Red Blood Cell Transfusions and Iron Therapy for Patients Presenting with Acute Upper Gastrointestinal Bleeding: A Survey of Canadian Gastroenterologists and Hepatologists
Table 4
Barriers to evidence-based practice.
NEJM Study: Why has this study NOT changed your transfusion practice? Choose as many as apply.
My current practice was already in line with the conclusions of this study
59.4% (41.4%; 77.4%)
There can never be a “strict” transfusion cutoff; need a case-by-case basis
50.0% (31.7%; 68.3%)
The protocol in the study was not usual practice (i.e., endoscopy within 6 hours)
43.8% (25.6%; 61.9%)
More studies are required
28.1% (11.7%; 44.6%)
I wouldn’t change my practice based on a single study
25.0% (9.1%; 40.9%)
The study was based out of a single center
12.5% (0.4%; 24.6%)
My patients are significantly different than those in the study
9.4% (0.0%; 20.1%)
I don’t agree with the study analysis and/or conclusions
6.3% (0.0%; 15.1%)
Other
1.4% (0.4%; 4.9%)
I will never feel comfortable with restrictive transfusion
0.0%
International Consensus Guidelines
Why do you NOT agree with these proposed transfusion thresholds? Choose as many as apply.
Using strict cut-offs prevents using clinical judgement
73.7% (59.0%; 88.4%)
There is insufficient high quality evidence to support the cut-offs
36.8% (20.8%; 52.9%)
I was not aware of these cut-offs
7.9% (0.0%; 16.9%)
Patient outcomes are better with more liberal transfusion thresholds
