Journal
LABORATORY MEDICINE
Volume 48, Issue 3, Pages 230-237Publisher
OXFORD UNIV PRESS
DOI: 10.1093/labmed/lmx029
Keywords
thalassemia trait; iron deficiency anemia; discrimination formula; Pakistan
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Funding
- Faculty of Medical Technology, Mahidol University, Bangkok
- Thailand Research Fund
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Thalassemia traits (TTs) and iron deficiency anemia (IDA) are the most common disorders of hypochromic microcytic anemia (HMA). The present study aimed to differentiate TTs from IDA by analyzing discrimination formulas and provides comprehensive data of hemoglobin disorders prevalent in Pakistan. Among 12 published discrimination formulas, 6 formulas-MI, EF, G&K, RDWI, R, and HHI-were the most reliable to discriminate TTs from IDA. The failure cutoff values were improved by the random forest (RF) decision-tree approach. Moreover, the Shine and Lal (S&L) formula, which completely failed to discriminate IDA from TTs with original cutoff value (< 1530), improved with the use of new proposed cutoff value (< 1016) and was found to successfully discriminate all cases of TTs from those with IDA. In addition, 2 newly proposed formulas discriminated TTs from IDA more reliably than the original 12 formulas assessed. The proposed formulas could play a crucial role for clinicians to discriminate between TTs and IDA.
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