Role of discrimination indices in screening of beta.thalassemia trait in West Bengal, India: An institutional experience on 10,407 subjects.

Background: Beta-thalassemia trait (BTT) is a common genetic disorder of hemoglobin and imposes a significant burden on global healthcare. Screening of this disorder is immensely important epidemiologically as it can reduce the future incidence of thalassemia major in newborns. The present study was carried out to evaluate the role of six discrimination indices to differentiate cases of BTT from others. Materials and Methods: A single-center, cross-sectional study was conducted on consecutive 10,407 participants. In addition to common diagnostic statistics association, concordance and receiver-operating characteristic curves were assessed to judge the role of discrimination indices. Results: Shine and Lal index, Mentzer index, and Srivastava index had revealed better discriminative function compared to England and Fraser index, red cell distribution width index, and Green and King index. Conclusion: Discrimination indices are rapid, reliable, and easy tools to suspect a case of BTT and send the subject for further high-performance liquid chromatography evaluation. But the cut-off value for these indices needs to be revised to achieve the best combination of sensitivity and specificity in this population. [ABSTRACT FROM AUTHOR]