[TIAB] OR “diaphoretic”[TIAB] OR “sweat”[TIAB] OR “sweaty”[TIAB] OR “sweating”[TIAB] OR “Dizziness”[Mesh] OR “dizzy”[TIAB] OR “dizziness”[TIAB] OR “light headedness”[TIAB] OR “lightheadedness”[TIAB] OR “Nausea”[Mesh:NoExp] OR “nausea”[TIAB] OR “nauseous”[TIAB] OR “vomit”[TIAB] OR “vomiting”[TIAB] OR “vomited”[TIAB] OR “weak”[TIAB] OR “weakened”[TIAB] OR “weakness”[TIAB] OR “Pallor”[Mesh] OR “pallor”[TIAB] OR “veins/injuries”[Mesh:NoExp] OR “Hematoma”[Mesh:NoExp] OR “hematoma”[TIAB] OR “haematoma”[TIAB] OR “Ecchymosis”[Mesh] OR “ecchymosis”[TIAB] OR “ecchymoses”[TIAB] OR “Contusions”[Mesh] OR “contusion”[TIAB] OR “contusions”[TIAB] OR “bruise”[TIAB] OR “bruises”[TIAB] OR “bruising”[TIAB] OR “nerve”[TIAB] OR side effect*[TIAB] OR “adverse”[TIAB] OR reaction*[TIAB] OR complication*[TIAB] OR “incident”[TIAB] OR “incidents”[TIAB] OR “safe”[TIAB] OR “safety”[TIAB])
  8. 8. 3. Evidence selection 8305 potentially relevant records 53 records (i.e. 45 peer-reviewed publications and 9 conference abstracts) 5418 records (including peer-reviewed publications and conference abstracts) Screening based on title and abstract evaluation 5365 irrelevant records excluded Full text evaluation Screening of reference list of included records Reviewer 1 102 articles Reviewer 2 identified: CENTRAL (n= 93), MEDLINE (n= 1838), Embase (n= 3757), CINAHL (n= 205) Web Of Science (n= 2412) 8 records selected (i.e. 7 peer-reviewed publications and 1 conference abstract) 9 records included in systematic review (8 peer-reviewed publications and 1 conference abstract including 10 observational studies in total) Duplicate removal 2887 duplicates removed Screening based on title and abstract evaluation 5379 irrelevant records excluded Full text evaluation Screening of reference list of included records 39 records (i.e. 30 peer-reviewed publications and 10 conference abstracts) 8 records selected (i.e. 7 peer-reviewed publications and 1 conference abstract)
  9. 9. 4. Extract and synthesize data
  10. 10. 4. Extract and synthesise data  Out of 8305 records, 10 observational studies were identified that addressed the question  Five of these studies (with a combined total of 1,482,020 donations and 2903 donors) included either a statistical analysis or an appropriate study design that controlled for possible confounding factors  Based on the currently available evidence, hypotension has not been shown to be an independent predictive factor for donor complications.
  11. 11. 5. Quality assessment  Overall quality of body of evidence INITIAL QUALITY LEVEL RELATED TO STUDY DESIGN LOW Limitations of study design No major limitations Imprecision No Inconsistency No Indirectness No Publication bias No QUALITY (GRADE) LOW − ‘Low quality’ = further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate www.gradeworkinggroup.org
  12. 12. Publication
  13. 13. From evidence to recommendation: the Evidence-Based Practice approach
  14. 14. From evidence to recommendation: the Evidence-Based Practice approach  Discussion with team of experts and representatives of the target group
  15. 15. Thank you Contact: Nele.Pauwels@rodekruis.be Cebap@rodekruis.be

×