Abstract

BackgroundSeveral hematological indices have been already proposed to discriminate between iron deficiency anemia (IDA) and β‐thalassemia trait (βTT). This study compared the diagnostic performance of different hematological discrimination indices with decision trees and support vector machines, so as to discriminate IDA from βTT using multidimensional scaling and cluster analysis. In addition, decision trees were used to determine the diagnostic classification scheme of patients.MethodsConsisting of 1178 patients with hypochromic microcytic anemia (708 patients with βTT and 470 patients with IDA), this cross-sectional study compared the diagnostic performance of 43 hematological discrimination indices with classification tree algorithms and support vector machines in order to discriminate IDA from βTT. Moreover, multidimensional scaling and cluster analysis were used to identify the homogeneous subgroups of discrimination methods with similar performance.ResultsAll the classification tree algorithms except the LOTUS tree algorithm showed acceptable accuracy measures for discrimination between IDA and βTT in comparison with other hematological discrimination indices. The results indicated that the CRUISE and C5.0 tree algorithms had better diagnostic performance and efficiency among other discrimination methods. Moreover, the AUC of CRUISE and C5.0 tree algorithms indicated more precise classification with values of 0.940 and 0.999, indicating excellent diagnostic accuracy of such models. Moreover, the CRUISE and C5.0 tree algorithms showed that mean corpuscular volume can be considered as the main variable in discrimination between IDA and βTT.ConclusionsCRUISE and C5.0 tree algorithms as powerful methods in data mining techniques can be used to develop accurate differential methods along with other laboratory parameters for the discrimination of IDA and βTT. In addition, the multidimensional scaling method and cluster analysis can be considered as the most appropriate techniques to determine the discrimination indices with similar performance for future hematological studies.

Highlights

  • Several hematological indices have been already proposed to discriminate between iron deficiency anemia (IDA) and β‐thalassemia trait

  • Additional file 1: Table S2 indicated the descriptive statistics of hematological parameters across the type of hypochromic microcytic anemia (IDA and β‐thalassemia trait (βTT))

  • The results showed that CRUISE and C5.0 tree algorithms had a better performance for discrimination between IDA and βTT in comparison to all indices and other classification tree methods

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Summary

Introduction

Several hematological indices have been already proposed to discriminate between iron deficiency anemia (IDA) and β‐thalassemia trait (βTT). This study compared the diagnostic performance of different hematological discrimination indices with decision trees and support vector machines, so as to discriminate IDA from βTT using multidimensional scaling and cluster analysis. IDA and βTT are the two common types of microcytic anemia disorders. IDA is a prevalent disorder worldwide, and βTT is, in turn, predominant in the Mediterranean region [5,6,7,8,9,10]. The discrimination between these two hematologic disorders is necessary to prevent iron overload and its complications caused by misdiagnosis and inaccurate treatment so as to determine the prenatal causes for hemoglobin chain disorders. The differential diagnosis of IDA from βTT is a major challenge given that they provide similar experimental conditions [3, 11, 12]

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