Detection of haemophilia carriers: multivariate analysis compared with discriminant analysis using up to five factor VIII variates.

Multivariate analysis is potentially superior to the linear discriminant analysis which is commonly used to identify carriers of haemophilia. Our aim was to compare these two statistical methods, and to find which factor VIII variates most effectively partitioned carrier and normal subjects. In this study we assayed one- and two-stage factor VIII coagulant activity, factor VIII related antigen by electroimmunoassay and by fluoroimmunoassay, and ristocetin co-factor in 50 normal females and 50 carriers of haemophilia. From the results we calculated multivariate ellipses which circumscribed the normal and the carrier populations, and we displayed these on the monitor of a microcomputer. These ellipses separated the two populations better than linear discriminants calculated on the same data. Multivariate analysis correctly identified 94% of the carriers whereas discriminant analysis correctly identified only 84%. Discriminant analysis gave poorer results because the statistical assumption of equal variance was breached, whereas the assumption of multivariate normality was upheld. Of the five factor VIII variates, two-stage factor VIII coagulant activity and factor VIII related antigen by electroimmunoassay correctly identified the most subjects. Ristocetin co-factor did not improve the diagnostic ability, either when in lieu of or when added to factor VIII related antigen.