Authors
Peerawit Yanyiam, Kanoot Jaruthamsophon, Kantarat Kusolthammarat
Published in
Vox sanguinis. Jul 12, 2026. Epub Jul 12, 2026.
Abstract
Iron deficiency without anaemia (IDWA) is a significant concern among blood donors. Reticulocyte haemoglobin content (RHC) has been increasingly investigated as an alternative biomarker to evaluate iron status, but its diagnostic performance remains unclear. We aim to assess the diagnostic accuracy of RHC for detecting iron deficiency in non-anaemic blood donors.
PubMed, Embase, Scopus, Web of Science, Cochrane Library, ProQuest Dissertations & Theses, trial registries and reference lists were searched. Study quality was assessed using the Revised Tool for Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2), and the certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. The pooled sensitivity, specificity, likelihood ratios (LRs) and summary receiver operating characteristic area under the curve (SROCAUC) were estimated.
Thirteen studies involving 5853 donors were included. The pooled sensitivity, specificity, positive LR (LR+) and negative LR (LR-) of RHC to evaluate iron deficiency compared to tests using ferritin, soluble transferrin receptor or a combination of parameters were 0.70 (95% confidence interval [CI]: 0.60-0.79), 0.85 (95% CI: 0.74-0.92), 4.84 (95% CI: 2.59-9.04) and 0.35 (95% CI: 0.25-0.48), respectively; the SROCAUC was 0.79 (95% CI: 0.71-0.85). The certainty of evidence was rated as very low to low.
Evidence from this review is insufficient to support the widespread use of RHC as a standalone screening test for IDWA in blood donors. Further studies are needed to improve RHC-based screening strategies.
PMID:
42437696
Bibliographic data and abstract were imported from PubMed on 13 Jul 2026.
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