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Table-II: Cutoff values of RDWand RDWI for iron deficiency anemia (IDA) and beta-thalassemia trait (ssTT).
RDWI showed better discriminative effect between ssTT and IDA, as this index had both sensitivity and specificity more than 85% in detection of ssTT and IDA.
Red cell distribution width (RDW) is provided in CBCs by the automated analyzers and can be utilized in the association with a derived value RDWI to distinguish IDA and ssTT.15
The sensitivity, specificity of RDW in the detection of ssTT didn't prove to be significant whereas RDWI came out as good discriminator between ssTT and IDA, its sensitivity and specificity were more than 80% in detection of ssTT and IDA.
In our study, the sensitivity of 89% and specificity of 94% were observed for RDWI. This is in accordance with the observations made by quite a few studies.18,20,21 In the present study, the highest YI was obtained for RDWI (83).
A Spanish group of haematologists also reported RDWI as the most reliable index.15 A study32 reported Shine and Lal formula as the best index for BTT, although in our study Shine and Lal had 100% sensitivity but only 39% specificity.
One study.33 suggested that Green and King's index is the best discriminator, but in our study it was the second best index after RDWI. Another study found that formulae presented by Shine and Lal, Srivastava and Mentzler had good discriminative function.34
RDWI appeared to be the most reliable formula in differentiating BTT from IDA in patients with hypochromic microcytic anaemia.
In our study, Youden's index of RBC count and RDWI were the highest and they were the most reliable discrimination indices in differentiating [beta]-TT from IDA in patients older than 10 years.
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- Rdultovskii, Vladimir
- Rdultovskii, Vladimir Iosifovich