The Evaluation of Results of Twenty Common Equations for Differentiation of Beta Thalassemia Trait from Iron Deficiency Anemia: A Cross-Sectional Study

Hassan  Ebrahimpour Sadagheyani; Rahim  Sharafkhani; Shahriar  Sakhaei; Hamid Jafaralilou; Parviz  Shahmirzalou

doi:10.18502/ijph.v51i4.9255

Hassan Ebrahimpour Sadagheyani Department of Health Information Technology, School of Para Medicine, Neyshabur University of Medical Sciences, Neyshabur, Iran
Rahim Sharafkhani School of Public Health, Khoy University of Medical Sciences, Khoy, Iran
Shahriar Sakhaei Department of Nursing, Khoy University of Medical Sciences, Khoy, Iran
Hamid Jafaralilou Health Education and Promotion, Khoy University of Medical Sciences, Khoy, Iran
Parviz Shahmirzalou School of Public Health, Khoy University of Medical Sciences, Khoy, Iran

DOI: https://doi.org/10.18502/ijph.v51i4.9255

Keywords: Red blood cell; Thalassemia; Anemia; Mentzer index; Differentiation equation

Abstract

Background: Beta Thalassemia Trait (BTT) and Iron Deficiency Anemia (IDA) were two common clinical problems with clinical hypochromic and microcytic manifestations, and their differentiation from each other was very important and needs innovative formulas and laboratory tests. Since the consideration of anemia as a pair with BTT leads to beta-thalassemia major birth in 25% of cases, offering prospective parents detailed information about the likelihood of their offspring developing BTT is essential. The present study aimed to investigate the performance of common equations in differentiation of BTT from IDA.

Methods: In the present cross-sectional study, twenty common equations were selected in the differentiation of BTT from IDA. To evaluate the equations, the tests of 292 individuals (73 individuals with BTT and 219 individuals with IDA) were compared with the initial diagnosis of hypochromic and microcytic anemia using the formulas. Descriptive and value indices and Roc curve were utilized for all equations to analyze the results.

Results: Among twenty differential equations, Bordbar, Kerman I, II and Srivastava equations had the highest area under Roc curve (AUC) of 0.841, 0.838, 0.836, and 0.830 respectively, but Kandhro I. equation had the lowest AUC (0.378).

Conclusion: Given the importance of AUC and value indices of differential equations in clinical decision making, and results of evaluating common equations in differentiation of BTT from IDA. It is essential to improve the values of the equations by re-examining the parameters involved in them.