ArticleScientific reports2020
Clinical thresholds for diagnosing iron deficiency: comparison of functional assessment of serum ferritin to population based centiles.
Article in Scientific reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 39 citations in OpenAlex.
- Ferritin Reference Curves and Optimal Curves in Preadolescent Children.JAMA network open · 2026Article
- Establishment and Validation of Serum Ferritin Reference Intervals Based on Real-World Big Data and Multi-Strategy Partitioning Algorithms.Journal of clinical medicine · 2026Article
- Iron Deficiency Diagnosis in Sub-Saharan Africa: Challenges, Barriers, and Opportunities.Anemia · 2026Review
- Anaemia prevalence, its determinants and profile of micronutrient status among rural school adolescent girls aged 14-19 years: a cross-sectional study in Nagpur district, Maharashtra, India.Public health nutrition · 2024Article
- Diagnostic Performance of Serum Erythropoietin to Discriminate Polycythemia Vera from Secondary Erythrocytosis through Established Subnormal Limits.Diagnostics (Basel, Switzerland) · 2024Article
- Prevalence, risk factors, and treatment of anemia in hospitalized older patients across geriatric and nephrological settings in Italy.Scientific reports · 2024Article
- Cohort-Based Reference Values for Serum Ferritin and Transferrin and Longitudinal Determinants of Iron Status in European Children Aged 3-15 Years.The Journal of nutrition · 2024Article
- Evaluation of inflammation adjustment methods to assess iron deficiency using longitudinal data from norovirus human challenge trials.PLOS global public health · 2024Article
- Haemoglobin diagnostic cut-offs for anaemia in Indian women of reproductive age.European journal of clinical nutrition · 2023Article
- Functional Reference Limits: Describing Physiological Relationships and Determination of Physiological Limits for Enhanced Interpretation of Laboratory Results.Annals of laboratory medicine · 2023Review
- Locally validated biomarker cutoffs should inform micronutrient deficiency burdens.The Lancet. Global health · 2023Article
- A New Artificial Intelligence Approach Using Extreme Learning Machine as the Potentially Effective Model to Predict and Analyze the Diagnosis of Anemia.Healthcare (Basel, Switzerland) · 2023Article
- Opioid prescribing among aged care residents during the first year of the COVID-19 pandemic: an analysis using general practice health records in Australia.BMC geriatrics · 2023Article
- Detection of factors affecting kidney function using machine learning methods.Scientific reports · 2022Article
- Iron Deficiency in the United States: Limitations in Guidelines, Data, and Monitoring of Disparities.American journal of public health · 2022Article
- COVID-19: protocol for observational studies utilizing near real-time electronic Australian general practice data to promote effective care and best-practice policy-a design thinking approach.Health research policy and systems · 2021Article
- Prevalence of select micronutrient deficiencies in Indian voluntary blood donors.Asian journal of transfusion scienceArticle
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Low serum ferritin is diagnostic of iron deficiency, yet its published lower cut-off values are highly variable, particularly for pediatric populations. Lower cut-off values are commonly reported as 2.5th percentiles, and is based on the variation of ferritin values in the population. Our objective was to determine whether a functional approach based on iron deficient erythropoiesis could provide a better alternative. Utilizing 64,443 ferritin test results from pediatric electronic health records, we conducted various statistical techniques to derive 2.5th percentiles, and also derived functional reference limits through the association between ferritin and erythrocyte parameters: hemoglobin, mean corpuscular volume, mean cell hemoglobin concentration, and red cell distribution width. We find that lower limits of reference intervals derived as centiles are too low for clinical interpretation. Functional limits indicate iron deficiency anemia starts to occur when ferritin levels reach 10 µg/L, and are largely similar between genders and age groups. In comparison, centiles (2.5%) presented with lower limits overall, with varying levels depending on age and gender. Functionally-derived limits better reflects the underlying physiology of a patient, and may provide a basis for deriving a threshold related to treatment of iron deficiency and any other biomarker with functional outcomes.
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