Sensitivity and specificity of mean corpuscular hemoglobin (MCH): for screening alpha-thalassemia-1 trait and beta-thalassemia trait. 2009

Savitree Pranpanus, and Supatra Sirichotiyakul, and Kasemsri Srisupundit, and Theera Tongsong
Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

OBJECTIVE To evaluate sensitivity, specificity, and positive and negative predictive value of mean corpuscular hemoglobin (MCH) for screening alpha-thalassemia-1 trait and beta-thalassemia trait. METHODS Descriptive analysis, diagnostic test, was conducted on 396 pregnant women attending the antenatal clinic between September 2007 and June 2008. Blood samples were collected from pregnant women after counseling and getting informed consent. MCH was measured in all samples by automated hematology analyzer Determination of HbA2 level for diagnosis of beta-thalassmia trait and PCR for alpha-thalassemia-1 gene (SEA type) were performed in all cases as a gold standard The data were collected and analyzed for sensitivity, specificity, and positive and negative predictive value of MCH for screening alpha-thalassemia-1 trait and beta-thalassemia trait. RESULTS Based on the ROC curve, the best cut-off level of MCH in predicting the thalassemia carriers was 26.5 picrograms. Positive MCH (< 26.5 picrograms) gave the sensitivity of 95.2% and specificity of 82.3% in screening alpha-thalassemia-1 trait and beta-thalassemia trait. The positive predictive value and negative predictive value were 40.4% and 99.3% respectively. CONCLUSIONS MCH is a good tool for screening alpha-thalassemia-1 trait and beta-thalassemia trait during pregnancy because of its simplicity, low cost, (when determined as a part of complete blood count), and high sensitivity.

UI MeSH Term Description Entries
D008403 Mass Screening Organized periodic procedures performed on large groups of people for the purpose of detecting disease. Screening,Mass Screenings,Screening, Mass,Screenings,Screenings, Mass
D011237 Predictive Value of Tests In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test. Negative Predictive Value,Positive Predictive Value,Predictive Value Of Test,Predictive Values Of Tests,Negative Predictive Values,Positive Predictive Values,Predictive Value, Negative,Predictive Value, Positive
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011250 Pregnancy Complications, Hematologic The co-occurrence of pregnancy and a blood disease (HEMATOLOGIC DISEASES) which involves BLOOD CELLS or COAGULATION FACTORS. The hematologic disease may precede or follow FERTILIZATION and it may or may not have a deleterious effect on the pregnant woman or FETUS. Complications, Hematologic Pregnancy,Hematologic Pregnancy Complications,Pregnancy Complications, Hematological,Pregnancy, Hematologic Complications,Complication, Hematologic Pregnancy,Complication, Hematological Pregnancy,Complications, Hematological Pregnancy,Hematologic Pregnancy Complication,Hematological Pregnancy Complication,Hematological Pregnancy Complications,Pregnancies, Hematologic Complications,Pregnancy Complication, Hematologic,Pregnancy Complication, Hematological
D004909 Erythrocyte Indices ERYTHROCYTE size and HEMOGLOBIN content or concentration, usually derived from ERYTHROCYTE COUNT; BLOOD hemoglobin concentration; and HEMATOCRIT. The indices include the mean corpuscular volume (MCV), the mean corpuscular hemoglobin (MCH), and the mean corpuscular hemoglobin concentration (MCHC). Erythrocyte Hemoglobin, Mean Cell,Erythrocyte Size Determination,Erythrocyte Volume, Mean Cell,Hemoglobin, Erythrocyte, Mean Cell,Mean Corpuscular Volume,Red Cell Indices,Erythrocyte Diameter,Erythrocyte Index,Erythrocyte Indexes,Erythrocyte Thickness,Mean Cell Hemoglobin Concentration,Mean Cell Volume,Mean Corpuscular Hemoglobin,Mean Corpuscular Hemoglobulin Concentration,Red Cell Distribution Width,Red Cell Index,Red Cell Indexes,Cell Volumes, Mean,Corpuscular Volumes, Mean,Determination, Erythrocyte Size,Determinations, Erythrocyte Size,Diameter, Erythrocyte,Diameters, Erythrocyte,Erythrocyte Diameters,Erythrocyte Size Determinations,Hemoglobin, Mean Corpuscular,Hemoglobins, Mean Corpuscular,Index, Erythrocyte,Index, Red Cell,Indexes, Erythrocyte,Indexes, Red Cell,Indices, Erythrocyte,Indices, Red Cell,Mean Cell Volumes,Mean Corpuscular Hemoglobins,Mean Corpuscular Volumes,Size Determination, Erythrocyte,Size Determinations, Erythrocyte,Thickness, Erythrocyte,Volume, Mean Cell,Volume, Mean Corpuscular,Volumes, Mean Cell,Volumes, Mean Corpuscular
D005260 Female Females
D006443 Hemoglobin A2 An adult hemoglobin component normally present in hemolysates from human erythrocytes in concentrations of about 3%. The hemoglobin is composed of two alpha chains and two delta chains. The percentage of HbA2 varies in some hematologic disorders, but is about double in beta-thalassemia. A2, Hemoglobin
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012372 ROC Curve A graphic means for assessing the ability of a screening test to discriminate between healthy and diseased persons; may also be used in other studies, e.g., distinguishing stimuli responses as to a faint stimuli or nonstimuli. ROC Analysis,Receiver Operating Characteristic,Analysis, ROC,Analyses, ROC,Characteristic, Receiver Operating,Characteristics, Receiver Operating,Curve, ROC,Curves, ROC,ROC Analyses,ROC Curves,Receiver Operating Characteristics

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