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CMAJ • July 10, 2001; 165 (1)
© 2001 Canadian Medical Association or its licensors

Review
Synthèse

A policy analysis of major decisions relating to Creutzfeldt–Jakob disease and the blood supply

Kumanan Wilson*, Paul C. Hébert*, Andreas Laupacis{dagger}, Christopher Dornan, Maura Ricketts§, Nadya Ahmad and Ian Graham

From the *University of Ottawa Centre for Transfusion Research, Ottawa, Ont.; the {dagger}Institute for Clinical Evaluative Sciences, Toronto, Ont.; the {ddagger}School of Journalism, Carleton University, Ottawa, Ont.; the §World Health Organization, Geneva, Switzerland; and the ¶Ottawa Hospital Research Institute, Ottawa, Ont.

Correspondence to: Dr. Kumanan Wilson, ENG-254, Toronto General Hospital, University Health Network, 200 Elizabeth St., Toronto ON M5G 2C4; fax 416 595-5826; kumanan.wilson{at}uhn.on.ca

Abstract

CREUTZFELDT–JAKOB DISEASE (CJD) IS THE FIRST major challenge that the blood system has faced since the completion of the Krever inquiry in 1997. We report the results of a detailed policy analysis comparing 2 CJD-related decisions: a 1995 recall of blood from a donor with classic CJD and the 1999 decision to defer donations from individuals with a 6-month travel history to the UK between 1980 and 1996 due to concerns related to variant CJD. Overall, we observed that decision-making improved significantly from 1995 to 1999. In 1998/99 the potential threat of variant CJD was identified at an early stage, and a systematic risk assessment process was initiated. Decision-making was consultative and involved consumers. However, the perception existed that further improvement could take place in the areas of transparency of process and interaction of organizations. We observed that the presence of a second operator had an important impact on decision-making in 1998/99.




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