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Cited by 1Blood donation and transfusion practicesCentral Venous Catheters and HemodialysisBlood transfusion and management

Evaluation of a scoring system for vein suitability in platelet apheresis donors

Open access
Noushad, Shahida, Basavarajegowda, Abhishekh, Toora, Esha, Sahoo, Dibyajyoti, Hari Priya, K M·2024·Journal of Clinical Apheresis
DOI 10.1002/jca.22106
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Abstract

Introduction: Donor vein assessment for the selection of good quality veins is crucial for a successful apheresis procedure. This study intends to find out the effectiveness of a vein assessment scoring tool (VST) used and found to be effective in selecting whole blood donors to reduce the difficulty in identifying good quality veins for the plateletpheresis procedure. Materials and methods: This was a prospective observational study on platelet apheresis donors with the application of a VST consisting of three vein descriptor parameters (vein visibility, vein palpability, and vein size) with 5 Likert‐type responses constituting a score of 0–12 for each arm. Two vein assessors independently evaluated the vein in both arms and marked their responses blinded from each other as well from the principal investigator. The scores were then calculated and analyzed at the end of the study for their association with phlebotomy and procedural outcomes. Results: A total of 190 donors were recruited. The mean scores for the arms with successful and failed phlebotomy were 9.1 and 9.4 (SD 2.3), respectively. The intra‐class correlation Alpha Cronbach value was 0.834 and 0.837 for total scoring in the left arm and right arm, respectively, between the two assessors. Scores neither showed a correlation with other outcomes like low flow alarms, hematoma formation, number of phlebotomy attempts, and procedure completion. Conclusion: The study showed that the vein score tool did not truly predict the phlebotomy outcome in apheresis donors, though there was a good degree of inter‐assessor reliability.

Integrity signals

Registry

Crossref · 10.1002/jca.22106

Cites

9 of 9 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 16 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    There was a statistically significant difference between average PA scores and the type of vein (central vs side).

    “Average scores of PA were correlated between central and side veins using an independent T-test, and there was a statistically significant difference between the scores and the type of veins, as shown in Table 7”
    Quote in the paperNot a substantial claim
  • Findingown data

    For donors who returned for repeat donation, the agreement between older and newer scoring showed a good degree of reliability, indicating repeatability of VST for vein scores.

    “For donors who returned for repeat donation, the agreement between the older scoring and newer scoring showed a good degree of reliability, indicating the repeatability of VST for the vein scores.”
    Quote in the paperSubstantial claim
  • Findingown data

    The relationship between PI's acceptance and the experience of vein assessors showed no statistically significant correlation.

    “The relationship between PI's acceptance (accepted/ deferred) and the experience of the vein assessors using Pearson's correlation test showed no statistically significant correlation.”
    Quote in the paperNot a substantial claim
  • Findingown data

    The number of LFA, especially continuous LFA, had a significant association with procedure failure.

    “the number of LFA, especially the continuous LFA, which had a significant association with procedure failure, was less in donors with 0-7 scores.”
    Quote in the paperSubstantial claim
  • Findingown data

    The number of LFA, especially continuous LFA, was less in donors with 0-7 scores.

    “the number of LFA, especially the continuous LFA, which had a significant association with procedure failure, was less in donors with 0-7 scores.”
    Quote in the paperNot a substantial claim
  • May combine two claims. 18
  • Classified as probably not a substantial claim. 13
  • The quote only partly states this claim. 1

  • May combine two claims.

    Findingown data

    More than one phlebotomy attempt was required in 13.5% (5/37) of donors in the 0-7 score group and 12% in each of the 8-9 and 10-12 score groups.

    “more than one phlebotomy attempt was required in 13.5% (5/37) in the 0-7 group and 12% in each of the 8-9 and 10-12 score groups.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Only three procedures failed because of continuous LFA in the score group 10-12, and all were in first-time apheresis donors.

    “Only three procedures failed because of continuous LFA in the score group of 10-12, and all were detected in first-time apheresis donors.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In donors with vein scores of 0-7, 84% had no LFA, and only 5% had continuous LFA.

    “in donors with vein scores of 0-7, 84% had no LFA, and only 5% had continuous LFA.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The remaining three procedures with hematoma showed continuous low flow alarms even after shifting to the other arm, and manipulation resulted in hematoma and immediate procedure termination; all occurred in side veins with a score of 10-12.

    “The remaining three procedures showed continuous low flow alarms even after shifting to the other arm, which on manipulation resulted in hematoma resulting in immediate procedure termination, and all occurred in side veins, which had a scoring of 10-12.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The intra-class correlation Alpha Cronbach value was 0.834 for total scoring in the left arm and 0.837 for the right arm between the two assessors.

    “The intra-class correlation Alpha Cronbach value was 0.834 and 0.837 for total scoring in the left arm and right arm, respectively, between the two assessors.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The scores for left and right arms, total PA score, and total visibility score had good inter-assessor reliability and were deemed acceptable.

    “However, the scores for left and right arms, total PA score, and total visibility score had good inter-assessor reliability and were deemed acceptable.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Vein scores showed no correlation with low flow alarms, hematoma formation, number of phlebotomy attempts, or procedure completion.

