“We are about to embark on a large international clinical trial supported by the NIH that will provide the evidence needed to determine the best course of action for patients who have had a heart attack,” says Dr. Carson. Data Center, and professor of biostatistics at the University of Pittsburgh Graduate School of Public Health, who is the principal investigator of the data coordinating center for the study. Assisting Dr. Carson will be a steering committee composed of authorities from participating clinical sites, among them the Centre Hospitalier de l’Université de Montréal, Duke Clinical Research Institute, Saint Louis University, University of Pittsburgh Medical Center, Rhode Island Hospital, Westchester Medical Center, Ottawa Hospital Research Institute, and University of Toronto Faculty of Medicine. The updated guidelines issued in JAMA also were a collaborative effort and included a second recommendation, resulting from evidence that blood stored under standard conditions for up to 42 days is just as safe as new blood that is less than 10 days old. “One of the biggest controversies in transfusion medicine is whether blood that is stored longer is harmful,” says Dr. Carson’s co-chair on the AABB guidelines panel, Aaron Tobian, MD, PhD, associate professor of pathology at the Johns Hopkins University School of Medicine. Dr. Carson, Dr. Tobian, and colleagues from throughout the United States and Canada were involved in the guideline development, reflecting the fact that the science of transfusion medicine has significantly advanced in recent years, providing high-quality evidence to support the new recommendations. Physicians performing surgeries and other procedures use these guidelines in deciding when a transfusion is needed and how much blood to give, based on how much the patient has lost, as well as close observation of vital signs such as low blood pressure. “It is important for physicians and patients to know that these recommendations are based on high-quality clinical evidence,” says Dr. Carson. “We need to promote guidelines based on what science reveals.” M Robert Wood Johnson I MEDICINE 31