Abstract
Many mathematical formulas containing simple red blood cell parameters have been proposed for differentiating between iron deficiency and thalassemia in patients with microcytic anemia. Approximately half of these formulas do include red cell distribution width (RDW), along with other red cell parameters. In the present study we investigated the role of RDW, expressed in relative or in absolute units in relation with the formulas' discriminant performance. We used a database containing over 2200 subjects with microcytic anemia, for whom a final diagnosis (iron-deficiency anemia, thalassemia, both or other) was available. Performance of the discriminant formulas was assessed by Receiver Operator Curve analysis. Substitution of relative by absolute RDW resulted in statistically significant performance increase (area under the ROC curve) in 16 out of 23 formulas, predominantly due to increased specificity. Relevant performance deterioration was seen in only three formulas that had low initial performance already with the original relative RDW. For optimal differential diagnostic performance, an RDW-based formula for distinguishing thalassemia from iron-deficiency anemia in microcytic anemia should contain 'absolute' instead of rel...Continue Reading
References
Nov 1, 1988·Scandinavian Journal of Clinical and Laboratory Investigation·P W HellemanG D van Waveren Hogervorst
Mar 3, 1973·Lancet·J M England, P M Fraser
Apr 21, 1973·Lancet·W C Mentzer
Mar 23, 2011·Hematology·Alexandre JanelAnne-Françoise Serre-Sapin
May 12, 2011·Journal of Psychosomatic Obstetrics and Gynaecology·Claire A I StramroodMaria G van Pampus
Jan 31, 2012·Clinica Chimica Acta; International Journal of Clinical Chemistry·Johannes J M L Hoffmann
May 11, 2012·Acta Haematologica·Kasama WongprachumFrank P Schlep
Jun 14, 2014·Clinical Biochemistry·Giuseppe LippiSilvia Pipitone
Jun 20, 2014·Clinical Chemistry and Laboratory Medicine : CCLM·Giuseppe Lippi, Mario Plebani
Nov 5, 2015·Clinical Chemistry and Laboratory Medicine : CCLM·Johannes J M L HoffmannUrko Aguirre
Feb 26, 2016·Hematology·Amal ZaghloulGhada A Wassif
Feb 10, 2017·Clinical Chemistry and Laboratory Medicine : CCLM·Eloísa Urrechaga, Johannes J M L Hoffmann
Sep 22, 2017·Laboratory Medicine·Abdul Hafeez KandhroPornlada Nuchnoi
Mar 6, 2018·Medicine·Xubing ZhangZiqiang Wang
Jul 20, 2018·International Journal of Technology Assessment in Health Care·Thomas G PoderPierre Dagenais
Jun 22, 2019·International Journal of Laboratory Hematology·Johannes J M L Hoffmann, Eloísa Urrechaga
Sep 4, 2019·Hemoglobin·Yu LianYizhou Zheng
Dec 11, 2019·Scientific Reports·Mina JahangiriAmal Saki Malehi
Jun 17, 2020·Laboratory Medicine·Johannes J M L Hoffmann, Eloísa Urrechaga