Research Background: Sickle cell trait has no treatment or cure and predominantly affects people who are Black, but can affect anyone of any race or ethnicity. While commonly incorrectly considered benign by providers...Research Background: Sickle cell trait has no treatment or cure and predominantly affects people who are Black, but can affect anyone of any race or ethnicity. While commonly incorrectly considered benign by providers and the public, people with a sickle cell trait experience life-threatening outcomes that are exacerbated by extreme conditions. There is a severe lack of awareness and understanding of sickle cell trait and the associated health complications among sickle cell trait carriers and healthcare providers. Purpose/Aim: Interventions that aim to improve awareness of sickle cell trait differ in approaches and are not well documented in the literature. This typology aims to highlight current efforts to inform targeted interventions that raise awareness through consistent messaging, educate people and providers on sickle cell trait and the related health complications, and support the design and implementation of comprehensive sickle cell trait awareness initiatives. Methods: We conducted a scoping review of United States-based sickle cell trait interventions and performed a content analysis to identify the categories and characteristics of these efforts. We then organized the results into a typology according to established protocols. Results: Among 164 interventions, twenty-five (15%) met the typology inclusion criteria described above and were grouped into categories: Seven of twenty-five interventions were Educational Interventions (28%), three of twenty-five interventions (12%) were Combined Screening and Educational-Based Interventions, eight of twenty-five interventions (32%) were Policy and Guideline-Based Intervention, and six of twenty-five interventions (24%) were Sickle Cell Trait Organization-Led Interventions. Conclusions: There is a lack of consistency in messaging across interventions whether delivered by credible healthcare institutions or national organizations, which can result in lack of education and awareness and confusion around sickle cell trait. Categorizing interventions through a typology allows clarity and informs consistency in messaging, which should be at the forefront of future sickle cell trait efforts.展开更多
目的通过比较7种红细胞参数计算公式对黔南地区儿童缺铁性贫血(IDA)和地中海贫血(TT)的鉴别诊断的效能,选择适合本地区的计算公式,并建立其最佳截断值。方法选取2022年5月至2024年2月在我院就诊的105例患儿为研究对象,根据诊断将其分为T...目的通过比较7种红细胞参数计算公式对黔南地区儿童缺铁性贫血(IDA)和地中海贫血(TT)的鉴别诊断的效能,选择适合本地区的计算公式,并建立其最佳截断值。方法选取2022年5月至2024年2月在我院就诊的105例患儿为研究对象,根据诊断将其分为TT组(55例)和IDA组(50例)。对两组患儿的7个红细胞参数结果和7个红细胞参数计算公式的敏感度(SEN)、特异度(SPE)、约登指数(YI)、阳性预测值、阴性预测值、受试者工作特征曲线下面积(AUC)、根据YI最大值确定的鉴别诊断最佳临界值进行回顾性比较分析。结果TT组的RBC、HBG和MCHC高于IDA组,而MCV、MCH和RDW低于IDA组(P<0.05);Green and King公式鉴别诊断效能最高,其AUC为0.893、SEN为80.0%、SPE为88.0%、YI为68.0%,其最佳截断值为75.9。结论Green and King公式对黔南地区儿童TT和IDA的鉴别诊断能力较好,建议在基层医院推广应用。展开更多
目的探讨红细胞参数计算公式对儿童β-地中海贫血(β-TT)诊断的意义及其影响因素分析。方法选择200例小细胞低色素性贫血的临床资料进行回顾性分析。其中β-TT 104例,缺铁性贫血(IDA)96例。将相关的红细胞参数分别代入Green and King指...目的探讨红细胞参数计算公式对儿童β-地中海贫血(β-TT)诊断的意义及其影响因素分析。方法选择200例小细胞低色素性贫血的临床资料进行回顾性分析。其中β-TT 104例,缺铁性贫血(IDA)96例。将相关的红细胞参数分别代入Green and King指数(GKI)及Mentzer指数(MI)计算得出相应的结果。分别以GKI=65(β-TT≤65,IDA>65)、GKI=73(β-TT≤73,IDA>73)、MI=13(β-TT≤13,IDA>13)为诊断界值,比较这3种方法对于鉴别β-TT和IDA的敏感度(SEN)、特异度(SPE)、阳性预测值(PPV)、阴性预测值(NPV)及约登指数(YI),绘制受试者工作特征(ROC)曲线及计算曲线下面积(AUC),并分析影响鉴别效能较好的计算公式的准确性的可能因素。结果本地区儿童β-TT基因缺陷类型以CD41-42(-TTCT)杂合突变、IVS-Ⅱ-654(C→T)杂合突变和CD17(A→T)杂合突变为主。MI(β-TT≤13,IDA>13)的诊断效能明显高于GKI(β-TT≤65,IDA>65或β-TT≤73,IDA>73),差异均有统计学意义(P<0.05),MI的AUC为0.840;以MI=13为最佳界值,YI=63.06%。年龄≤4个月的患儿使用MI的准确性偏低(P<0.05),性别和检测前是否使用铁剂治疗对MI的准确性无影响(P>0.05)。结论MI(β-TT≤13,IDA>13)对于鉴别β-TT和IDA具有较高的临床价值,为保障MI的准确性,建议适用年龄>4个月,对于年龄≤4个月的患儿建议联合血红蛋白电泳和地中海贫血基因检测以提高检查的准确性。展开更多
