{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:55:57Z","timestamp":1773017757828,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T00:00:00Z","timestamp":1676505600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["CH\/12\/2\/29428"],"award-info":[{"award-number":["CH\/12\/2\/29428"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["RG\/13\/13\/30194"],"award-info":[{"award-number":["RG\/13\/13\/30194"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["RG\/18\/13\/33946"],"award-info":[{"award-number":["RG\/18\/13\/33946"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/L003120\/1"],"award-info":[{"award-number":["MR\/L003120\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["BRC\u20101215\u201020014"],"award-info":[{"award-number":["BRC\u20101215\u201020014"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR BTRU\u20102014\u201010024"],"award-info":[{"award-number":["NIHR BTRU\u20102014\u201010024"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR203337"],"award-info":[{"award-number":["NIHR203337"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Deferrals due to low hemoglobin are time\u2010consuming and costly for blood donors and donation services. Furthermore, accepting donations from those with low hemoglobin could represent a significant safety issue. One approach to reduce them is to use hemoglobin concentration alongside donor characteristics to inform personalized inter\u2010donation intervals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design and Methods<\/jats:title><jats:p>We used data from 17,308 donors to inform a discrete event simulation model comparing personalized inter\u2010donation intervals using \u201cpost\u2010donation\u201d testing (i.e., estimating current hemoglobin from that measured by a hematology analyzer at last donation) versus the current approach in England (i.e., pre\u2010donation testing with fixed intervals of 12\u2010weeks for men and 16\u2010weeks for women). We reported the impact on total donations, low hemoglobin deferrals, inappropriate bleeds, and blood service costs. Personalized inter\u2010donation intervals were defined using mixed\u2010effects modeling to estimate hemoglobin trajectories and probability of crossing hemoglobin donation thresholds.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The model had generally good internal validation, with predicted events similar to those observed. Over 1\u2009year, a personalized strategy requiring \u226590% probability of being over the hemoglobin threshold, minimized adverse events (low hemoglobin deferrals and inappropriate bleeds) in both sexes and costs in women. Donations per adverse event improved from 3.4 (95% uncertainty interval 2.8, 3.7) under the current strategy to 14.8 (11.6, 19.2) in women, and from 7.1 (6.1, 8.5) to 26.9 (20.8, 42.6) in men. In comparison, a strategy incorporating early returns for those with high certainty of being over the threshold maximized total donations in both men and women, but was less favorable in terms of adverse events, with 8.4 donations per adverse event in women (7.0, 10,1) and 14.8 (12.1, 21.0) in men.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Personalized inter\u2010donation intervals using post\u2010donation testing combined with modeling of hemoglobin trajectories can help reduce deferrals, inappropriate bleeds, and costs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.17277","type":"journal-article","created":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T10:02:06Z","timestamp":1676541726000},"page":"541-551","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Impact of a post\u2010donation hemoglobin testing strategy on efficiency and safety of whole blood donation in England: A modeling study"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4552-3820","authenticated-orcid":false,"given":"Lois G.","family":"Kim","sequence":"first","affiliation":[{"name":"Blood and Transplant Research Unit in Donor Health and Behaviour  Cambridge UK"},{"name":"Dept of Public Health &amp; Primary Care University of Cambridge  Cambridge UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Bolton","sequence":"additional","affiliation":[{"name":"Dept of Public Health &amp; Primary Care University of Cambridge  Cambridge UK"},{"name":"BHF Data Science Centre Health Data Research  UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Sweeting","sequence":"additional","affiliation":[{"name":"Dept of Health Sciences University of Leicester  Leicester 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Donor Health and Behaviour  Cambridge UK"},{"name":"Dept of Public Health &amp; Primary Care University of Cambridge  Cambridge UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7678-1451","authenticated-orcid":false,"given":"Eamonn","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Blood and Transplant Research Unit in Donor Health and Behaviour  Cambridge UK"},{"name":"School of Psychology University of Nottingham  Nottingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gail","family":"Miflin","sequence":"additional","affiliation":[{"name":"NHS Blood &amp; Transplant  Bristol UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Blood and Transplant Research Unit in Donor Health and Behaviour  Cambridge UK"},{"name":"NHS Blood &amp; Transplant John Radcliffe Hospital  Oxford UK"},{"name":"Radcliffe Dept of 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