Can Policy Decisions in Transfusion Medicine Be Evidence‐Based? *

SUMMARy If the concept of evidence‐based medicine were considered at a policy level, it would likely dictate that policy decisions be made on the basis of the best available research evidence. In transfusion medicine, however, decisions are based on a broader range of inputs, and the criteria for evaluating the efficacy and/or cost‐effectiveness of proposed interventions differ from those used in other areas. Reasons why policy decisions in transfusion medicine are often based on considerations other than solely the best available research evidence include public perceptions of transfusion as being an inherently “unsafe” intervention, public expectations with regard to transfusion safety, and proposals for applying the precautionary principle to transfusion medicine. In the authors' opinion, use of the precautionary principle may be justified in addressing transfusion risks that are viewed as “dread events,” but this principle should not be applied indiscriminately to all transfusion risks.