Optimal Blood Screening Strategies for Infectious Agents: Mathematical Models and Decision Support Tools

该奖项的研究目标是开发数学模型，以确定从血液供应中消除病原体的最佳筛选策略。血液制品对许多医疗手段至关重要，由于许多危险病原体可通过血液制品传播，因此血液筛查是一项至关重要的医疗服务。对于每种病原体，通常有多种fda批准的筛选测试可供选择，每种测试都有不同的特征（例如，假阳性和假阴性的概率和成本）。因此，必须确定一套筛查试验、检测策略（例如，联合检测与单独检测）和决策规则（根据检测结果将血液分类为“安全”），以尽量减少输血传播感染的风险。这项研究将产生新的数学模型和有效的解决方法，以确定最佳的筛选策略。考虑因素包括通过筛选错误丢弃的无病原体血液的数量，亚群特异性和不确定的感染率和测试性能参数，病原体间的合并感染率以及有限的可用资源。其他目标集中在利用这个问题来帮助进一步教育工程专业的学生。如果成功，本研究的结果将有助于通过更好地了解捐献血液的最佳筛查策略，考虑到非传统的解决方案，如区域、血型或亚人群特定的测试，这些解决方案侧重于结果的公平性，从而有助于医疗保健服务的安全性。因此，它有可能通过将重点转移到非常规测试方案上而实现变革。这项研究是由当前血液供应商的需求推动的，我们与美国红十字会的合作，在一个由工程师和医学专业人员组成的多学科团队中，是这个项目的重要组成部分。此外，这项研究的应用范围超出了血液筛查（例如，器官/组织移植、致癌物质检测、食品检测）。研究生和本科生将受益于课堂教学和参与研究。

The research objective of this award is to develop mathematical models to determine an optimal screening strategy to eliminate pathogens from the blood supply. Blood products are essential for many medical treatments, and because many dangerous pathogens can be transmitted through blood products, blood screening is a vital medical service. For each pathogen, there are often multiple FDA-approved screening tests from which to choose, each having different characteristics (e.g., false-positive and false negative probabilities and cost). Thus, the set of screening tests, testing strategies (e.g., pooled versus individual testing), and decision rules (to classify blood as "safe" based on test outcomes) must be determined to minimize the risk of a transfusion-transmitted infection. This research will result in novel mathematical models and effective solution methodologies to determine an optimal screening strategy. Considerations include the amount of pathogen-free blood falsely discarded through screening, subpopulation specific and uncertain infection rates and test performance parameters, co-infection rates among pathogens, and the limited resources available. Other objectives focus on using this problem to help further the education of engineering students.If successful, the results of this research will contribute to the safety of healthcare delivery by building a better understanding of optimal screening strategies for donated blood, considering unconventional solutions, such as regional, blood group, or sub-population specific testing, which focus on equity in outcomes. As such, it has the potential to be transformative by shifting focus to unconventional testing schemes. This research is driven by the current needs of blood suppliers, and our collaboration with the American Red Cross, within a multi-disciplinary team of engineers and medical professionals, is an essential component of this project. Further, this research has application beyond blood screening (e.g., organ/tissue transplants, carcinogen testing, food testing). Graduate and undergraduate engineering students will benefit through classroom instruction and involvement in the research.