Sehgal index: A new index and its comparison with other complete blood count-based indices for screening of beta thalassemia trait in a tertiary care hospital.
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Date
2015-07
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Abstract
Introduction: Beta thalassemia trait (BTT) must be differentiated from iron
defi ciency anemia to avoid unnecessary iron therapy and for the prevention
of thalassemia major by genetic counseling. In a tertiary care hospital, it is
vital that the screening tool is not only sensitive but also specifi c so as to be
cost effective and save time. Aim: The aim of this study was to evaluate the
new Sehgal index and compare it to existing complete blood count-based
indices for the best combination of sensitivity and specifi city to predict BTT.
Materials and Methods: Study was done in 2 phases - Phase 1: A retrospective
analysis of 1022 consecutive high-performance liquid chromatography (HPLC)
cases from July 2008 to June 2011. Phase 2: A prospective analysis of 973
consecutive HPLC cases from July 1, 2011 to June 10, 2013 was done to
confi rm the results of Phase 1 and the applicability of the new Sehgal index.
Results: Prevalence of BTT was 28.8% (294/1022) and 25.39% (247/973)
in Phase 1 and Phase 2, respectively. Receiver operating characteristic-area
under the curve and Youden index was highest for new Sehgal index, followed
by Mentzers index <14. The prospective study shows results similar to those
in Phase 1 confi rming the superiority of the above two indices. Conclusion:
Sehgal index and Mentzers index <14 showed the best combination of sensitivity
and specifi city in predicting BTT. The best indices or combination can be used
as a “validated fl ag rule” in the analyzer middleware program in a hospital for
identifying suspected cases of BTT.
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Keywords
Beta thalassemia trait, complete blood count, iron deficiency anemia, mentzers index, Sehgal index
Citation
Sehgal Kunal, Mansukhani Preeti, Dadu Tina, Irani Meher, Khodaiji Shanaz. Sehgal index: A new index and its comparison with other complete blood count-based indices for screening of beta thalassemia trait in a tertiary care hospital. Indian Journal of Pathology & Microbiology. 2015 Jul-Sept 58(3): 310-315.