Red Blood Cell Transfusion: Precision vs Imprecision Medicine

JAMA 

....Current transfusion guidelines, though well-intentioned are admittedly deficient.<sup>3

.....</sup> Using hemoglobin concentration to determine the need for red blood cell transfusion is a time-honored and well-reasoned concept, but the original recommendations from 1942 have regularly been misunderstood and misused. The oft-cited “10/30 rule” (hemoglobin/hematocrit) was less a rule than a proposal to include hemoglobin as one of several perioperative measures to improve care for poor-risk surgical patients. That guidance was prudent for the intended patients and the era, but was never meant to be generalized as the sole determinant of transfusion....