Role of RDW in mathematical formulas aiding the differential diagnosis of microcytic anemia.

Scandinavian Journal of Clinical and Laboratory Investigation
Johannes J M L Hoffmann, Eloísa Urrechaga

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
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
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 10, 2017·Clinical Chemistry and Laboratory Medicine : CCLM·Eloísa Urrechaga, Johannes J M L Hoffmann
Jun 22, 2019·International Journal of Laboratory Hematology·Johannes J M L Hoffmann, Eloísa Urrechaga

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