A data‐informed system to manage scarce blood product allocation in a randomized controlled trial of convalescent plasma

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Abstract
Background: Equitable allocation of scarce blood products needed for a randomized controlled trial (RCT) is a complex decision‐making process within the blood supply chain. Strategies to improve resource allocation in this setting are lacking.Methods: We designed a custom‐made, computerized system to manage the inventory and allocation of COVID‐19 convalescent plasma (CCP) in a multi‐site RCT, CONCOR‐1. A hub‐and‐spoke distribution model enabled real‐time inventory monitoring and assignment for randomization. A live CCP inventory system using REDCap was programmed for spoke sites to reserve, assign, and order CCP from hospital hubs. A data‐driven mixed‐integer programming model with supply and demand forecasting was developed to guide the equitable allocation of CCP at hubs across Canada (excluding Québec).Results: 18/38 hospital study sites were hubs with a median of 2 spoke sites per hub. A total of 394.5 500‐ml doses of CCP were distributed; 349.5 (88.6%) doses were transfused; 9.5 (2.4%) were wasted due to mechanical damage sustained to the blood bags; 35.5 (9.0%) were unused at the end of the trial. Due to supply shortages, 53/394.5 (13.4%) doses were imported from Héma‐Québec to Canadian Blood Services (CBS), and 125 (31.7%) were transferred between CBS regional distribution centers to meet demand. 137/349.5 (39.2%) and 212.5 (60.8%) doses were transfused at hubs and spoke sites, respectively. The mean percentages of total unmet demand were similar across the hubs, indicating equitable allocation, using our model.Conclusion: Computerized tools can provide efficient and immediate solutions for equitable allocation decisions of scarce blood products in RCTs.
Funding Information
  • Mitacs (Accelerate Program (IT24709))
  • Natural Sciences and Engineering Research Council of Canada (Discovery Grant Program (RGPIN‐2016‐04518), Discovery Grant Program (RGPIN‐2022‐02999))
  • Canadian Blood Services (Blood Efficiency Accelerator Program, Transfusion Medicine Research Program Support)

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