A systematic review and diagnostic meta-analysis of 13 studies and 5,853 blood donors evaluated reticulocyte haemoglobin content for iron deficiency without anaemia. Pooled sensitivity was 0.70 and specificity 0.85, but certainty was very low to low, insufficient for widespread standalone screening.
Key findings
- Pooled sensitivity was 0.70 (95% CI 0.60-0.79), specificity 0.85 (0.74-0.92), LR+ 4.84 (2.59-9.04), LR- 0.35 (0.25-0.48), and AUC 0.79 (0.71-0.85). This is moderate accuracy, not enough for RHC alone to confidently rule in or rule out iron deficiency.
Why this matters globally
Blood services must balance supply with donor health. A marker available from automated blood counts could reduce burden if instrument- and population-specific thresholds are paired with appropriate confirmatory pathways.
Thai researcher contribution
The Prince of Songkla University pathology team led the evidence synthesis and certainty assessment, supporting informed decisions before adoption in blood-donor systems.
Limitations to consider
Reference standards and cutoffs varied, creating heterogeneity and possible spectrum bias. Very-low-to-low certainty means pooled estimates may change with better evidence, and results should not transfer across analyzers or populations without calibration.
Verify the original sources
Vox SanguinisRead the original article↗DOI: 10.1111/vox.70321