文摘Research Background: Sickle cell trait has no treatment or cure and predominantly affects people who are Black, but can affect anyone of any race or ethnicity. While commonly incorrectly considered benign by providers and the public, people with a sickle cell trait experience life-threatening outcomes that are exacerbated by extreme conditions. There is a severe lack of awareness and understanding of sickle cell trait and the associated health complications among sickle cell trait carriers and healthcare providers. Purpose/Aim: Interventions that aim to improve awareness of sickle cell trait differ in approaches and are not well documented in the literature. This typology aims to highlight current efforts to inform targeted interventions that raise awareness through consistent messaging, educate people and providers on sickle cell trait and the related health complications, and support the design and implementation of comprehensive sickle cell trait awareness initiatives. Methods: We conducted a scoping review of United States-based sickle cell trait interventions and performed a content analysis to identify the categories and characteristics of these efforts. We then organized the results into a typology according to established protocols. Results: Among 164 interventions, twenty-five (15%) met the typology inclusion criteria described above and were grouped into categories: Seven of twenty-five interventions were Educational Interventions (28%), three of twenty-five interventions (12%) were Combined Screening and Educational-Based Interventions, eight of twenty-five interventions (32%) were Policy and Guideline-Based Intervention, and six of twenty-five interventions (24%) were Sickle Cell Trait Organization-Led Interventions. Conclusions: There is a lack of consistency in messaging across interventions whether delivered by credible healthcare institutions or national organizations, which can result in lack of education and awareness and confusion around sickle cell trait. Categorizing interventions through a typology allows clarity and informs consistency in messaging, which should be at the forefront of future sickle cell trait efforts.
文摘目的通过比较7种红细胞参数计算公式对黔南地区儿童缺铁性贫血(IDA)和地中海贫血(TT)的鉴别诊断的效能,选择适合本地区的计算公式,并建立其最佳截断值。方法选取2022年5月至2024年2月在我院就诊的105例患儿为研究对象,根据诊断将其分为TT组(55例)和IDA组(50例)。对两组患儿的7个红细胞参数结果和7个红细胞参数计算公式的敏感度(SEN)、特异度(SPE)、约登指数(YI)、阳性预测值、阴性预测值、受试者工作特征曲线下面积(AUC)、根据YI最大值确定的鉴别诊断最佳临界值进行回顾性比较分析。结果TT组的RBC、HBG和MCHC高于IDA组,而MCV、MCH和RDW低于IDA组(P<0.05);Green and King公式鉴别诊断效能最高,其AUC为0.893、SEN为80.0%、SPE为88.0%、YI为68.0%,其最佳截断值为75.9。结论Green and King公式对黔南地区儿童TT和IDA的鉴别诊断能力较好,建议在基层医院推广应用。
文摘目的探讨红细胞参数计算公式对儿童β-地中海贫血(β-TT)诊断的意义及其影响因素分析。方法选择200例小细胞低色素性贫血的临床资料进行回顾性分析。其中β-TT 104例,缺铁性贫血(IDA)96例。将相关的红细胞参数分别代入Green and King指数(GKI)及Mentzer指数(MI)计算得出相应的结果。分别以GKI=65(β-TT≤65,IDA>65)、GKI=73(β-TT≤73,IDA>73)、MI=13(β-TT≤13,IDA>13)为诊断界值,比较这3种方法对于鉴别β-TT和IDA的敏感度(SEN)、特异度(SPE)、阳性预测值(PPV)、阴性预测值(NPV)及约登指数(YI),绘制受试者工作特征(ROC)曲线及计算曲线下面积(AUC),并分析影响鉴别效能较好的计算公式的准确性的可能因素。结果本地区儿童β-TT基因缺陷类型以CD41-42(-TTCT)杂合突变、IVS-Ⅱ-654(C→T)杂合突变和CD17(A→T)杂合突变为主。MI(β-TT≤13,IDA>13)的诊断效能明显高于GKI(β-TT≤65,IDA>65或β-TT≤73,IDA>73),差异均有统计学意义(P<0.05),MI的AUC为0.840;以MI=13为最佳界值,YI=63.06%。年龄≤4个月的患儿使用MI的准确性偏低(P<0.05),性别和检测前是否使用铁剂治疗对MI的准确性无影响(P>0.05)。结论MI(β-TT≤13,IDA>13)对于鉴别β-TT和IDA具有较高的临床价值,为保障MI的准确性,建议适用年龄>4个月,对于年龄≤4个月的患儿建议联合血红蛋白电泳和地中海贫血基因检测以提高检查的准确性。
