Decision-tree-based methods for differential diagnosis of -thalassemia trait from iron deficiency anemia

Several discrimination indices have been proposed to distinct between -thalassemia trait (TT) and iron deficiency anemia (IDA). This study is the first application of tree-based methods for differential diagnosis of TT from IDA. One hundred forty-four patients with hypochromic microcytic anemia aged 18-40years old from Ayat Hospital of Tehran were recruited. Classification and Regression tree, CHi-squared Automatic Interaction Detector (CHAID), Exhaustive CHi-squared Automatic Interaction Detector (E-CHAID), Quick, Unbiased, Efficient Statistical Tree (QUEST), Classification Rule with Unbiased Interaction Selection and Estimation (CRUISE), and Generalized, Unbiased, Interaction Detection and Estimation (GUIDE) have been used to discriminate the diagnosis. Mean corpuscular volume (MCV) was found as the main predictor in discrimination. All the mentioned tree-based methods showed acceptable sensitivity, specificity, accuracy, Youden's index, false positive and negative rate, positive and negative predictive values and AUC in differential diagnosis of TT from IDA. However, Classification Rule with Unbiased Interaction Selection and Estimation revealed more precise classification with an area under the curve value of 0.99. Decision-tree-based methods can be used to develop sensitive and accurate diagnostic methods for differentiating TT from IDA.