Validity of different hematological indices to differentiate between iron deficiency anemia and beta-thalassemia trait

Background Several discrimination formulas have been proposed as a quick simple screening tool to differentiate between beta-thalassemia trait (βTT) and iron deficiency anemia (IDA) using red blood cells (RBCs) parameters. Our aim was to evaluate the reliability of some of the RBC indices and formulas used in the differentiation between βTT and IDA among Egyptian children. Patients and methods A total of 110 patients (50 βTT, 50 IDA, and 10 combined βTT and IDA) were enrolled. Accuracy, sensitivity, specificity, and positive and negative predictive values were calculated for different discriminating formulas, and a receiver operative characteristic curve was plotted for each one to check its discriminative effectiveness in β-thalassemia detection. Results RBC count has the highest accuracy among other RBC parameters with accuracy of 82%, sensitivity 90%, and specificity 70%. Green and King index then red blood cell distribution width index were the best with the accuracy of 93.2% and 92.8%, respectively. 11 T score showed the highest accuracy over all with accuracy of 94.9%, sensitivity of 88%, and the highest specificity over all of 92%. Conclusion 11 T score can be considered as a simple and accurate tool to discriminate between βTT and IDA.