New Bioinformatics-Based Discrimination Formulas for Differentiation of Thalassemia Traits From Iron Deficiency Anemia

Abdul Hafeez Kandhro; Watshara Shoombuatong; Virapong Prachayasittikul; Pornlada Nuchnoi

doi:10.1093/labmed/lmx029

New Bioinformatics-Based Discrimination Formulas for Differentiation of Thalassemia Traits From Iron Deficiency Anemia

Lab Med. 2017 Aug 1;48(3):230-237. doi: 10.1093/labmed/lmx029.

Authors

Abdul Hafeez Kandhro^{1

2}, Watshara Shoombuatong¹, Virapong Prachayasittikul³, Pornlada Nuchnoi^{2

4}

Affiliations

¹ Center of Data Mining & Biomedical Informatics, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand.
² Center for Research & Innovation Faculty of Medical Technology, Mahidol University, Bangkok.
³ Department of Clinical Microbiology & Applied Technology, Faculty of Medical Technology, Mahidol University, Bangkok.
⁴ Department of Clinical Microscopy, Faculty of Medical Technology, Mahidol University, Bangkok.

PMID: 28934514
DOI: 10.1093/labmed/lmx029

Abstract

Thalassemia traits (TTs) and iron deficiency anemia (IDA) are the most common disorders of hypochromic microcytic anemia (HMA). The present study aimed to differentiate TTs from IDA by analyzing discrimination formulas and provides comprehensive data of hemoglobin disorders prevalent in Pakistan. Among 12 published discrimination formulas, 6 formulas-MI, EF, G&K, RDWI, R, and HHI-were the most reliable to discriminate TTs from IDA. The failure cutoff values were improved by the random forest (RF) decision-tree approach. Moreover, the Shine and Lal (S&L) formula, which completely failed to discriminate IDA from TTs with original cutoff value (<1530), improved with the use of new proposed cutoff value (<1016) and was found to successfully discriminate all cases of TTs from those with IDA. In addition, 2 newly proposed formulas discriminated TTs from IDA more reliably than the original 12 formulas assessed. The proposed formulas could play a crucial role for clinicians to discriminate between TTs and IDA.

Keywords: Pakistan; discrimination formula; iron deficiency anemia; thalassemia trait.

MeSH terms

Anemia, Iron-Deficiency / diagnosis*
Computational Biology / methods*
Decision Trees
Diagnosis, Computer-Assisted / methods*
Diagnosis, Differential
Erythrocyte Indices
Humans
Pakistan
Retrospective Studies
beta-Thalassemia / diagnosis*