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Defining ferritin clinical decision limits to improve diagnosis and treatment of iron deficiency: A modified Delphi study.

Defining ferritin clinical decision limits to improve diagnosis and treatment of iron deficiency: A modified Delphi study.

Authors :
Naveed K
Goldberg N
Shore E
Dhoot A
Gabrielson D
Goodarzi Z
Lin Y
Pai M
Pardy NA
Robinson S
Andreou R
Sood M
Price V
Storm S
Verduyn A
Parker ML
Fralick M
Beriault D
Sholzberg M
Source :
International journal of laboratory hematology [Int J Lab Hematol] 2023 Jun; Vol. 45 (3), pp. 377-386. Date of Electronic Publication: 2023 Jan 05.
Publication Year :
2023

Abstract

Background: Iron deficiency is highly prevalent worldwide and is an issue of health inequity. Despite its high prevalence, uncertainty on the clinical applicability and evidence-base of iron-related lab test cut-offs remains. In particular, current ferritin decision limits for the diagnosis of iron deficiency may not be clinically appropriate nor scientifically grounded.<br />Methods: A modified Delphi study was conducted with various clinical experts who manage iron deficiency across Canada. Statements about ferritin decision limits were generated by a steering committee, then distributed to the expert panel to vote on agreement with the aim of achieving consensus and acquiring feedback on the presented statements. Consensus was reached after two rounds, which was defined as 70% of experts rating their agreement for a statement as 5 or higher on a Likert scale from 1 to 7.<br />Results: Twenty-six clinical experts across 10 different specialties took part in the study. Consensus was achieved on 28 ferritin decision limit statements in various populations (including patients with multiple comorbid conditions, pediatric patients, and pregnant patients). For example, there was consensus that a ferritin <30 μg/L rules in iron deficiency in all adult patients (age ≥ 18 years) and warrants iron replacement therapy.<br />Conclusion: Consensus statements generated through this study corresponded with current evidence-based literature and guidelines. These statements provide clarity to facilitate clinical decisions around the appropriate detection and management of iron deficiency.<br /> (© 2023 John Wiley & Sons Ltd.)

Details

Language :
English
ISSN :
1751-553X
Volume :
45
Issue :
3
Database :
MEDLINE
Journal :
International journal of laboratory hematology
Publication Type :
Academic Journal
Accession number :
36602151
Full Text :
https://doi.org/10.1111/ijlh.14016