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Rev Saude Publica. 2003 Aug;37(4):404-8. Epub 2003 Aug 20.

[Reliability and validity of palmar and conjunctival pallor for anemia detection purposes].

[Article in Portuguese]

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  • 1Secretaria Municipal da Assistência Social, Prefeitura do Município de São Paulo, São Paulo, SP, Brasil.



To evaluate the reliability and the validity of the use of simple clinical signs as a method of anemia detection.


The study was carried out in a S o Paulo, Brazil, day-care center, and included 135 children from ages 3 months-6 years. Hemoglobin level results and palmar and conjunctival pallor assessment were used. Children with Hb under 11g/dl were considered as anemic; subjective criteria were used for the assessment of palmar and conjunctival pallor. Kappa statistics were used in order to verify agreement, and, in order to evaluate the technique's validity, sensitivity and specificity levels were calculated.


The results show low levels of agreement. There was a greater level of sensitivity to conjunctival pallor than to palmar pallor. Specificity results may be considered as good.


It is still early to recommend the routine use of this technique. However, it could promote substantial savings if perfected.

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