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The kinetics of haemoglobin and ferritin in longitudinal community patients with iron deficiency or hypoxia

  • Tony Badrick , Alice M. Richardson ORCID logo EMAIL logo , Ashley Arnott and Brett A. Lidbury
Published/Copyright: November 23, 2016
Diagnosis
From the journal Diagnosis Volume 4 Issue 1

Abstract

Background:

Red cell distribution width (RDW) is well recognised as a marker of iron-deficient anaemia, as well as useful to the distinction between some anaemic states. A role in the prediction of patient mortality and for the laboratory diagnosis of organ dysfunction has been also investigated. RDW has recently been suggested as a marker of acute and chronic hypoxia.

Methods:

In this paper we use RDW kinetics to identify different patient groups and then investigate the relationship between RDW, ferritin and haemoglobin kinetics in a large cross-sectional community patient dataset.

Results:

A novel mathematical model of this relationship is developed that captures all aspects of variation in the data. A linear regression of RDW/log(ferritin) on days is combined with a multi-level random structure including random intercepts and slopes for each patient.

Conclusions:

No evidence of an age affect was found in the data. On the other hand, significant patterns in the rises and falls of log(ferritin) and haemoglobin with RDW over time are identified.

Keywords: fixed effects; multilevel model; random effects
Corresponding author: Dr. Alice M. Richardson, National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT 0200, Australia; and Genomics and Predictive Medicine, Department of Genome Sciences, The John Curtin School of Medical Research, ANU, Canberra, Australia
aPresent address: Chief Executive RCPAQAP, Suite 201/8 Herbert Street, St Leonards, NSW 2065, AustraliabPresent address: National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT 2601, Australia

Acknowledgments

The authors wish to thank the Quality Use of Pathology Programme (QUPP), The Commonwealth Department of Health and Ageing, Canberra, Australia, for funding this study.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

References

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Received: 2016-7-25
Accepted: 2016-10-1
Published Online: 2016-11-23
Published in Print: 2017-3-1

©2017 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/dx-2016-0031
Keywords for this article
fixed effects; multilevel model; random effects

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Exploring the iceberg of inappropriateness in hemostasis testing
  4. Review
  5. Diagnoses in and out of time: historical and medical perspectives on the diagnoses of distress
  6. Mini Review
  7. Five things to know about diagnostic error
  8. Opinion Paper
  9. The scientific nature of diagnosis
  10. Original Articles
  11. An assessment of overutilization and underutilization of laboratory tests by expert physicians in the evaluation of patients for bleeding and thrombotic disorders in clinical context and in real time
  12. Misdiagnosis of cerebellar hemorrhage – features of ‘pseudo-gastroenteritis’ clinical presentations to the ED and primary care
  13. The kinetics of haemoglobin and ferritin in longitudinal community patients with iron deficiency or hypoxia
  14. Which of low-density lipoprotein cholesterol estimates can be used in children with type 1 diabetes?
  15. Case Report
  16. Aseptic myonecrosis following intramuscular benzathine penicllin G injection: a novel syndrome
  17. Congress Abstracts
  18. Diagnostic Error in Medicine
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