Evidence and Programme Guidance Unit, Department of Nutrition for Health and Development, World Health Organization, Geneva, Switzerland.
Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia.
Ann N Y Acad Sci. 2019 Aug;1450(1):5-14. doi: 10.1111/nyas.14090. Epub 2019 Apr 21.
Anemia is an important public health problem that negatively affects health of individuals and economic potential of populations. An accurate case definition is critical for understanding burden and epidemiology of anemia, for planning public health interventions, and for clinical investigation and treatment of patients. The current threshold hemoglobin concentrations for diagnosis of anemia were proposed in 1968 and based on studies predominantly of Caucasian adult populations in Europe and North America. The World Health Organization is undertaking a project to review global guidelines for anemia. We describe the process of obtaining input from technical experts, researchers, blood bank experts, policy makers, and program implementers to identify key information or knowledge gaps for anemia diagnosis. From this scoping exercise, six priority areas were identified on diverse topics related to the use and interpretation of hemoglobin concentrations to diagnose anemia in individuals and populations. A call for authors was conducted to produce background, review, and research papers across priority topics. This paper summarizes the first technical meeting, which included commissioned papers as well as case studies, describes key data gaps identified, and describes the next steps in the guideline development process to assess available evidence and define knowledge gaps to improve anemia characterization.
贫血是一个重要的公共卫生问题,它会对个人的健康和人群的经济潜力产生负面影响。准确的病例定义对于了解贫血的负担和流行病学、规划公共卫生干预措施以及临床调查和治疗患者至关重要。目前用于诊断贫血的血红蛋白浓度阈值是在 1968 年提出的,其依据的主要是欧洲和北美的白种成年人的研究。世界卫生组织正在开展一个项目,审查全球贫血指南。我们描述了从技术专家、研究人员、血库专家、政策制定者和方案实施者那里获取意见的过程,以确定用于个体和人群贫血诊断的血红蛋白浓度的使用和解释方面的关键信息或知识空白。从这项范围界定工作中,确定了六个与血红蛋白浓度用于诊断个体和人群贫血的使用和解释相关的不同主题的优先领域。为此开展了征文活动,以便就优先主题撰写背景、综述和研究论文。本文总结了第一次技术会议的情况,包括委托撰写的论文和案例研究,描述了确定的主要数据空白,并介绍了在评估现有证据和确定知识空白以改善贫血特征方面的指南制定过程的下一步。