{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T13:58:31Z","timestamp":1792418311351,"version":"4.4.0"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"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"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n Automated surveillance systems such as the electronic automatic notification system (\n EANS<\/jats:styled-content>\n ) have been introduced to improve recognition of adverse transfusion reactions (\n ATRs<\/jats:styled-content>\n ), but their long\u2010term sustainability and operational limitations remain incompletely defined.\n <\/jats:p>\n <\/jats:sec>\n \n Study Design and Methods<\/jats:title>\n We conducted a 6\u2010year retrospective study (2019\u20132025) evaluating EANS performance at a tertiary hospital, analyzing quarterly suspected ATR (sATR) and confirmed ATR detection rates. Detection sources, positive predictive value (PPV), and reporting pathways were evaluated. During a focused 87\u2010day period, all alerts were reviewed to assess signal\u2010to\u2010noise ratio (SNR) and vital sign\u2010specific alert patterns.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Following implementation,\n sATR<\/jats:styled-content>\n and\n ATR<\/jats:styled-content>\n detection rates peaked at 1.26% and 0.53%, but gradually declined over time, with further reductions during periods of healthcare system strain.\n EANS<\/jats:styled-content>\n \u2010generated alerts accounted for 94.4% of\n sATR<\/jats:styled-content>\n reports (\n PPV<\/jats:styled-content>\n 58.1%), whereas clinician\u2010initiated reports demonstrated higher specificity (\n PPV<\/jats:styled-content>\n 92.5%). In the focused analysis, only 1.5% of alerts were reported (\n SNR<\/jats:styled-content>\n 1:78, one notification per five units transfused), yet 86.2% of reported alerts were confirmed\n ATRs<\/jats:styled-content>\n after clinical triage. Nearly two\u2010thirds of alerts were attributable to multiple vital sign entries or documentation errors. Body temperature\u2010containing and multi\u2010parameter alerts showed markedly higher rates of potential missed\n ATR<\/jats:styled-content>\n than isolated triggers.\n <\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n Automated vital sign\u2010based surveillance expands hemovigilance coverage but generates considerable alert burden potentially placing the system at risk of reduced reporting performance during prolonged use and periods of healthcare system strain. Continuous system optimization and vital sign specific alert prioritization strategies may be necessary to improve performance of automated hemovigilance systems.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/trf.70342","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T04:52:16Z","timestamp":1785991936000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical performance and limitations of a vital sign\u2010based electronic automatic notification system for suspected transfusion reactions: A 6\u2010year experience"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8472-289X","authenticated-orcid":false,"given":"Young Ae","family":"Lim","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine Ajou University School of Medicine Suwon South Korea"},{"name":"Transfusion Management Room Ajou University Hospital Suwon South Korea"},{"name":"Department of Laboratory Medicine Ajou University Hospital Suwon South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chorong","family":"Park","sequence":"additional","affiliation":[{"name":"Transfusion Management Room Ajou University Hospital Suwon South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Transfusion Management Room Ajou University Hospital Suwon South Korea"},{"name":"Department of Laboratory Medicine Ajou University Hospital Suwon South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.13060"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.15931"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.13730"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.13549"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/PTS.0000000000000527"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPOQNBKCDXFWU3"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/voxs.12404"},{"key":"e_1_2_10_9_1","volume-title":"The National Healthcare Safety Network (NHSN) Manual: Biovigilance Component v2.2","author":"U.S. Centers for Disease Control and 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Transfus"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.12621"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/13.2.307"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/nuf.12697"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.70342","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/trf.70342","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.70342","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T09:53:43Z","timestamp":1788861223000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.70342"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,5]]},"references-count":23,"alternative-id":["10.1111\/trf.70342"],"URL":"https:\/\/doi.org\/10.1111\/trf.70342","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,5]]},"assertion":[{"value":"2026-03-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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