Study | Design | Change sought in primary outcome | Absolute Δ Time 1- Time 2 | Reported p value | Absolute Δ Time 1- Time 3 | Reported p value |
---|---|---|---|---|---|---|
Solomon 1988 | UBA | Transfusion ordering: Decrease in use of FFP /month for the SICU and MICU (units not reported) | -79 | NR | ||
Paes 1994 | UBA | Lab test ordering: Decrease number of superficial cultures per patient | -1.72 | NR | ||
Hendryx 1998 | RCT | Lab test ordering: Improveϕ process compliance for ‘lab work’ (%) | Treatment = +17% Control = -7% | <0.0001 | ||
Merlani 2001 and Diby 2005 | UBA | Lab test ordering: | ||||
Decrease median # ABGs (per patient day) | -1.7 | <0.001 | -3.4 | <0.001 | ||
Improveϕ average adherence to guideline (%) | +15% | <0.0001 | +27% | <0.0001 | ||
Beland 2003 | UBA | Lab test ordering: Decrease & ImproveΣ: | ||||
Total # of ‘blood work’ tests per patient | +144 | NR | +214 | NR | ||
Unordered ‘blood work’ tests per patient | +15 | NR | +6 | NR | ||
Wisser 2003 | UBA | Lab test ordering: Decrease number of tests (various) per patient | -8 | NR | ||
Petäjä 2004a | UBA | Transfusion ordering: Improve⊗: | ||||
FFP (transfusions per patient) | -0.74 | NR* | +0.03 | NR* | ||
Platelets (units per patient) | -0.05 | NR* | -0.47 | NR* | ||
Distribution of pre-transfusion platelet counts | Δ Time 2 – Time3 Presented graphically | 0.452 | ||||
Distribution of pre-transfusion prothrombin time values | Presented graphically | <0.001 | ||||
Audited + Prothrombin time value > 39% | -17% | <0.0001 | ||||
Audited + Prothrombin time value > 49% | -9.7% | <0.0001 | ||||
All transfusions + Prothrombin time value > 49% | -6.9% | <0.0001 | ||||
Calderon-Margalit 2005 | UBA | Lab test ordering: | ||||
Decrease clinical Biochemistry Test orders per 100 hospital days for ICUs (mean volume per 4-month period) (TARGET) | -613.1 (-5579) | 0.009 | ||||
Hematology Test orders per 100 hospital days for ICUs (mean volume per 4-month period) (not targeted) | +34.2 (+707) | NS (NR) | ||||
Schramm 2011b | UBA | Lab test and transfusion ordering: ImproveΔ # of compliant episodes: | ||||
Lactate measured (%) | +15.8% | <0.001 | +21.6% | <0.001 | ||
Blood cultures before antibiotics (%) | +5.3% | <0.001 | +10.0% | <0.001 | ||
Appropriate RBC transfusion (%) | +3.8% | 0.397 | +3.1 | 0.397 | ||
Masud 2011c | CBA | Transfusion ordering: | ||||
Decrease proportion of CABG patients receiving transfusion (total blood product use) | Δ 2006-2007= -9.9% Δ 2007-2008= -6% | NR NR | Δ 2006-2008= -15.9% | <0.005 | ||
Decrease Volume (units) for CVICU Patients | ||||||
All products | Δ 2007-2008= -2288 | NR | ||||
Red Cells | Δ 2007-2008= -870 | NR | ||||
Platelets (concentration) | Δ 2007-2008= -566 | NR | ||||
Plateletpheresis | Δ 2007-2008= -53 | NR | ||||
Fresh Frozen Plasma | Δ 2007-2008= -660 | NR | ||||
Cryoprecipitate | Δ 2007-2008= -139 | NR | ||||
Arnold 2011 | UBA | Transfusion ordering: Improveϑ: | ||||
Number of frozen plasma (FP) requests per patient | -0.36 | NR* | -0.19 | NR* | ||
Inappropriate FP requests | T2 reported graphically | NR | -14% | 0.09 | ||
FP requests consistent with guidelines | T2 reported graphically | NR | -1% | 0.86 | ||
FP requests inconsistent with guidelines yet appropriate for the ICU | T2 reported graphically | NR | +15% | 0.04 | ||
Beaty 2013d | UBA | Transfusion ordering: | ||||
Improveϕ Odds Ratio (risk of RBC transfusion above a Hgb threshold of 8gm/dL determined by univariate logistic regression) | T2 OR= 0.52 | 0.003 | T3 OR= 0.37 | < 0.001 | ||
Improve proportion of RBC units with a Hgb threshold of ≥ 8gm/dL | Reported graphically (decrease) | <0.001 | Reported graphically (decrease) | <0.001 | ||
Gutsche 2013 | UBA | Transfusion ordering: Improve appropriatenessϕ; assessed proportion of patients receiving unnecessary RBC transfusion (%) | -6.6% | 0.016 | ||
Yeh 2015 | UBA | Transfusion ordering: Improveϕ: | ||||
RBC Transfusions (U per event) | -0.4 | NR* | Unclear; -0.53 to -0.73 | NR* | ||
Hgb trigger >8.0 g/dL | -23% | <0.001 | -8% | 0.44 | ||
Over-transfusion rate (post-transfusion Hgb >10 g/dL) | -8% | 0.004 | -5% | 0.50 | ||
Mean pre-transfusion Hgb trigger (g/dL) | -0.5 | <0.001 | -0.3 | 0.068 | ||
Murphy 2016 | UBA | Lab test and transfusion ordering: | ||||
Decrease mean ABG orders per encounter | -1.6 | < 0.05 | -1.6 | <0.05 | ||
Decrease mean RBC unit orders per encounter | -0.1 | <0.05 | -0.1 | <0.05 |