{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T11:31:06Z","timestamp":1770895866023,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2015,5,21]],"date-time":"2015-05-21T00:00:00Z","timestamp":1432166400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"National Science Foundation","award":["SES-1129688"],"award-info":[{"award-number":["SES-1129688"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p><jats:italic>Babesia microti<\/jats:italic> causes transfusion\u2010transmitted babesiosis (TTB); currently, blood donor screening assays are unlicensed but used investigationally.<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY DESIGN AND METHODS<\/jats:title><jats:p>We developed a decision tree model assessing the comparative\u2010 and cost\u2010effectiveness of <jats:italic>B. microti<\/jats:italic> blood donation screening strategies in endemic areas compared to the status quo (question regarding a history of babesiosis), including testing by: 1) universal antibody (Ab), 2) universal polymerase chain reaction (PCR), 3) universal Ab\/PCR, and 4) recipient risk\u2013targeted Ab\/PCR. The model predicted the number of TTB cases, complicated TTB cases, cases averted, and quality\u2010adjusted life years (QALYs). Economic outcomes included each strategy's per\u2010donation cost, waste (number of infection\u2010free units incorrectly discarded), and waste index (number wasted units\/number true positives). Sensitivity analyses examined uncertainty in transmission probabilities, prevalence rates, and other key model inputs.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Universal PCR in four endemic states would prevent 24 to 31 TTB cases\/100,000 units transfused (pht) at an incremental cost\u2010effectiveness ratio (ICER) of $26,000 to $44,000\/QALY (transmission probability dependent) and waste index of zero. Universal Ab\/PCR would prevent 33 to 42 TTB cases pht at an ICER of $54,000 to $83,000\/QALY and waste index of 0.05. The questionnaire is most wasteful (99.62 units wasted pht; 208.62 waste index), followed by the risk\u2010targeted strategy (76.27 units wasted pht; 0.68 waste index). The model predicted zero cases of TTB or complicated TTB with universal Ab\/PCR (versus [33, 42] and [13, 18] pht, respectively [no screening]). Results are highly sensitive to transmission probabilities.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Universal PCR in endemic states is an effective blood donation screening strategy at a threshold of $50,000\/QALY. Using a higher cost\u2010effectiveness ratio, universal Ab\/PCR is the most effective strategy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.13136","type":"journal-article","created":{"date-parts":[[2015,5,21]],"date-time":"2015-05-21T12:09:25Z","timestamp":1432210165000},"page":"2256-2271","source":"Crossref","is-referenced-by-count":33,"title":["Cost\u2010effectiveness of <i>Babesia microti<\/i> antibody and nucleic acid blood donation screening using results from prospective investigational studies"],"prefix":"10.1111","volume":"55","author":[{"given":"Ebru K.","family":"Bish","sequence":"first","affiliation":[{"name":"Grado Department of Industrial and Systems Engineering Virginia Polytechnic Institute and State University Blacksburg Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin D.","family":"Moritz","sequence":"additional","affiliation":[{"name":"Scientific Support Office American Red Cross Gaithersburg Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hadi","family":"El\u2010Amine","sequence":"additional","affiliation":[{"name":"Grado Department of Industrial and Systems Engineering Virginia Polytechnic Institute and State University Blacksburg Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas R.","family":"Bish","sequence":"additional","affiliation":[{"name":"Grado Department of Industrial and Systems Engineering Virginia Polytechnic Institute and State University Blacksburg Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan L.","family":"Stramer","sequence":"additional","affiliation":[{"name":"Scientific Support Office American Red Cross Gaithersburg Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,5,21]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197010152831607"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/00034983.1998.11813307"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197710132971511"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpara.2008.03.001"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2008.03.010"},{"key":"e_1_2_7_7_1","first-page":"505\u20109","article-title":"Babesiosis surveillance\u201418 states, 2011","volume":"61","author":"Centers for Disease Control and Prevention (CDC).","year":"2012","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.13.3.451-469.2000"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-155-8-201110180-00362"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1086\/525852"},{"key":"e_1_2_7_11_1","unstructured":"July 26\u201027 2010: Blood Products Advisory Committee meeting presentations [Internet]. Silver Spring (MD): US Food and Drug Administration; last updated 2014 Feb 21 [cited 2014 Jul 25]. 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