LABORATORY DIAGNOSIS OF ANEMIA AND RELATED DISEASES USING MULTIVARIATE-ANALYSIS

To establish a simple computer program for the laboratory diagnosis of anemia and related diseases, multivariate analyses were applied to th e results of routine hematological laboratory tests obtained from 48 p atients and 51 healthy volunteers. The patients studied were limited t o those who had not been treated hematologically by the time of their first visit to our hospital, and their first data obtained in our labo ratory were analyzed. Final diagnoses were aplastic anemia (AA) in 21, myelodysplastic syndrome (MDS) in 14, iron deficiency anemia (IDA) in 3, polycytemia vera (PV)in 3, and idiopathic thrombocytopenic purpura (ITP) in 7. Eight parameters, WBC, RBC, Hb, Ht, MCV, MCH, MCHC, and P LT, were transformed to normal distribution and then applied to princi pal component analysis to evaluate their independence. Very close rela tionships were observed between Ht and Hb, and between MCV and MCH. On e each of these pairs was selected by discriminant analysis and two se ts, RBC, MCH, Hb, PLT, and WBC, and RBC, MCV, Ht, PLT, and WBC, were o btained. Two canonical components gave good discrimination of these fi ve diseases and also of normal subjects. When disease prediction was m ade using this analysis, 37 of 48 patients (77.1%) were predicted corr ectly, and furthermore, when two disease predictions were allowed, all patients were diagnosed properly. Some overlaps were observed in this two-dimensional coordinate system, especially of AA and MDS, and also with normal subjects. To improve the system further, the additional p arameters of age and sex were added to construct a three-dimensional a nalysis which resulted in much clearer discrimination. The whole proce dure described is being developed with subjects who are not taking med ication. Subsequently, the general application of this analytical proc edure should be limited to only those not on medications. In conclusio n, this is in essence a demonstration project; however, this trial of laboratory diagnosis using routine hematological laboratory results ap pears to be promising. Further extension of the study by increasing nu mbers of patients and disorders studied, including secondary anemias, will allow the design of diagnostic software for use with personal com puters at the sites of primary care. (C) 1997 Wiley-Liss Inc.