    “Scores neither showed a correlation with other outcomes like low flow alarms, hematoma formation, number of phlebotomy attempts, and procedure completion.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The PI accepted all donors who were accepted by the vein assessors, and 75% of donors (12 out of 16 deferred) who were deferred by the assessors based on the vein score (≤7).

    “The PI had accepted all the donors who were accepted by the vein assessors, and 75% of the donors (12 out of 16 deferred) who were deferred by the assessors based on the vein score (≤7).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The incidence of hematoma was 9.8% (13/132) in first-time donors and 6.9% (4/58) in repeat donors, with no statistically significant difference (P = .702).

    “The incidence of hematoma was 9.8% (13/132) in first-time donors and 6.9% (4/58) in repeat donors, which was not statistically significant (P À.702).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Total size score of phlebotomy hand showed a negative correlation (-0.031) with number of LFA, not statistically significant (P = .667).

    “total palpability and total size score of phlebotomy hand showed negative correlation (À0.023) and (À0.031) with the number of LFA though it was statistically not significant (P-value À.752 and .667respectively).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Total palpability score of phlebotomy hand showed a negative correlation (-0.023) with number of LFA, not statistically significant (P = .752).

    “total palpability and total size score of phlebotomy hand showed negative correlation (À0.023) and (À0.031) with the number of LFA though it was statistically not significant (P-value À.752 and .667respectively).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims. The quote only partly states this claim.

    Findingown data

    The median score for the phlebotomy arm was 9, with a range of 1-12.

    “The median score for the PA was 9, with a range of 1-12.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The median score in successful and failed phlebotomy was 9, though palpability scores were comparatively higher in the successful group (P = .08).

    “The median score in successful and failed phlebotomy was 9, though palpability scores were comparatively higher in the successful group (P-value À.08).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Peripheral vascular access is the only recommended means by which apheresis platelets are collected in donors unless under exceptional circumstances.

    “peripheral vascular access is the only recommended means by which this product is collected in donors unless under exceptional circumstances. 2”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2] 2. Kristin G, Jill A. Vascular Access. Principles of apheresis technol- ogy. 7th ed. Vancouver, British Columbia: ASFA; 2020;59-74.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The revised sample size was a minimum of 176 donors.

    “the revised sample size was a minimum of 176 donors.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The centrally placed median cubital vein in the antecubital fossa is the first choice for vascular access, with the cephalic vein and basilic vein as the second and third choices, respectively.

    “The centrally placed median cubital vein in the antecubital fossa is the first choice as it is well anchored and thus more stable, with the cephalic vein and basilic vein as the second and third choices, respectively.3”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3] 3. James W, Smith MD. Blood component collection by apheresis. AABB technical manual. 19th ed. Bethesda, USA: AABB Press; 2011;227-238.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    The study planned a sample size of 8 experimental and 160 control subjects.

    “we needed to study 8 experimental subjects and 160 control subjects”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    All study subjects were males, so the effect of VST in female apheresis donors is not known.

    “All study subjects were males, so the effect of VST in female apheresis donors, if it could have been any different, is not known.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Currently, there are no guidelines for assessing good-quality veins.

    “Currently, there are no guidelines for assessing goodquality veins”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [13] 13. McDiarmid S, Bredeson C, Huebsch LB. Selection of appropri- ate venous access for the collection of peripheral blood progeni- tor cells by experienced apheresis nurses. J Clin Apher. 1999; 14(2):51-56. source

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    Two vein assessors independently evaluated the vein in both arms and marked their responses blinded from each other and from the principal investigator.

    “Two vein assessors independently evaluated the vein in both arms and marked their responses blinded from each other as well from the principal investigator.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In the study by Hirani et al., VST was helpful in predicting successful outcomes in phlebotomies in whole blood donors.

    “Research by Hirani et al., which evaluated the effectiveness of VST for determining whole-blood donor vein suitability, demonstrated that VST is helpful in predicting successful outcomes in phlebotomies in wholeblood donors.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8] 8. Rena H, Justine O, Elizabeth K, Barbara B, Phillip M. Evalua- tion of a tool to score donor vein suitability for blood donation. VoxSanguinis. 2019;114:588-594.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Donors were consecutively enrolled till the sample size was achieved.

    “The donors were consecutively enrolled till the sample size was achieved.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The whole procedure of scoring was blinded from the principal investigator.

    “The whole procedure of scoring was blinded from the principal investigator (PI).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    The guidelines devised for inserting peripheral cannulas mainly focus on the device selection, site of insertion and infection control precautions and little focus on the quality of the vein selection.

