Jason and the Algorithms
I distinctly recall my aunt and uncle taking my cousins and me to a drive-in theater back in 1963 to see that year's big special-effects film, "Jason and the Argonauts." Based on Greek mythology, the hero Jason stood before Zeus and Hera in the heavenly Olympus and received direct guidance about how he might find and steal the Golden Fleece, which reminds me now of how I attend ABC meetings to derive enlightenment from conversations with my mythic colleagues at ABC. The gods offered Jason some support, but ultimately, he had to overcome many obstacles himself. There were two images from that film that remain vivid in my mind to this day. The first was when Jason battled the Hydra. Jason had to kill the many-headed monster in order to make off with the Golden Fleece. The other was the frightening moment when the skeletons broke out from the rocky earth with their swords and began battling Jason and his men.
Recently at my center, we reviewed our blood testing algorithms. What does this have to do with Greek mythology, you ask? Well, the comparison dawned on me when I marveled at how complex our infectious disease testing algorithms have become. They are comprised of more than 40 if/then scenarios in all, and along with each one, there's cost and the possibility of screwing up. On top of all this, our industry is now weighing adding Babesia and point-of-care bacterial testing, as well as the appropriate response to autochthonous dengue. Each algorithm is based on Food and Drug Administration requirements and guidances regarding the approved testing methodologies. Some laboratories adapt additional scenarios to account for local or state regulation, or to apply an augmenting safeguard. Some algorithms have more than one acceptable option and it's left up to each institution to choose. The algorithms need frequent review so that they reflect the ever-changing realities of reagent availability, new or revised standards, and emerging epidemiology. So while I was wrestling with my algorithm charts, the Hydra came to mind and how each of its serpentine heads pose as much mortal danger as the next.
Whenever I think of blood donor testing these days, I invariably imagine the potential positive impact of pathogen inactivation. Since my June "Our Space" column went into more detail on pathogen inactivation, this one will not. But like Jason, we need to fight our way through today's perilous journey to achieve blood safety and cost sustainability. Along the way to pathogen inactivation, (or some other novel blood safety approach) old ideas and methodologies will rise up from the dirt, shaking their swords at us, but let's be brave and battle on until we have that Golden Fleece.
Chris Staub, MT(ASCP) SBB, Board Member; firstname.lastname@example.org