Validation of Several Formulas to Differentiate Thalassemia from Iron Deficiency Anemia and Proposal of a Thalassemia–Iron Deficiency Discrimination (TID) Predictive Score

Abstract

Objective: This study aimed to validate the sensitivity analysis of all the available formulas for their ability to differentiate between IDA and thalassemia and propose a novel formula to improve the sensitivity of all thalassemia subtypes screening. Material and Methods: We conducted a 5-year, single-center, Cohort study on 227 microcytic anemia patients diagnosed between June 2015 and September 2020 at Chaophraya Yommarat Hospital, Suphanburi, Thailand to validate the sensitivity of all the available formulas and invent the novel predictive score. Results: Approximately three-quarters of our cases were all subtypes of thalassemia diseases while 26.9% were IDA. The sensitivity of almost all the previous formulas for thalassemia prediction ranged between 13.9%-44.0%, while the specificity varied between 0%–98.4%. Nevertheless, the sensitivity of the formulas that had favorable sensitivity was quite low. Here, a novel thalassemia–iron deficiency discrimination (TID) predictive score is proposed, which demonstrated a sensitivity of 90.4% the specificity of 78.7%, the positive predictive value of 92.0 %, the negative predictive value of 75.0%, and the accuracy of 87.2%. Conclusion: The proposed TID predictive score is a novel uncomplicated formulation which offers high sensitivity for all thalassemia subtypes prediction.

Keywords

• iron deficiency anemia
• microcytic anemia
• predictive score
• thalassemia