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Int J Gynaecol Obstet. 2009 Oct;107(1):26-9. doi: 10.1016/j.ijgo.2009.05.012. Epub 2009 Jul 9.

A comparison of the accuracy of the corpuscular fragility and mean corpuscular volume tests for the alpha-thalassemia 1 and beta-thalassemia traits.

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Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.



To compare the accuracy of the osmotic fragility test (OFT) and mean corpuscular volume (MCV) calculation when screening for the alpha-thalassemia 1 and/or beta-thalassemia trait.


In this cross-sectional study, blood samples from 328 apparently healthy pregnant women were sent on the same day to separate laboratories for the OFT (performed using a glycerol 0.45%, phosphate-buffered, sodium chloride solution) and MCV testing (by means of a standard automated hematology analyzer). A polymerase chain reaction was also performed to positively diagnose alpha-thalassemia 1 carriers, and a quantitative HbA(2) test to positively diagnose beta-thalassemia carriers.


Sensitivity and specificity were 95.0% and 86% for the OFT; and based on the cut-off point of 78.1 fL derived from the ROC curve, they were 93% and 93.4% for MCV calculation. The latter test was found to be slightly more accurate than the OFT in predicting the presence of the alpha-thalassemia 1 and/or beta-thalassemia trait.


Both tests have high screening sensitivity for the alpha-thalassemia 1 and/or beta-thalassemia traits, and their simplicity and very low cost make them attractive as screening tests for large populations. Since MCV seems to provide fewer false-positive results, it may be the first choice wherever an automated hematology analyzer calculating MCV is available.

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