Statistical analysis

Data from data collection sheet was analyzed using SPSS software version 25.0 and MedCalc statistical
software version 19.0. Comparison of parameters between test and control group was performed using
One Way ANOVA test. Diagnostic performance of the tests for Iron deficiency was assessed using receiver
operating characteristics curves. Sensitivity and specificity of each test was determined. Statistical
significance was set at a P-value of 0.05 or less.

Results
Table 1: Gender distribution

IDA GROUP n=41 NON-IDA GROUP n=45

MALE 14(34%) 19(42%)

FEMALE 27(66%) 26(58%)

Table 2: Age distribution

Mean age (years)

IDA GROUP n=41 NON-IDA GROUP n=45

35.4 31.3

Table 3: Specificity and Sensitivity of Ret Hb

Ret Hb
Test Disease present Disease absent
Positive 38(a) 3(C)
Negative 12(b) 29(d)
Sensitivity= 76%
Specificity= 90%
Table 4: Specificity and Sensitivity of %Micro R
Micro R
Test Disease present Disease absent
Positive 41(a) 41(C)
Negative 0(b) 0(d)
Sensitivity= 100%
Specificity= 100%

Table 5: Specificity and Sensitivity of %Hypo He

Hypo He
Test Disease present Disease absent
Positive 41(a) 41(C)
Negative 0(b) 0(d)
Sensitivity= 100%
Specificity= 100%

Graph 1: ROC curve for Ret Hb as indicator of iron deficiency anemia

Classification: Disease
100
90
80
70
60
Sensitivity (%)
50
Specificity (%)
40
30
20
10
0
10 15 20 25 30
Ret_Hb
Graph 2: ROC curve for % Micro R as indicator of iron deficiency
anemia:

Classification: Disease2
100
90
80
70
60
Sensitivity (%)
50
Specificity (%)
40
30
20
10
0
0 20 40 60 80 100
%MICRO_R
Graph 3: ROC curve for % Hypo He as indicator of iron deficiency
anemia
Classification: IDA_3
100
90
80
70
60
Sensitivity (%)
50
Specificity (%)
40
30
20
10
0
0 5 10 15 20 25 30 35
%Hypo_He

Table 6: Test characteristics for the diagnosis of IDA determined by

receiver operating characteristic curve analysis:

Variable AUC SE a 95% CI b

Ret_Hb 1.000 0.000 0.914 to 1.000

%Hypo_He 0.895 0.108 0.759 to 0.969

%MICRO_R 0.868 0.101 0.726 to 0.953

a DeLong et al., 1988

b Binomial exact
Table 7: Comparison of various RBC indices and new parameters among
iron deficient and non-iron deficient group

PARAMETERS Iron deficient group Non- iron deficient group p value

HB 7.3±1.5 14.5±1.3 < .00001

RBC COUNT 3.79±0.68 5.06±0.32 < .00001
MCV 66.9±5.11 85.3±3.12 < .00001
MCH 19.8±2.8 28.1±4.2 < .00001
MCHC 29.5±3.2 33.4±1.2 < .00001
RDW 19.9±4.6 14.4±1.2 < .00001
RET% 2.75±8.1 1.35±0.68 0.24
RET He 19.2±3.6 28.5±2.68 < .00001
%MICRO R 38.7±14.5 2.59±2.68 < .00001
% HYPO He 17.4±6.4 0.49±0.3 < .00001

Epidemiology:
During the study period 86 patients were evaluated for complete blood count and Serum ferritin
levels and as per the inclusion and exclusion criterion were included in the final analysis. Out of
these 41 patients were with ID and 45 patients were without ID. The diagnosis of ID was based
on the values of serum ferritin <30 ng/mL. Thirty four percent of the population in ID group were
male and 66% were female whereas 42% were male in non-ID group and rest were female. The
mean age 35.4 years in ID group and 31.3 years in non-ID group.
Comparison of parameters:
The sensitivity and specificity of Ret He, % Micro R and % Hypo He are described in table 3, 4 and
5 respectively. The test characteristics obtained by analysis of ROC curve has been described in
Table 6. Though the sensitivity and specificity of % Micro R and Hypo He is found to be 100% but
the AUC (area under the curve) for Ret-He (1.00, CI 0.914 to 1.000) indicates that Ret He is the
best discriminator of ID (p<0.00001). The hematological parameters in ID and non-ID groups are
compared and presented in table 7. Ret-He levels showed a mean ± SD values of 19.2±3.6 and
28.5±2.68 in the ID and non-ID groups (p<0.00001). A moderate negative correlation was found between
MCV and % Micro R (r=-0.5) and strong positive correlation was found between MCH and % Hypo He
(r=0.88). The mean Hb, MCV, MCH, MCHC and RDW were significantly different among ID and non-ID
groups (p<0.0001), whereas no difference was noted for Ret%.