{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T04:31:43Z","timestamp":1792816303112,"version":"4.5.0"},"reference-count":21,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR203334"],"award-info":[{"award-number":["NIHR203334"]}],"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":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Monitoring Patient Blood Management (PBM) practices against evidence\u2010based standards is essential for quality improvement; however, current approaches are limited. In the UK, perioperative tranexamic acid (TXA) use is a national quality standard, yet monitoring relies on manual audit cycles that are resource\u2010intensive and limited in scope. We evaluated whether an audit could be automated using routinely collected electronic health record (EHR) data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective study at a tertiary NHS center using linked perioperative and transfusion datasets. Automated compliance indicators were constructed using coded procedures (denominator) and digitally documented TXA administration from WHO Surgical Safety Checklists and electronic prescribing records (numerator). A structured validation framework assessed data extractability, completeness, denominator coverage, coding accuracy, and concordance between electronic sources. Outputs were assessed by specialty and procedure and compared with contemporaneous manual audit findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between July\u2013September 2025, 800 eligible procedures were identified. Comparison with an independent dataset demonstrated procedural coverage of 96.2% and miscoding rate of 3.9%. Overall automated TXA compliance was 86.3%. Concordance between WHO checklist and electronic prescription was 74.2%, with explainable discordance patterns. Substantial inter\u2010specialty variation was identified, ranging from 98.2% (trauma and orthopedics) to 0% (vascular surgery). Compared with October\u2013December 2024, overall compliance increased by 7.6%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Automated EHR\u2010based audit of perioperative TXA compliance is feasible and demonstrates good validity. Structured validation confirmed data reliability, and full\u2010population extraction revealed granular specialty\u2010 and procedure\u2010level variation, likely undetectable by manual audits, supporting its wider evaluation as a continuous PBM quality monitoring tool.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.70270","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T15:47:03Z","timestamp":1779205623000},"page":"1506-1519","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Electronic patient blood management monitoring using routine health record data: A proof\u2010of\u2010principle study monitoring perioperative tranexamic acid use"],"prefix":"10.1111","volume":"66","author":[{"given":"Muhammad Naim","family":"Che Rahimi","sequence":"first","affiliation":[{"name":"Department of Hematology Oxford University Hospitals NHS Foundation Trust  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Polzella","sequence":"additional","affiliation":[{"name":"Department of Hematology Oxford University Hospitals NHS Foundation Trust  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehir","family":"Amin","sequence":"additional","affiliation":[{"name":"ORBIT, Data &amp; Analytics Oxford University Hospitals NHS Foundation Trust  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gardash","family":"Bakhishli","sequence":"additional","affiliation":[{"name":"NIHR Blood &amp; Transplant Research Unit in Data\u2010Driven Transfusion Practice  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Godley","sequence":"additional","affiliation":[{"name":"ORBIT, Data &amp; Analytics Oxford University Hospitals NHS Foundation Trust  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2375-7503","authenticated-orcid":false,"given":"Michael F.","family":"Murphy","sequence":"additional","affiliation":[{"name":"Department of Hematology Oxford University Hospitals NHS Foundation Trust  Oxford UK"},{"name":"NIHR Blood &amp; Transplant Research Unit in Data\u2010Driven Transfusion Practice  Oxford UK"},{"name":"Nuffield Division of Clinical Laboratory Sciences Radcliffe Department of Medicine, The University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7414-4950","authenticated-orcid":false,"given":"Simon J.","family":"Stanworth","sequence":"additional","affiliation":[{"name":"Department of Hematology Oxford University Hospitals NHS Foundation Trust  Oxford UK"},{"name":"NIHR Blood &amp; Transplant Research Unit in Data\u2010Driven Transfusion Practice  Oxford UK"},{"name":"Nuffield Division of Clinical Laboratory Sciences Radcliffe Department of Medicine, The University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2396-1659","authenticated-orcid":false,"given":"Hayley G.","family":"Evans","sequence":"additional","affiliation":[{"name":"NIHR Blood &amp; Transplant Research Unit in Data\u2010Driven Transfusion Practice  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD013295.pub2"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-019-0772-0"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa2028788"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2024.6048"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa2201171"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e3054"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2021.0884"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2025-112512"},{"key":"e_1_2_11_10_1","volume-title":"Standards for a patient blood management program","author":"AABB","year":"2023"},{"key":"e_1_2_11_11_1","volume-title":"Blood transfusion. NICE guideline [NG24]","author":"National Institute for Health and Care Excellence","year":"2015"},{"key":"e_1_2_11_12_1","volume-title":"Blood transfusion. Quality standard [QS138]","author":"National Institute for Health and Care Excellence","year":"2016"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X18811977"},{"key":"e_1_2_11_14_1","unstructured":"Grant\u2010CaseyJ BoothC DaviesA DaviesP MurphyMF UprichardJ et al.National comparative audit of NICE quality standard QS138. National Comparative Audit of Blood Transfusion (NCABT) NHS Blood and Transplant; March 2025.2024."},{"key":"e_1_2_11_15_1","volume-title":"QS138 quality insights audit tool [Internet]","author":"NHS Blood and Transplant","year":"2023"},{"key":"e_1_2_11_16_1","volume-title":"Patient blood management and perioperative care (PBMPC) theme [Internet]","author":"NIHR Health Informatics Collaborative","year":"2025"},{"key":"e_1_2_11_17_1","unstructured":"Grant\u2010CaseyJ BoothC DaviesA DaviesP MurphyMF UprichardJ et al.National Comparative Audit of NICE Quality Standard QS138. National Comparative Audit of Blood Transfusion (NCABT) NHS Blood and Transplant; February 2024.2023."},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2296-12-85"},{"key":"e_1_2_11_19_1","volume-title":"The report. Volume 1. Overview and recommendations","author":"Infected Blood Inquiry","year":"2024"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD000259.pub3"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-017-0646-0"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.0364"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.70270","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/trf.70270","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.70270","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T18:29:17Z","timestamp":1786213757000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.70270"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,19]]},"references-count":21,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/trf.70270"],"URL":"https:\/\/doi.org\/10.1111\/trf.70270","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,19]]},"assertion":[{"value":"2026-03-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}