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Big data modeling to predict platelet usage and minimize wastage in a tertiary care system

  1. Tho D. Phamb,d,f,2
  1. aDepartment of Statistics, Stanford University, Stanford, CA 94305;
  2. bDepartment of Pathology, Stanford University, Stanford, CA 94305;
  3. cStanford Center for Clinical Informatics, Stanford University, Stanford, CA 94305;
  4. dStanford Hospital Transfusion Service, Stanford Medicine, Stanford, CA 94305;
  5. eDepartment of Biomedical Data Science, Stanford University, Stanford, CA 94305;
  6. fStanford Blood Center, Stanford Medicine, Stanford, CA 94305
  1. Contributed by Robert J. Tibshirani, August 10, 2017 (sent for review June 25, 2017; reviewed by James Burner, Pearl Toy, and Minh-Ha Tran)

  1. Fig. 2.

    Daily platelet expiration wastage patterns by day of week and month. (A) Similar to daily transfusion rates, daily expiration rates from January 1, 2013 through May 31, 2015 is also highly variable. (B) Mean daily platelet expiration wastage is higher on weekdays than weekend (4.09 vs. 2.56, P value = 5.4e-04). (C) Mean daily platelet expiration wastage varies with month as determined by one-way ANOVA (F = 4.90, P = 2.16e-07).

  2. Fig. 3.

    Marginal correlation plot between the platelet usage and the selected predictors, with correlations coded from +1 (dark blue) to ?1 (dark red), as indicated by the heat map legend on the right. Abnormal CBC values are aggregated as the average daily number of patients with specific abnormal CBC (MCHC; MCV, mean corpuscular volume; Plt, platelet count; RBC; RDW, red cell distribution width). Census data are reported as the number of patients in the indicated unit for the day.

  3. Fig. 4.

    Daily platelets transfused (red line), modeled remaining (green line), and modeled wastage due to expiration (blue line) during the validation period (from day 201 to day 880), with c0 = 30. With the model during the validation set, there was never a day wherein there were not enough platelets on the shelf. The number of units remaining at the end of each day stayed above 10, and the expiration rate during this period was reduced to 3.2%.

  4. Fig. 5.

    Cumulative plot for historical number of platelet units transfused (black line), historical waste due to expiration (blue line), and projected waste due to expiration under our model (red line), during the validation period from day 201 to day 880. The total number of units historically transfused and wasted during this period was 24,700 and 2,600, respectively. Using our model, the cumulative waste was reduced to 780, representing a reduction in expiration rate from 10.5 to 3.2%.

Online Impact

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