Informing the State of Process Modeling and Automation of Blood Banking and Transfusion Services Through a Systematic Mapping Study

Shaima’ Abdallah Elhaj,1 Yousra Odeh,1,2 Dina Tbaishat,1,3,4 Anwar Rjoop,5,6 Asem Mansour,1 Mohammed Odeh1,7,8 1Cancer Care Informatics Research, King Hussain Cancer Center (KHCC), Amman, Jordan; 2Faculty of Information Technology, Philadelphia University, Amman, Jordan; 3College of Technological Innovation, Zayed University, Dubai, United Arab Emirates; 4Library and Information Science Department, University of Jordan, Amman, Jordan; 5Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 6Department of Pathology, Blood Bank, King Abdullah University Hospital, Irbid, Jordan; 7College of Arts, Technology and Environment, University of the West of England, Bristol, UK; 8Global Academy for Digital Health, Bristol, UKCorrespondence: Mohammed Odeh, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol, BS16 1QY, UK, Tel +44 (0)117 9656261, Email [email protected] Yousra Odeh, Philadelphia University, Jarash Road, P.O.Box 19392, Amman, Tel +96 (2) 64799000, Fax +96 (2) 64799040, Email [email protected]; [email protected]: The current state of the art in process modeling of blood banking and transfusion services is not well grounded; methodological reviews are lacking to bridge the gap between such blood banking and transfusion processes (and their models) and their automation. This research aims to fill this gap with a methodological review.Methods: A systematic mapping study was adopted, driven by five key research questions. Identified research studies were accepted based on fulfilling the following inclusion criteria: 1) research studies should focus on blood banking and transfusion process modeling since the late 1970s; and 2) research studies should focus on process automation in relation to workflow-based systems, with papers classified into categories in line with the analysis undertaken to answer each of the research questions.Results: The search identified 22 papers related to modeling and automation of blood banking and transfusion, published in the period 1979– 2022. The findings revealed that only four process modeling languages were reported to visualize process workflows. The preparation of blood components, serologic testing, blood distribution, apheresis, preparation for emergencies, maintaining blood banking and transfusion safety, and documentation have not been reported to have been modeled in the literature. This review revealed the lack of use of Business Process Modeling Notation (BPMN) as the industry standard process modeling language in the domain. The review also indicated a deficiency in modeling specialized processes in blood banking and transfusion, with the majority of reported processes being described as high level, but lacking elaboration. Automation was reported to improve transfusion safety, and to reduce cost, time cycle, and human errors.Conclusion: The work highlights the non-existence of a developed process architectural framework for blood banking and transfusion processes, which is needed to lay the groundwork for identifying and modeling strategic, managerial, and operational processes to bridge the gap with their enactment in healthcare systems. This paves the way for the development of a data-harvesting platform for blood banking and transfusion services.Keywords: blood banking, blood transfusion, blood banking process model, blood banking process automation, blood transfusion process model, blood transfusion process automation, Systematic Mapping Study, Blood Banking and Transfusion Service

Presentation and treatment of two cases of malignant struma ovarii

Abstract Background Malignant Struma Ovarii (MSO) is a rare type of germ cell tumour which is diagnosed postoperatively on surgical pathology specimens by the presence of differentiated thyroid cancer in mature cystic teratomas in the ovaries. Treatment and follow-up procedures are not clearly established due to the paucity of MSO cases. Case 1 A 44-year-old multiparous female presented with an irregular period. Ultrasound showed a left ovarian lesion mostly a dermoid cyst, however, CT showed a 3.8 × 2.7 × 4 cm complex cystic lesion with thick septation and enhancing soft tissue component. Laparoscopic left salpingo-oophorectomy was performed and histopathology showed a follicular variant of papillary thyroid carcinoma arising in a mature cystic teratoma. Peritoneal cytology was positive for malignancy. A thyroid function test was normal before surgery. Total thyroidectomy was performed followed by radioactive (RAI) iodine therapy. Later, a total laparoscopic hysterectomy and right salpingo-oophorectomy were performed. There is no evidence of recurrent disease during the 26-months follow-up. Case 2 A 46-year-old single female presented with left lower abdominal pain that had persisted for 2 months. Imaging revealed an 8 × 9 × 9.5 cm left ovarian mass. Laparoscopic left salpingo-oophorectomy was performed and histopathology showed mature cystic teratoma with small papillary thyroid cancer. CT showed no evidence of metastatic disease. Later, the patient had a total thyroidectomy followed by radioactive (RAI) iodine therapy. She was started on thyroxine and later had total abdominal hysterectomy and right salpingo-oophorectomy. Conclusion MSO is a very rare tumour. Preoperative diagnosis is very difficult because of the nonspecific symptoms and the lack of specific features in imaging studies. Also, there is no consensus on the optimal treatment of women with MSO. Our two cases add to the limited number of MSO cases