Trial of Feedback on Blood Use
Stopped early · Not applicable
Conditions studied: Compliance With Restrictive RBC Transfusion Guideline
In brief
Trial of Feedback on Blood Use (TOFU) The TOFU study will represent the first attempt to rigorously assess the impact of audit-feedback on changing transfusion practice. The primary hypothesis is that providing individual feedback on transfusion practice to orthopedic surgeons will reduce elective RBC transfusions in the postoperative period. TOFU is a two-arm, cluster-randomized controlled trial. Initially, baseline blood use data will be collected at all study sites. Next, the PI at each site will give a short educational presentation to the orthopedic surgeons. The presentation will consist of a standardized 10-minute presentation reviewing the data from the FOCUS trial and the recommended red blood cell (RBC) transfusion trigger of 8 g/dL (or symptomatic anemia) based on that data. Clusters of orthopedic surgeons will then be randomized to either the Control arm (no feedback) or the Intervention arm (monthly feedback). All of the surgeons at a given site will either receive or not receive feedback. The feedback will take the form of emailed monthly reports detailing blood use by each surgeon post-hip surgery. Surgeons will be anonymized in the reports as "A, B, C . . ." but each surgeon will know which data are his own. The primary end point is the decrease from baseline in the proportion of patients transfused with a pretransfusion hemoglobin of \> 8 g/dL. TOFU will be conducted at 8 sites in Europe and North and South America. Care has been taken to minimize the labor and costs required to conduct this study. The only data collected will be: patient age/gender; procedure; surgeon (anonymized); surgery \& discharge dates; RBC units transfused; Hgb levels. The data will be entered at each site into a web-based Case Report Form, and will be stored centrally by the Data Coordinating Center (DCC). The DCC will generate monthly feedback reports and email them to each Intervention arm site PI. The site PI will then email the reports to each local orthopedic surgeon.
Key facts
- Study ID
- NCT02232568
- Run by
- Brigham and Women's Hospital
- People needed
- 426
- Starts
- 2014-09-01
- Expected to finish
- 2017-11-01
- Last updated by the study team
- 2020-05-18
Who can join
Age: any. Sex: any. Healthy volunteers: not accepted.
You may qualify if…
- Patients >= 18 years old undergoing total hip arthroplasty or hip hemiarthroplasty
You may not qualify if…
- Refusal of blood transfusions
- Surgeons utilizing "fast track" protocols (planned discharge on postoperative day 1 or 2 following surgery.)
Where it is running
- Richard Kaufman MD — Boston, Massachusetts, United States
- University of Minnesota — Minneapolis, Minnesota, United States
- Ronald Jackups MD, PhD — St Louis, Missouri, United States
- Temple University — Philadelphia, Pennsylvania, United States
- University of Washington — Seattle, Washington, United States
Full record on ClinicalTrials.gov
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