Past, present, and future: a qualitative and literature study identifying historical trends, drivers, and transformational factors for the future demand of blood supply in the Netherlands

Forecasting blood demand for different blood groups in Shiraz using auto regressive integrated moving average (ARIMA) and artificial neural network (ANN) and a hybrid approaches

Providing fresh blood to keep people in need of blood alive, has always been a main issues of health systems. Right policy-making in this area requires accurate forecasting of blood demand. The current study aimed at predicting demand for different blood groups in Shiraz using Auto Regressive Integrated Moving Average (ARIMA), Artificial Neural Network (ANN) and a hybrid approaches. In the current time series analysis, monthly data of the Shiraz hospitals and medical centers demand for 8 blood groups during 2012-2019 were gathered from Shiraz branch of Iranian Blood Transfusion Organization. ARIMA, ANN and a hybrid model of them was used for prediction. To validate and comprise ARIMA and ANN models, Mean Square Error (MSE) and Mean Absolute Error (MAE) criteria were used. Finally, ARIMA, ANN and hybrid model estimates were compared to actual data for the last 12 months. R3.6.3 were used for statistical analysis. Based on the MSE and MAE of models, ARIMA had the best prediction for demand of all blood groups except O+ and O-. Moreover, for most blood groups, ARIMA had closer prediction to actual data. The demand for four blood groups (mostly negative groups) was increasing and the demand for other four blood groups (mostly positive ones) was decreasing. All three approaches including ARIMA, ANN and the hybrid of them predicted an almost downward trend for the total blood demand. Differences in the performance of various models could be due to the reasons such as different forecast horizons, daily/month/annual data, different sample sizes, types of demand variables and the transformation applied on them, and finally different blood demand behaviors in communities. Advances in surgical techniques, fetal screening, reduction of accidents leading to heavy bleeding, and the modified pattern of blood request for surgeries appeared to have been effective in reducing the demand trend in the current study. However, a longer time period would certainly provide more accurate estimates.

Using a scenario approach to assess for the current and future demand of immunoglobulins: An interview and literature study from The Netherlands

OBJECTIVES

To explore the current and future demand of immunoglobulins globally and specifically for the Netherlands by assessing: (I) which specialties contribute to current demand, (II) new areas of medical need, (III) which transformational factors may impact demand and to what effect, by using a scenario approach.

BACKGROUND

As immunoglobulin demand continues to increase globally, there is concern of increasing shortages and questions of whether and how future demand will continue based on medical need.

METHODS/MATERIALS

In line with scenario principles, a scoping review of Pubmed, Web of Science, Embase and Cochrane and grey literature was conducted. Semi-structured interviews with subject matter experts were held. The results of the review and interviews were analysed for major themes.

RESULTS

The scoping review resulted in 97 articles, 74 regarding clinical uses, and 23 regarding organisational and other themes. Fifteen clinical and non-clinical experts were interviewed. I) Neurology, immunology, and haematology were specialties that contribute most to current demand. II) Regarding potential new areas of medical need, the literature review resulted in more indications than the interviews, for example, post-renal transplants. III) Four groups of key transformational factors were found: factors that could increase immunoglobulin demand (e.g., EMA revisions), decrease demand (e.g., replacement products, Dutch Transfer Act 2021), factors that remain to be seen how it impacts demand (e.g., further evidence), and miscellaneous factors (e.g., supply-related).

CONCLUSION

Having identified the specialties and relevant transformational factors that affect immunoglobulin demand, more research is needed on what clinical or organisational strategies would be effective in controlling demand in general for the Netherlands and abroad. Other blood establishments may also use a scenario approach to increase preparedness for future (un)expected developments.

Not a crystal ball: Mapping opportunities and threats for the future demand of red blood cells in the Netherlands using a scenario approach

BACKGROUND

As Western blood transfusion practices are changing, there is interest and need in anticipating the future demand of blood products and how a blood establishment can actively prepare for various long-term developments. This article provides an overview of how a scenario approach was used to prioritize key categories of drivers for the future demand of red blood cells and the organizational implications thereof for Sanquin, the Dutch national blood establishment.

STUDY DESIGN AND METHODS

Based on previously identified drivers from interviews and a literature review (Step 1), we conducted scenario sessions and a survey to rank a list of drivers ("themes") with its related opportunities and threats (Step 2), to identify mitigating measures per theme through focus groups (Step 3).

RESULTS

In Step 2, 10 themes were found that were classified in terms of importance and uncertainty. These were plotted on a two-dimensional graph with an ellipse to indicate the interquartile ranges per theme. Experts rated the top three most important themes to be the blood supply organization, precision medicine, and red blood cell replacements. In Step 3, focus groups identified specific mitigating measures per theme. These measures had parallel ideas, such as the need for an innovative mentality, internal and external communication and collaboration, and building Sanquin's reputation and trust with the public.

CONCLUSION

Having identified the most important themes with suggestions for mitigating measures, Sanquin can take steps to become adaptive and proactive. Other blood establishments may also use a scenario approach to create contextualized long-term strategies.