Safety and waste considerations in donated blood screening
We study an important problem faced by Blood Centers, of selecting screening tests for donated blood to reduce the risk of “transfusion-transmitted infectious diseases” (TTIs), including the human immunodeficiency virus (HIV), hepatitis viruses, human T-cell lymphotropic virus, syphilis, West Nile Virus, and Chagas’ Disease. This decision has a significant impact on health care quality in both developed and developing countries. The budget-constrained decision-maker needs to construct a portfolio of screening tests, from a set of available tests, each with given efficacy (sensitivity and specificity) and cost, to administer to each unit of donated blood so as to minimize the “risk” of a TTI for blood classified as “infection-free.” While doing this, it is critical, for a viable blood system, that the decision-maker does not falsely (i.e., through screening error) discard too much of the infection-free blood (“waste”). We construct mathematical models of this decision problem, considering the various objective functions (minimization of the TTI risk or the weighted TTI risk) and various constraints (on budget and wasted blood) relevant in practice. Our work generates insights on the test selection problem. We show, for example, that a reduction in risk does not necessarily come at the expense of an increase in waste. This underscores the importance of considering these different metrics in decision-making through an optimization-based model. Our work also highlights the importance of generating region-specific testing schemes that explicitly take into account the regional prevalence and co-infection rates, along with the impacts of the infections on the society and individuals.
If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Volume (Year): 217 (2012)
Issue (Month): 3 ()
|Contact details of provider:|| Web page: http://www.elsevier.com/locate/eor|
When requesting a correction, please mention this item's handle: RePEc:eee:ejores:v:217:y:2012:i:3:p:619-632. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu)
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.