Shortcomings in infant iron deficiency screening methods

Paul Biondich, Stephen Downs, Aaron Carroll, Antoinette L. Laskey, Gilbert C. Liu, Marc Rosenman, Jane Wang, Nancy Swigonski

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

BACKGROUND. Screening for iron deficiency anemia is a well-established practice in pediatrics, but numerous challenges surrounding current recommendations raise questions about the effectiveness of this strategy. OBJECTIVE. To evaluate iron deficiency anemia screening approaches, by assessing rates of follow-up testing and resolution among patients meeting screening criteria in a primary care setting. METHODS.A retrospective cohort study was performed. We extracted electronic medical record data on complete blood counts for infants who received primary care in our clinics in the past 10 years. We calculated rates of positive screening results with 9 different measurement criteria and determined rates of follow-up testing and of documented correction of iron deficiency among those who screened positive. RESULTS. Our cohort consisted of 4984 children who were screened at 9 to 15 months of age, between 1994 and 2004. There was a wide distribution of positive detection rates (range: 1.5-14.5%) among the 9 screening criteria. Follow-up testing rates were low. No more than 25% of infants who screened positive by any criterion underwent a repeat complete blood count within 6 months. Moreover, no more than 11.6% (range: 4.4-11.6%) had documented correction of their laboratory abnormalities. CONCLUSIONS. Significant shortcomings exist in current iron deficiency anemia screening practices. A widely agreed-on, specific, and inexpensive screening criterion, with increased emphasis on systems-based approaches to iron deficiency screening, is needed.

Original languageEnglish
Pages (from-to)290-294
Number of pages5
JournalPediatrics
Volume117
Issue number2
DOIs
StatePublished - Feb 2006

Fingerprint

Iron-Deficiency Anemias
Blood Cell Count
Iron
Primary Health Care
Electronic Health Records
Cohort Studies
Retrospective Studies
Pediatrics

Keywords

  • Anemia
  • Iron deficiency
  • Quality improvement
  • Screening

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Shortcomings in infant iron deficiency screening methods. / Biondich, Paul; Downs, Stephen; Carroll, Aaron; Laskey, Antoinette L.; Liu, Gilbert C.; Rosenman, Marc; Wang, Jane; Swigonski, Nancy.

In: Pediatrics, Vol. 117, No. 2, 02.2006, p. 290-294.

Research output: Contribution to journalArticle

Biondich, Paul ; Downs, Stephen ; Carroll, Aaron ; Laskey, Antoinette L. ; Liu, Gilbert C. ; Rosenman, Marc ; Wang, Jane ; Swigonski, Nancy. / Shortcomings in infant iron deficiency screening methods. In: Pediatrics. 2006 ; Vol. 117, No. 2. pp. 290-294.
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