    “The guidelines devised for inserting peripheral cannulas mainly focus on the device selection, site of insertion and infection control precautions and little focus on the quality of the vein selection.13”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [13] 13. McDiarmid S, Bredeson C, Huebsch LB. Selection of appropri- ate venous access for the collection of peripheral blood progeni- tor cells by experienced apheresis nurses. J Clin Apher. 1999; 14(2):51-56. source

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    A randomized controlled trial for evaluating the impact of vein visualization technologies on whole blood donation success rates, which also used a VST, demonstrated that the use of vein visualization technology does not improve phlebotomy outcome and donation experience; however, it showed a higher rate of successful phlebotomy in donors with higher vein score and vein assessment score could预测 ph

    “A randomized controlled trial for evaluating the impact of vein visualization technologies on whole blood donation success rates, which also used a VST to assess the vein suitability of the donor prior to donation, demonstrated that the use of vein visualization technology does not improve phlebotomy outcome and donation experience; however, it showed a higher rate of successful phlebotomy in”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [9] 9. Mondy PJ, Thijsen A, Brama T, et al. Vein suitability scoring to predict phlebotomy outcomes in young whole blood donors. 34th International Congress of the International Society of Blood Transfusion; 3-8 September 2016. Dubai, United Arab Emirates: VoxSanguinis; 2016;7-305.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [10] 10. Waller D, Mondy P, Brama T, et al. Determining the effect of vein visualization technology on donation success, vasovagal symptoms, anxiety and intention to re-donate in whole blood donors aged 18-30 years: a randomized controlled trial. Vox Sang. 2016;111(2):135-143. source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The training and experience the phlebotomist had received is an important factor that determines their ability to select a good quality vein.

    “The training and the experience the phlebotomist had received is an important factor that determines their ability to select a good quality vein.6,7”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [6] 6. World Health Organization. Guidelines on drawing blood: best practices in phlebotomy. Geneva, Switzerland: WHO Press; 2010.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [7] 7. Gorski LA, Hadaway L, Hagle M, McGoldrick M, Orr M, Doellman D. Infusion therapy standards of practice. J Infus Nurs. 2016;39(1 Suppl):S1-S159. source

  • May combine two claims.

    Premisecitation

    Inadequate flow in apheresis procedures may lead to a suboptimal procedure, resulting in decreased efficiency, longer procedural times, the need to abort it before the target volume has been processed, and kit wastage.

    “Inadequate flow in apheresis procedures may lead to a suboptimal procedure, resulting in decreased efficiency, longer procedural times, the need to abort it before the target volume has been processed, and kit wastage.5”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [5] 5. Spectra Optia ® Apheresis System Operator's Manual. Colorado, USA: TerumoBCT, Inc.; 2018.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

27 of 27

  • The paper relies on this without support.

    The VST was validated for use in the study population and setting.

    “was utilized after validating it in our population and setting.”

  • The paper relies on this without support.

    Low flow alarms are due to poor vein status.

    “low flow alarms (LFA) due to poor vein status”
2 of 2

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Phlebotomy outcome totals differ between tables

    Minor

    Table 5 reports 22 failures and 168 successes, whereas Table 6 reports 23 failures and 167 successes.

  • Success is defined by completion but counted by attempts

    Minor

    The text defines successful phlebotomy as a completed procedure. Table 5 shows 187 completed procedures but labels only 168 single-attempt procedures as successful.

  • Multiple-attempt rate is overstated for the 8-9 score group

    Minor

    The text gives a 12% multiple-attempt rate for the 8-9 group. Table 6 shows 34 donors in that group and 31 single-attempt procedures, leaving 3 of 34, or 8.8%, with multiple attempts.

3 of 3

Cites

Flagged first, then by citations

Research works printed but not linked: 5

  1. Burgstaler EA, 2009, Apheresis: principles and technology of hemepheresis. Rossi's principles of transfusion medicine, 373
  2. Kristin G, 2020, Vascular Access. Principles of apheresis technology, 59
  3. 2018, Spectra Optia® Apheresis System Operator's Manual
  4. World Health Organization, 2010, Guidelines on drawing blood: best practices in phlebotomy
  5. Mondy PJ, 2016, Vein suitability scoring to predict phlebotomy outcomes in young whole blood donors. 34th International Congress of the International Society of Blood Transfusion; 3–8 September 2016, 7

Cited by

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Related

Authors
Noushad, S., Basavarajegowda, A., Toora, E., Sahoo, D., & Hari Priya, K. M.
Affiliations
  • Jawaharlal Institute of Post Graduate Medical Education and Research (IN)
  • Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Puducherry India
Corresponding author
Basavarajegowda, Abhishekh
ORCID
Venue
Journal of Clinical Apheresis
Publisher
Wiley
Published
2024-02
Volume
39
Issue
1
Pages
e22106-e22106
ISSN
  • 0733-2459 (ISSN-L)
  • 1098-1101
DOI
10.1002/jca.22106
OpenAlex
W4391682432
Cited by
1
References
9
Citations by year
2026: 1
FWCI
0.44
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 8 d)
Locations
  • Journal of Clinical Apheresis (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Business, Management and Accounting › Management of Technology and Innovation › Blood donation and transfusion practices
  • Health Sciences › Health Professions › Emergency Medical Services › Central Venous Catheters and Hemodialysis
  • Health Sciences › Medicine › Biochemistry › Blood transfusion and management
Keywords
platelet apheresis, inter-rater reliability, hematoma, low flow alarm, whole blood donors
MeSH terms
Blood Donors, Humans, Plateletpheresis, Veins, Reproducibility of Results, Phlebotomy

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