A Local Equation for Differential Diagnosis of β-Thalassemia Trait and Iron Deficiency Anemia by Logistic Regression Analysis in Southeast Iran

Sargolzaie, Narjes; Miri‐Moghaddam, Ebrahim

doi:10.3109/03630269.2014.948187

Cited by 8 publications

(4 citation statements)

References 16 publications

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“…Although, the original published indices and formulas revealed very high discrimination power (almost 100%) in terms of the correctly diagnosed cases [3] , [21] , none of the suggested indices or formulas provided an absolute discrimination power when applied thereafter in other settings [10] , [13] , [24] , [25] , [26] , [27] , [28] , [29] , [30] . The index or formula that offered the highest discrimination power for one population, yet, it showed moderate or low power when applied to other populations.…”

Section: Discussionmentioning

confidence: 99%

Should sex differences be considered when applying mathematical indices and formulas for discriminating β- thalassemia minor from iron deficiency?

Sirdah

Mghari

Abuzaid

et al. 2018

Practical Laboratory Medicine

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Backgroundβ-thalassemia minor (BTM) and iron deficiency (ID) are common disorders characterized by microcytosis and/or hypochromasia, leading to a challenge in their discrimination during mass-screening programs especially in developing countries where resources are limited. It has been shown with varying reliability that quick exclusion of either disorder could be achieved mathematically using RBC-based indices and formulas. However, none of these proposed indices and formulas considered the sex-based hematological differences. This comparative retrospective study examined the efficacy of using sex-based RBC indices in the mathematical discrimination BTM and ID in adult males and females.MethodsThe CBC of randomly selected eight hundred adults diagnosed with BTM or ID (200M & 200F BTM, and 200M & 200F ID) were used in the comparisons. The discrimination power, in terms of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and Youden index were calculated for all subjects and separately for males and females for 20 mathematical indices and formulas.ResultsData revealed significant differences in the RBC-based indices between males and females for both BTM and ID groups. Significant variation in reliability indicators for the different indices and formulas were discovered between males and females samples.ConclusionSex-based indices and formulas are necessary to improve the reliability in mathematically discriminating between BTM and ID in mass screening programs. We also advocate for a large–scale multicenter study to establish the parameters of such indices and formulas with sex and age.

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Section: Discussionmentioning

confidence: 99%

Should sex differences be considered when applying mathematical indices and formulas for discriminating β- thalassemia minor from iron deficiency?

Sirdah

Mghari

Abuzaid

et al. 2018

Practical Laboratory Medicine

View full text Add to dashboard Cite

show abstract

“…The results of different studies evaluating the efficiencies of various erythrocyte indices in the differential diagnosis of IDA and BTT seem to be controversial. [15][16][17][18][19][20][21][22][23][24][25][26][35][36][37][38][39] In our study, the Green and King Index and RDW Index were found to be the most reliable indices. Some previous studies from different countries have also reported the Green and King Index to be among the most reliable erythrocyte indices in differentiation between IDA and BTT.…”

Section: Highlightsmentioning

confidence: 68%

Validity of Erythrocyte Indices in Differentiation between Iron Deficiency Anemia and β-Thalassemia Trait in Children

Uzunoğlu,

Yılmaz Keskin

2024

JPA

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Iron deficiency anemia (IDA) and β-thalassemia trait (BTT) are the most common causes of hypochromic microcytic anemia (HMA). Various erythrocyte indices that may help in the initial discrimination between IDA and BTT have been reported, but data evaluating their reliability in children are scarce. We aimed to evaluate the validity of 12 erythrocyte indices in the differentiation between IDA and BTT in children. These indices were red blood cell (RBC) count, Mentzer Index, England and Fraser Index, Srivastava Index, Shine and Lal Index, RBC distribution width (RDW), Ricerca Index, Green and King Index, RDW Index, Sirdah Index, Ehsani Index, and Serdar Index. Among 1,444 children with HMA, 136 (9.4%) were stratified into the IDA group and 137 (9.5%) into the BTT group. Of the 12 indices, the Green and King Index showed the highest reliability, as it had the highest Youden’s index (75.1%). Its sensitivity, specificity, positive predictive value, negative predictive value and correct diagnosis rate were 92.7%, 82.4%, 84.1%, 91.8% and 87.5%, respectively. The second most reliable index was the RDW Index, having a Youden’s index, sensitivity, specificity, positive predictive value, negative predictive value and correct diagnosis rate of 64.0%, 94.2%, 69.9%, 75.9%, 92.2% and 82.0%, respectively. Receiver operating characteristic analysis showed that the revised cut-off values for the Green and King Index and RDW Index had higher sensitivity and specificity levels than the cut-off values commonly used in the literature. The findings of this study suggest the superiority of the Green and King Index and the RDW Index as screening tools in the initial differentiation between IDA and BTT among children with HMA.

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“…Hameed index with the new cut-off value showed balanced sensitivity and specificity with acceptable accuracy ( 19 ). After defining the optimal cut-off value, the Sargolzaie index also significantly increased its accuracy ( 30 ). Defining the cut-off values of the Zaghloul II index in children (regardless of gender), the index showed a significant improvement in accuracy mainly due to its increase in specificity and PPV ( 31 ).…”

Section: Discussionmentioning

confidence: 99%

Differentinating between non-transfusion dependant β-thalassemia and iron deficinecy anemia in children using ROC and logistic regression analysis: two novel discrimination indices designed for pediatric patients

Turudic,

Vucak,

Kocheva

et al. 2024

Front. Pediatr.

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IntroductionThis cross-sectional study enrolled a group of 271 children with microcytic anemia in order to test the performance of 41 single and 2 composite formulas andindices in distinguishing between β-thalassemia (β-thal) and iron deficiency anemia (IDA) in the pediatric population.MethodsOptimal pediatric cut-off values from the previously published formulas and indices were generated using ROC analysis. Logistic regression in R using generalized linear models (GLM) generated two new indices.ResultsFormulas and indices with optimal cut-offvalues in children with accuracy ≥90% were (in descending order): Matos & Carvalho index, MDHL(Telmissani) formula, England and Fraser formula, Pornprasert index, Sirachainan index, Telmissani (MCHD) formula, CRUISE index, Hameed index, Sargolzaie formula and Zaghloul II index. The CroThalDD-LM1 index has an accuracy of 93.36% (AUC 0.986, 95% CI 0.975–0.997), while the second CroThalDD-LM2 index utilizes absolute reticulocyte count alongside CBC variables, with an accuracy of 96.77% (AUC 0.985, 95% CI 0.988–0.999).Discussion and conclusionWe recommend using aforementioned formulas and indices with corrected cut-off values and accuracy >90% alongside two new proposed indices. A comparison of both native and these new indices is encouraged. These are the first discrimination indices generated and designed precisely for the pediatric population, which includes preschool children.

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A Local Equation for Differential Diagnosis of β-Thalassemia Trait and Iron Deficiency Anemia by Logistic Regression Analysis in Southeast Iran

Cited by 8 publications

References 16 publications

Should sex differences be considered when applying mathematical indices and formulas for discriminating β- thalassemia minor from iron deficiency?

Should sex differences be considered when applying mathematical indices and formulas for discriminating β- thalassemia minor from iron deficiency?

Validity of Erythrocyte Indices in Differentiation between Iron Deficiency Anemia and β-Thalassemia Trait in Children

Differentinating between non-transfusion dependant β-thalassemia and iron deficinecy anemia in children using ROC and logistic regression analysis: two novel discrimination indices designed for pediatric patients

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