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查策略。血液制品对许多医疗是必不可少的，由于许多危险的病原体可以通过血液制品传播，血液筛查是一项重要的医疗服务。对于每种病原体，通常有多个FDA批准的筛查试验可供选择，每种试验都有不同的特征(例如，假阳性和假阴性概率和成本)。因此，必须确定一套筛查检测、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归类为“安全”)，以最大限度地减少通过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求解方法来确定最优的筛选策略。考虑的因素包括通过筛查被错误丢弃的无病原体血液的数量，特定亚群和不确定的感染率和测试性能参数，病原体之间的混合感染率，以及可用的有限资源。其他目标集中在利用这一问题来帮助进一步教育工程学学生。如果成功，这项研究的结果将通过更好地理解捐献血液的最佳筛查策略，考虑非常规解决方案，如区域、血型或亚人群特定测试，重点关注结果的公平性，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计划来实现变革。这项研究是由血液供应商目前的需求推动的，我们与美国红十字会在一个由工程师和医疗专业人员组成的多学科团队中的合作是该项目的重要组成部分。此外，这项研究的应用超越了血液筛查(例如，器官/组织移植、致癌物质检测、食品检测)。工程专业的研究生和本科生将从课堂教学和参与研究中受益。

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.