This is an interesting paper that describes the findings of a panel of transfusion medicine experts that used the RAND/UCLA Appropriateness Method to assess the appropriateness of transfusion in 38 clinical settings in which transfusion is commonly administered. This approach is especially useful in settings where there is limited evidence to guide medical decisions. The most common cases rated as uncertain occurred in patients with hemoglobin concentration ≤ 7.9 g/dL. The findings from this analysis can be used to direct research to areas with the greatest uncertainty and to provide clinicians suggestions on when to or not transfuse in situations where there is a consensus among clinical experts.
– Jeffrey L. Carson