Noninvasive Color-Based Shade card for Risk Assessment of Anemia in Young Children: A Real-World User Experience

Abstract

Background: Prompt risk assessment and early intervention is essential to improve outcomes in children with anemia. Resource-poor settings mandate the use of tests that are inexpensive, noninvasive, reliable, and durable. This study aimed to utilize the Noninvasive Screening of Anemia (NISA) color shade card to present the real-world user experience of medical practitioners in using the tool among children aged 6- 60 months. Methods: The NISA shade card was used to determine the presence or absence of anemia and grade the severity by comparing the natural color tint of palpebral conjunctiva with the shade card. A feedback questionnaire was used to assess the experience of using the tool. Descriptive statistics were analyzed using R software. Results: Nine pediatricians participated in this user experience and observations from 173 children were included. The sensitivity and specificity of the NISA shade card for risk assessment of anemia were 80.83% (95% confidence interval [CI], 72.64%–87.44%) and 66.04% (95% CI, 51.73%–78.48%), respectively. The tool was rated from good to very good by the pediatricians for its utility as an anemia risk assessment shade card. It was agreed that caregivers could effectively use it with proper training. Conclusion: The NISA shade card may serve as an additional screening aid to clinicians in their routine practice. The ease of use and simplicity of interpreting combined with other clinical clues could make it an effective risk assessment tool in identifying children at risk of anemia.