Alternatives to homologous blood transfusion - development of evidence- based decision aids.

输血是治疗创伤或手术中失血的传统方法。献血者的血液供不应求，过去曾发生过被病毒污染导致肝炎和艾滋病的事件。因此，人们对一系列旨在减少献血者输血需求的技术非常感兴趣。其中最流行的一种是输血(自体输血)。尽管其中一些技术很受欢迎，但它们的真正价值还没有得到真正的证明。它们可能能够减少对献血者输血的需求，但这种做法的长期影响尚不清楚。此外，自体血液的制备是超负荷工作的血库的负担，自体血液本身可能与其自身的问题有关。这项研究的主要目的是对各种输血替代方案的最佳质量试验进行审查，并进行调查，以了解患者和医生的想法。在项目的第三阶段，我们将使用在前两个阶段收集的信息来设计决策辅助工具。这些是对现有证据的全面、结构化的摘要，使患者和他们的医生能够合作做出可能为患者带来最佳结果的知情决定。这项研究的成果将是发表在国际科克伦图书馆(International Cochrane Library)上的一系列“最佳证据”的评论，世界各地的卫生专业人员都可以获得。此外，如果成功，决策辅助工具将以一种可供所有面临可能需要输血的手术的澳大利亚患者使用的形式提供。

Transfusion of donor blood is the traditional means of treating blood loss resulting from injury or during surgery. Donor blood is in short supply and in the past there have been episodes of contamination by viruses that have led to hepatitis and AIDS. Consequently there is much interest in a range of techniques designed to reduce the need for transfusion of donor blood. One of the most popular is transfusion of patients' own blood (autologous transfusion). Despite the popularity of some of these techniques their true value is not really proven. They may be capable of diminishing the need for a transfusion of donor blood, but the long-term effects of this are not clear. In addition the preparation of autologous blood is a burden for overworked blood banks, and autologous blood may itself be associated with its own problems. The main aims of this study are to carry out reviews of the best quality trials of the various alternatives to transfusion of donor blood and to carry out surveys to find out what patients and doctors think. In a third phase of the project we will use the information gathered in the first two phases to design decision aids. These are comprehensive structured summaries of the available evidence to enable patients and their physicians to collaborate in making informed decisions that are likely to lead to the best outcomes for patients. The products of the research will be a number of reviews of 'best evidence' that appear in the International Cochrane Library, available to health professionals around the world. In addition, the decision aids, if successful, will be made available in a form that can be used by all Australian patients who are facing surgery that is likely to require a blood transfusion.