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Background and Objective: Evidence-based guidelines on platelet transfusion therapy assist clinicians to optimize patient care, but currently do not take into account costs associated with different methods used during the preparation, storage, selection and dosing of platelets for transfusion. This systematic review aimed to summarize the available literature regarding the cost effectiveness (CE) of these methods. Methods: Eight databases and registries, as well as 58 grey literature sources, were searched up to 29 October 2021 for full economic evaluations comparing the CE of methods for preparation, storage, selection and dosing of allogeneic platelets intended for transfusion in adults. Incremental CE ratios, expressed as standardized cost (in 2022 EUR) per quality-adjusted life-year (QALY) or per health outcome, were synthesized narratively. Studies were critically appraised using the Philips checklist. Results: Fifteen full economic evaluations were identified. Eight investigated the costs and health consequences (transfusion-related events, bacterial and viral infections or illnesses) of pathogen reduction. The estimated incremental cost per QALY varied widely from EUR 259,614 to EUR 36,688,323. For other methods, such as pathogen testing/culturing, use of apheresis instead of whole blood-derived platelets, and storage in platelet additive solution, evidence was sparse. Overall, the quality and applicability of the included studies was limited. Conclusions: Our findings are of interest to decision makers who consider implementing pathogen reduction. For other preparation, storage, selection and dosing methods in platelet transfusion, CE remains unclear due to insufficient and outdated evaluations. Future high-quality research is needed to expand the evidence base and increase our confidence in the findings.

BackgroundAdequate on-site first aid delivery at mass gatherings (MGs) is one of the cornerstones to ensure safe and healthy MGs. We investigated medical usage rates, frequency of triage categories and type of injury or medical complaint, among attendees at MGs in Belgium.MethodsWe analysed the Medical Triage and Registration Informatics System database, which includes prospectively collected person-level data regarding individuals visiting on-site posts at MGs in Belgium. MGs attended by >10 000 people and organised ≥5 times between 2009 and 2018 were included. We determined the proportion of patients in each triage category (‘first aid’ vs ‘medical condition’ vs ‘medical emergency’ vs ‘no treatment’) and each type of injury or medical complaint, and we calculated patient presentation rate (PPR) and transfer to hospital rate (TTHR).ResultsTwenty-eight MGs, totalling 194 events, were included involving 148 265 patient visits. ‘First aid’ was the most common triage category (80%, n=118 514). The need for a nurse/physician (‘medical condition’), and for the treatment of life-threatening conditions (‘medical emergency’) was rare (8.9%, n=13 052, and 0.6%, n=860, of all patient presentations, respectively), but remarkably higher during indoor electronic dance music (EDM) events (17.8% (n=26 391) and 4.0% (n=5930), of all patient presentations, respectively). ‘Skin wounds’ were the most common injury category (42.4%, n=62 275). ‘Respiratory problems’, ‘neurological problems’, ‘intoxication’, ‘heart complaints’ and ‘gastrointestinal complaints’ were more frequent during indoor (electronic) dance, whereas ‘burns’, ‘fracture/contusion’ and ‘skin wounds’ were higher during outdoor music, sports events and city festivals, respectively. PPR (per 10 000 attendees) was highest for outdoor EDM and outdoor music (median 130 (IQR 79) and 129 (IQR 104), respectively). TTHR (per 10 000 attendees) was highest for indoor EDM (median 4.4 (IQR 8.5)).ConclusionMedical usage rates, proportion of patients in triage and injury or medical complaint categories varied across different MG categories, suggesting opportunities for planning medical coverage at these events.

There is a wide variability in measurement methodology of physical activity. This study investigated the effect of different analysis techniques on the statistical power of physical activity outcomes after pulmonary rehabilitation.

Seifried: Medac: Other: BSD owns IP and is contract manufacturer; Uniqure BV: Research Funding.

Introduction:The analysis of published clinical trial results is essential for the evidence base of patient blood management (PBM). In addition, an evidence-based way of developing guidelines and recommendation is indispensable for high quality patient-centred hemotherapy. The international Consensus Conference (ICC) was set up in order to develop evidence-based clinical and research recommendations for preoperative anemia, red blood cell (RBC) transfusion thresholds in adult patients and implementation of PBM programmes.