{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T13:51:11Z","timestamp":1781877071157,"version":"3.54.5"},"reference-count":9,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion Medicine"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Transfusion\u2010associated circulatory overload (TACO) prevention requires identification of susceptible patients and enactment of appropriate mitigation strategies. We implemented a clinical decision support (CDS) tool at our institution to reduce TACO occurrence by alerting transfusing clinicians to at\u2010risk patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Materials<\/jats:title>\n                    <jats:p>A CDS tool was designed to screen patient charts for TACO risk factors (age\u2009&gt;\u200960, renal\/cardiac impairment and prior TACO) at the time of inpatient blood component ordering through the electronic health record (EHR). The presence of risk factors triggered a Best Practice Advisory (BPA) pop\u2010up featuring mitigation strategies. TACO rates and frequencies were compared pre\u2010 and post\u2010BPA implementation using a Z\u2010test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      TACO as a proportion of transfusion reactions decreased 40% from 9.6% (406\/4208) to 5.8% (47\/804) in the 941\u2009days after BPA implementation (\n                      <jats:italic>z<\/jats:italic>\n                      \u2009=\u20093.44,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.00056). TACO frequency decreased 44% from 1 of 11.2\u2009days to 1\/20.0\u2009days post\u2010BPA (\n                      <jats:italic>z<\/jats:italic>\n                      \u2009=\u20094.00,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.00001), while overall reaction frequency decreased 8% from 1 of 1.08\u2009days to 1 of 1.17\u2009days (\n                      <jats:italic>z<\/jats:italic>\n                      \u2009=\u20097.31,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.00001). Among 47 post\u2010BPA TACO events, 38 were subjected to the CDS algorithm, with the BPA firing for 4 of 36 (11%) of cases with TACO risk factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TACO rates decreased at our institution following BPA implementation, despite BPA under\u2010firing. Ongoing monitoring for BPA sustained effects is needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tme.70094","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T06:46:12Z","timestamp":1781246772000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Can a pop\u2010up stop a\n                    <scp>TACO<\/scp>\n                    ? A best practice advisory alert as a clinical decision support tool to mitigate the occurrence of transfusion\u2010associated circulatory overload"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2678-8986","authenticated-orcid":false,"given":"Lianne","family":"Rotin","sequence":"first","affiliation":[{"name":"University of Toronto Department of Laboratory Medicine and Pathobiology  Toronto Canada"},{"name":"Canadian Blood Services  Ottawa Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farzana","family":"Tasmin","sequence":"additional","affiliation":[{"name":"University Health Network Laboratory Medicine Program  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Ieshu","sequence":"additional","affiliation":[{"name":"University Health Network Digital University Health Network  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Jamorski","sequence":"additional","affiliation":[{"name":"University Health Network Digital University Health Network  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5297-6406","authenticated-orcid":false,"given":"Christine","family":"Cserti\u2010Gazdewich","sequence":"additional","affiliation":[{"name":"University Health Network Laboratory Medicine Program  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.13730"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2013.02.001"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41746\u2010020\u20100221\u2010y"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2016.01.024"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/hematology.2019000062"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.13086"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2017.5123"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/tme.12284"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2021.100891"}],"container-title":["Transfusion Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tme.70094","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tme.70094","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tme.70094","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T12:58:20Z","timestamp":1781873900000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tme.70094"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,11]]},"references-count":9,"alternative-id":["10.1111\/tme.70094"],"URL":"https:\/\/doi.org\/10.1111\/tme.70094","archive":["Portico"],"relation":{},"ISSN":["0958-7578","1365-3148"],"issn-type":[{"value":"0958-7578","type":"print"},{"value":"1365-3148","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,11]]},"assertion":[{"value":"2026-02-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"tme.70094"}}