Blood Disease Clinical Trial
To determine optimal values for transferrin saturation for use in population screening for hereditary hemochromatosis.
BACKGROUND:
Once considered to be a rare disorder, hemochromatosis is now recognized to be one of the
most common autosomal recessive disorders in white populations. Substantial morbidity and
mortality may result from untreated hemochromatosis; thus, early detection and treatment are
essential. The Centers for Disease Control and Prevention and the College of American
Pathologists now recommend regular screening for hereditary hemochromatosis. Transferrin
saturation is regarded as the best single screening test for the detection of individuals at
risk for the disorder.
DESIGN NARRATIVE:
Statistical mixture modeling was used to develop guidelines for hemochromatosis screening
regimes and to determine the frequency of the gene for hemochromatosis. The research was
designed to provide a statistical foundation for the analysis of population transferrin
saturations to assist in development of optimal screening regimens for hemochromatosis. To
determine potential screening thresholds, probability methods were applied to data from the
third National Health and Nutrition Examination Survey (NHANES III), a cross-sectional
probability sample weighted to represent the U.S. population. Statistical mixture modeling
was used to determine potential transferrin saturation screening thresholds to identify
individuals for repeat testing and possible further evaluation. The actual sensitivity and
specificity of these screening thresholds was then assessed using data from a separate
demonstration project, "Cost effective Hemochromatosis Survey in Primary Care", designed to
identify individuals with hemochromatosis. In addition, the gene frequency for
hemochromatosis for whites and ethnic subgroups was also determined by analysis of
transferrin saturation data from NHANES III.
The study has two specific aims, as follow: (1) to develop guidelines for the use of
transferrin saturation and related tests in detection of individuals at risk for
hemochromatosis, and (2) to determine the frequency of the gene for hemochromatosis in the
United States by statistical mixture modeling of population transferrin saturation data from
NHANES III. Providing the statistical foundation for the analysis of transferrin saturations
should facilitate development of optimal, cost-effective screening regimens for
identification of individuals requiring further evaluation for hemochromatosis.
The study completion date listed in this record was obtained from the "End Date" entered in
the Protocol Registration and Results System (PRS) record.
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