{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T17:11:27Z","timestamp":1783357887752,"version":"3.54.6"},"reference-count":46,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,6,13]],"date-time":"2023-06-13T00:00:00Z","timestamp":1686614400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Universidad Peruana Cayetano Heredia"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>We evaluated the available literature on the diagnostic performance of hemoglobin (Hb) in the diagnosis of iron deficiency anemia (IDA) in high-altitude populations. We searched PubMed, Web of Science, Scopus, Embase, Medline by Ovid, the Cochrane Library, and LILCAS until 3 May 2022. We included studies that evaluated the diagnostic performance (sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), receiver operating characteristic (ROC) curves, and accuracy) of Hb (with and without an altitude correction factor) compared to any iron deficiency (ID) marker (e.g., ferritin, soluble transferrin receptor (sTFR), transferrin saturation, or total body iron (TBI)) in populations residing at altitudes (\u22651000 m above sea level). We identified a total of 14 studies (with 4522 participants). We found disagreement in diagnostic performance test values between the studies, both in those comparing hemoglobin with and in those comparing hemoglobin without a correction factor for altitude. Sensitivity ranged from 7% to 100%, whereas specificity ranged from 30% to 100%. Three studies reported higher accuracy of uncorrected versus altitude-corrected hemoglobin. Similarly, two studies found that not correcting hemoglobin for altitude improved the receiver operating characteristic (ROC) curves for the diagnosis of iron deficiency anemia. Available studies on high-altitude populations suggest that the diagnostic accuracy of Hb is higher when altitude correction is not used. In addition, the high prevalence of anemia in altitude regions could be due to diagnostic misclassification.<\/jats:p>","DOI":"10.3390\/ijerph20126117","type":"journal-article","created":{"date-parts":[[2023,6,14]],"date-time":"2023-06-14T02:01:40Z","timestamp":1686708100000},"page":"6117","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Evaluating the Diagnostic Performance of Hemoglobin in the Diagnosis of Iron Deficiency Anemia in High-Altitude Populations: A Scoping Review"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3326-0437","authenticated-orcid":false,"given":"Cinthya","family":"V\u00e1squez-Vel\u00e1squez","sequence":"first","affiliation":[{"name":"Laboratorio de Endocrinolog\u00eda y Reproducci\u00f3n, Laboratorios de Investigaci\u00f3n y Desarrollo (LID), Departamento de Ciencias Biol\u00f3gicas y Fisiol\u00f3gicas, Facultad de Ciencias y Filosof\u00eda Alberto Cazorla T\u00e1lleri, Universidad Peruana Cayetano Heredia, Lima 15102, Peru"},{"name":"Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia, Lima 15102, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9441-1067","authenticated-orcid":false,"given":"Daniel","family":"Fernandez-Guzman","sequence":"additional","affiliation":[{"name":"Carrera de Medicina Humana, Universidad Cient\u00edfica del Sur, Lima 15067, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0076-0985","authenticated-orcid":false,"given":"Carlos","family":"Quispe-Vicu\u00f1a","sequence":"additional","affiliation":[{"name":"Sociedad Cient\u00edfica San Fernando, Universidad Nacional Mayor de San Marcos, Lima 15081, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda","family":"Caira-Chuquineyra","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad Nacional de San Agust\u00edn de Arequipa, Arequipa 04001, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3172-2113","authenticated-orcid":false,"given":"Fabricio","family":"Ccami-Bernal","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad Nacional de San Agust\u00edn de Arequipa, Arequipa 04001, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piero","family":"Castillo-Gutierrez","sequence":"additional","affiliation":[{"name":"Sociedad Cient\u00edfica San Fernando, Universidad Nacional Mayor de San Marcos, Lima 15081, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6269-7593","authenticated-orcid":false,"given":"Miriam","family":"Arredondo-Nontol","sequence":"additional","affiliation":[{"name":"Escuela Profesional de Medicina Humana, Universidad Nacional de Tumbes, Tumbes 24001, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1611-2894","authenticated-orcid":false,"given":"Gustavo F.","family":"Gonzales","sequence":"additional","affiliation":[{"name":"Laboratorio de Endocrinolog\u00eda y Reproducci\u00f3n, Laboratorios de Investigaci\u00f3n y Desarrollo (LID), Departamento de Ciencias Biol\u00f3gicas y Fisiol\u00f3gicas, Facultad de Ciencias y Filosof\u00eda Alberto Cazorla T\u00e1lleri, Universidad Peruana Cayetano Heredia, Lima 15102, Peru"},{"name":"Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia, Lima 15102, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1186\/s13045-021-01202-2","article-title":"Burden of anemia and its underlying causes in 204 countries and territories, 1990\u20132019: Results from the Global Burden of Disease Study 2019","volume":"14","author":"Safiri","year":"2021","journal-title":"J. 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