AUTHOR=Turudic Daniel , Vucak Jerko , Kocheva Svetlana , Milosevic Danko , Bilic Ernest TITLE=Differentinating between non-transfusion dependant β-thalassemia and iron deficinecy anemia in children using ROC and logistic regression analysis: two novel discrimination indices designed for pediatric patients JOURNAL=Frontiers in Pediatrics VOLUME=11 YEAR=2024 URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2023.1258054 DOI=10.3389/fped.2023.1258054 ISSN=2296-2360 ABSTRACT=Introduction

This cross-sectional study enrolled a group of 271 children with microcytic anemia in order to test the performance of 41 single and 2 composite formulas andindices in distinguishing between β-thalassemia (β-thal) and iron deficiency anemia (IDA) in the pediatric population.

Methods

Optimal pediatric cut-off values from the previously published formulas and indices were generated using ROC analysis. Logistic regression in R using generalized linear models (GLM) generated two new indices.

Results

Formulas and indices with optimal cut-offvalues in children with accuracy ≥90% were (in descending order): Matos & Carvalho index, MDHL(Telmissani) formula, England and Fraser formula, Pornprasert index, Sirachainan index, Telmissani (MCHD) formula, CRUISE index, Hameed index, Sargolzaie formula and Zaghloul II index. The CroThalDD-LM1 index has an accuracy of 93.36% (AUC 0.986, 95% CI 0.975–0.997), while the second CroThalDD-LM2 index utilizes absolute reticulocyte count alongside CBC variables, with an accuracy of 96.77% (AUC 0.985, 95% CI 0.988–0.999).

Discussion and conclusion

We recommend using aforementioned formulas and indices with corrected cut-off values and accuracy >90% alongside two new proposed indices. A comparison of both native and these new indices is encouraged. These are the first discrimination indices generated and designed precisely for the pediatric population, which includes preschool children.