107 Using a scenario approach to assess for the current and future demand of immunoglobulins coding followed a pre-determined coding framework based on the research aims.23 Author PLS and two other researchers assessed three transcripts initially to review and revise the coding framework. Coding differences were settled through consensus and adjustments were made to the framework. The framework was expanded to allow for inductive themes that arose. Author PLS coded the rest of the transcripts with this adjusted framework, and author MvK checked five random transcripts for quality assurance. 3.3 Results Of the 15 experts interviewed, 8 (53%) were clinician-researchers representing 6 specialties; almost all experts had 11+ years working in their respective fields (Table 3.1). Of the 97 articles obtained from the scoping review, 74 concerned clinical factors, subdivided by specialty, and 23 regarded supply, demand, or organizational actions (Supplementary Table 1). To answer the research questions, the literature is reviewed (A) followed by the interviews (B). For B, all quotations were directly taken from the experts. I. Clinical specialties that contribute to Ig demand A. From both the literature and interviews, it was found that there is no centralized monitoring system that monitors Ig demand across the different specialties in the Netherlands—only national numbers of certain product usage (i.e., Nanogam)24 and private, hospital-based numbers. However, it was assumed that the Dutch setting was similar to other high-income countries like the UK: the National Database Annual Reports for 2017–2020 reported Ig use by specialty by volume were (in order of) neurology, immunology, and hematology.25–27 Further, documents such as the EMA Guidelines and Dutch transfusion guidelines (CBO Consensus 2020) are applicable for the Dutch setting. As of January 2019, the EMA Guidelines have been amended and expanded for the European setting28 (Table 3.2 describes these changes including its impact for multiple specialties). The CBO Consensus 2019 (unchanged from 2011) also specifies Ig to be indicated in pregnancy when fetal and neonatal alloimmune thrombocytopenia (FNAIT) is suspected,35 which is also an established therapeutic role in the Australian Criteria36 and literature.27,37 B. Clinicians could provide examples of specific specialties in which demand has grown, including internal medicine (specifically oncology, humoral immune de-
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