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A new index to discriminate between iron deficiency anemia and thalassemia trait

View Article: PubMed Central - PubMed

ABSTRACT

Background: The most common microcytic and hypochromic anemias are iron deficiency anemia and thalassemia trait. Several indices to discriminate iron deficiency anemia from thalassemia trait have been proposed as simple diagnostic tools. However, some of the best discriminative indices use parameters in the formulas that are only measured in modern counters and are not always available in small laboratories.

Background: The development of an index with good diagnostic accuracy based only on parameters derived from the blood cell count obtained using simple counters would be useful in the clinical routine. Thus, the aim of this study was to develop and validate a discriminative index to differentiate iron deficiency anemia from thalassemia trait.

Methods: To develop and to validate the new formula, blood count data from 106 (thalassemia trait: 23 and iron deficiency: 83) and 185 patients (thalassemia trait: 30 and iron deficiency: 155) were used, respectively. Iron deficiency, β-thalassemia trait and α-thalassemia trait were confirmed by gold standard tests (low serum ferritin for iron deficiency anemia, HbA2 > 3.5% for β-thalassemia trait and using molecular biology for the α-thalassemia trait).

Results: The sensitivity, specificity, efficiency, Youden's Index, area under receiver operating characteristic curve and Kappa coefficient of the new formula, called the Matos & Carvalho Index were 99.3%, 76.7%, 95.7%, 76.0, 0.95 and 0.83, respectively.

Conclusion: The performance of this index was excellent with the advantage of being solely dependent on the mean corpuscular hemoglobin concentration and red blood cell count obtained from simple automatic counters and thus may be of great value in underdeveloped and developing countries.

No MeSH data available.


Receiver operating characteristic curve for the Matos & Carvalho Index.
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fig0010: Receiver operating characteristic curve for the Matos & Carvalho Index.

Mentions: MCI values were calculated for all patients using CBC data. MCI correctly diagnosed 154 (99.3%) of the 155 patients with IDA and 23 (76.7%) of the 30 patients with TT. MCI performance was analyzed by calculating sensitivity [99.3; 95% confidence interval (95% CI): 96.4–99.9], specificity (76.7; 95% CI: 59.1–88.2), accuracy (95.7; 95% CI: 91.7–97.8), area under ROC curve (0.95; 95% CI: 0.90–1.00), Youden's Index (76.0) and the kappa coefficient (0.83; 95% CI: 0.68–0.97) (Table 2). Figure 2 shows the ROC curve for the MCI. This index showed high accuracy and has revealed excellent agreement with the gold standard diagnostic techniques as well as good clinical applicability as a method of screening.


A new index to discriminate between iron deficiency anemia and thalassemia trait
Receiver operating characteristic curve for the Matos & Carvalho Index.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4997903&req=5

fig0010: Receiver operating characteristic curve for the Matos & Carvalho Index.
Mentions: MCI values were calculated for all patients using CBC data. MCI correctly diagnosed 154 (99.3%) of the 155 patients with IDA and 23 (76.7%) of the 30 patients with TT. MCI performance was analyzed by calculating sensitivity [99.3; 95% confidence interval (95% CI): 96.4–99.9], specificity (76.7; 95% CI: 59.1–88.2), accuracy (95.7; 95% CI: 91.7–97.8), area under ROC curve (0.95; 95% CI: 0.90–1.00), Youden's Index (76.0) and the kappa coefficient (0.83; 95% CI: 0.68–0.97) (Table 2). Figure 2 shows the ROC curve for the MCI. This index showed high accuracy and has revealed excellent agreement with the gold standard diagnostic techniques as well as good clinical applicability as a method of screening.

View Article: PubMed Central - PubMed

ABSTRACT

Background: The most common microcytic and hypochromic anemias are iron deficiency anemia and thalassemia trait. Several indices to discriminate iron deficiency anemia from thalassemia trait have been proposed as simple diagnostic tools. However, some of the best discriminative indices use parameters in the formulas that are only measured in modern counters and are not always available in small laboratories.

Background: The development of an index with good diagnostic accuracy based only on parameters derived from the blood cell count obtained using simple counters would be useful in the clinical routine. Thus, the aim of this study was to develop and validate a discriminative index to differentiate iron deficiency anemia from thalassemia trait.

Methods: To develop and to validate the new formula, blood count data from 106 (thalassemia trait: 23 and iron deficiency: 83) and 185 patients (thalassemia trait: 30 and iron deficiency: 155) were used, respectively. Iron deficiency, β-thalassemia trait and α-thalassemia trait were confirmed by gold standard tests (low serum ferritin for iron deficiency anemia, HbA2 > 3.5% for β-thalassemia trait and using molecular biology for the α-thalassemia trait).

Results: The sensitivity, specificity, efficiency, Youden's Index, area under receiver operating characteristic curve and Kappa coefficient of the new formula, called the Matos & Carvalho Index were 99.3%, 76.7%, 95.7%, 76.0, 0.95 and 0.83, respectively.

Conclusion: The performance of this index was excellent with the advantage of being solely dependent on the mean corpuscular hemoglobin concentration and red blood cell count obtained from simple automatic counters and thus may be of great value in underdeveloped and developing countries.

No MeSH data available.