31 Past, present, and future of red blood cells An interview guide was created in accordance with the research questions and composed of three sections: 1) historical trends and drivers in blood demand, 2) transformational factors (broadly defined as changes or innovations within society, science, or biomedical technology), and 3) medium-term scenarios in relation to future trends in blood demand (see Appendix A). Experts from the Netherlands answered from the Dutch context, while international experts answered from the perspective of their home country or high-income countries at large. A semi-structured approach was adopted so that the interview guide was followed with additional probing and follow-up questions when appropriate to the response. This allowed for the interviews to be more conversational in nature, which is essential for such an exploratory topic.24 Analysis of semi-structured interviews Of the 42 interviews done, 41 were recorded with consent and one was not recorded due to the difficulties of the (noisy) setting. Interview notes were kept for all. Recorded interviews were transcribed verbatim and then coded using qualitative software (MAXQDA 2018, VERBI Software GmbH). First-cycle coding followed a provisional (predetermined) coding scheme based on the research aims.25 Authors PLS and MR first assessed three transcripts individually and came together to discuss coding differences. Coding differences were settled through consensus, and adjustments were made to the framework. This was repeated in the process of coding the remaining transcripts separately to ensure continual agreement. After all transcripts were coded, the authors applied second-cycle coding, where categories were combined under emergent themes. A codebook was developed with the final themes and categories (see Appendix B). MAXQDA 2018 was also used to calculate simple descriptives for the final themes and categories. Literature review A literature review was conducted as a secondary data source to triangulate findings from the semi-structured interviews. This helped to ensure more comprehensiveness than one method alone.26 From January to February 2018, the literature review was conducted with a twoaim focus on 1) historical trends and drivers and 2) innovations that would impact blood demand. This literature review was not systematic but applied systematic principles. Key words related to and including blood transfusion, history/trends, and innovation were created and inserted in Pubmed, Google Scholar, and gray literature. For Pubmed, search strategies were created in which Mesh terms were first exploded to check if its subdivisions were relevant (see Appendix C). These
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