Aim To develop a semi-quantitative nail color scale for the prediction of hemoglobin concentration in humans. Subjects and methods A nail color scale was developed and used to predict hemoglobin concentrations of 67 children (1 month-10 years), 26 adolescents (11-20 years) and 82 adult men and women (21-60 years). The scale was evaluated by comparing the predicted values with actual hemoglobin concentrations of the subjects estimated by the cyanomethemoglobin method. Results A statistically significant correlation was obtained between the observed and predicted hemoglobin levels (R 2 = 0.77, coefficient = 0.75, intercept = 2.95). In 139 (78.8%) cases the predicted values were between ±10% of the observed values. For the remaining 36 cases (21.2%), 13 showed an underestimation bias and 23 showed an overestimation bias. The nail color scale method had sensitivity 67.85%, specificity 93.2% and positive predictive value 0.826. Conclusion The nail color scale developed in the study holds promise as a fast, noninvasive, cheap, semiquantitative hemoglobin estimation method for initial screening of patients for different diseases, particularly anemia.
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