title: Causality assessment of suspected virus transmission by human plasma products.
abstract: BACKGROUND
  Causality assessment of reports on suspected virus transmission is crucial for early detection of infectious plasma products. Commonly used algorithms, such as the WHO criteria, do not meet the specific requirements for causality assessment of suspected virus transmission.
  
  
  METHODS
  A special algorithm, based on nucleic acid amplification and gene sequencing technology, effectiveness of validated virus-inactivation methods, empirical data concerning the safety record of the product, and information on batch-related infection clusters, was developed. The algorithm is focused on laboratory test results or otherwise standardized data, with few clinical data being required. To facilitate practical application, the algorithm has been converted into a graphical decision tree.
  
  
  RESULTS
  The feasibility of the algorithm is shown by causality assessment of sample cases. Three cases are presented with the details of each case used in the 12-question checklist. The answers provided by the checklist led to the causality classification.
  
  
  CONCLUSIONS
  The algorithm is a tool for evaluating reports of suspected virus transmission in a standardized manner. It thus has the potential to improve early signal detection in pharmacovigilance of plasma products by confirmation or exclusion of suspected infectivity in most cases.
authors.affiliation: Medical Affairs, Hyland Immuno Division, Baxter Deutschland GmbH, Heidelberg, Germany. rudolf_schosser@baxter.com
authors.forename: R
authors.initials: R
authors.lastname: Schosser
authors.forename: B
authors.initials: B
authors.lastname: Keller-Stanislawski
authors.forename: C M
authors.initials: CM
authors.lastname: Nübling
authors.forename: J
authors.initials: J
authors.lastname: Löwer
mesh_terms: D000328:Adult; D000465:Algorithms; D015984:Causality; D003257:Consumer Product Safety; D004279:DNA, Viral / Q000097:blood; D003663:Decision Trees; D005838:Genotype; D006801:Humans; D007239:Infections / Q000453:epidemiology* / Q000635:transmission / Q000821:virology*; D008297:Male; D018570:Risk Assessment; D017422:Sequence Analysis, DNA; D065227:Transfusion Reaction
chemical_list: D004279:DNA, Viral