Comparison of Indices to Differentiate Iron Deficiency

Anemia and Beta Thalassemia Trait in Local Population

Synopsis for M.S MLS (Medical Laboratory Sciences)

By
Ayaz Khan

Supervisor:
Prof. Dr. Iftikhar Ahmed
MBBS, M.Phil. Ph.D.
Principal Baqai Medical College
Dean
Basic Medical Science

Baqai Medical University

Karachi, Pakistan.
 Different mathematical formulas have been used by researcher to differentiate IDA from βTT
some of the formulas are shown in below

Differentiating Indices and their cut- off values used to differentiate between
iron deficiency anemia and thalassemia minor

Index Formula βTT IDA

(Cut off) (Cut off)
Mentzer Index (MI) MCV/RBCs cunt <13 >13
England And Fraser MCV-RBCs-(5×Hb)-K <0 >0
Index (E&FI) K is Calculated to be 8.4
Shine and LAl index MCV²×MCH ×0.01 <1530 >1530
(S&LI)
Green and King index MCV²×RDW/100×Hb <72 >72
(G&KI)
RDW Index (RDWI) MCV ×RDW/RBC <220 >220
Srivastava Index(SRI) MCH/RBCs <3.8 >3.8
Ricerca Index(RI) RDW/RBCs <3.3 >3.3
Red Blood Cell Count RBCs Count >5 <5
Ehsani et al Index (EI) MCV-10×RBC <15 >15
Kerman Index 1 MCH ×MCV/RBCs <250 321-370
Bessman and RDW-CV <14 >14
Feinstien index
Sirdah index SI MCV-RBC-3×HB <27 >27

EXPECTED TABLES

Table.1
Number of cases correctly identified by the Differentiating indices
Total Number of Correctly
Indices IDA β-TT diagnosed patients Correctly diagnosed
(n=) (n=) (n=) (%)
 Mentzer Index
IDA>13
β-TT <13

England And Fraser Index

IDA >0
β-TT <0

Shine and LAl index

IDA >1530
β-TT<1530

Green and King index

IDA >72
β-TT <72

RDW Index (RDWI)

IDA >220
β-TT <220

Srivastava Index
IDA >38
β-TT <3.8

Ricerca Index
IDA>3.3
β-TT<3.3

Red Blood Cell Count

IDA<5
β-TT >5

Ehsani et al Index
IDA >15
β-TT <15

Kerman Index 1
IDA 321-370
β-TT <250
Bessman and Feinstien index
IDA>14
β-TT <14

Sirdah index
IDA >27
β-TT<27

Table.2

Sensitivity, specificity, positive predictive (PPV) and

negative predictive (NPV) values, and Accuracy of differentiating
indices to differentiate between IDA and βTT

Index Sensitivity Specificity PPV NPV Accuracy

(%) (%) (%) (%)
(%)

MI βTT
IDA

EFI βTT
IDA

SLI βTT
IDA

GKI βTT
IDA

RDWI βTT
IDA
SRI βTT
IDA

RI βTT
IDA

EI βTT
IDA

RBC count βTT

IDA

KI βTT
IDA

B&F βTT
IDA

SI βTT
IDA

Table.3
Values of Area under the ROC curve and Youden’s index of different of
Discriminating Index
Index Area under the ROC Youden’s index

Mentzer Index (MI)

England And Fraser Index (E&FI)

Shine and LAl index (S&LI)

Green and King index (G&KI)

RDW Index (RDWI)

Srivastava Index(SRI)

Ricerca Index(RI)

Red Blood Cell Count

Ehsani et al Index (EI)

Kerman Index 1

Bessman and Feinstien index

Sirdah index SI