An internist sees a 70-year-old man whose main problem is fatigue. The initial investigation reveals a hemoglobin of 90 g/L. The internist suspects iron deficiency anemia. How might she proceed?

The way of the past

When faced with this situation during her training just a few years earlier, the internist was told by the attending physician that one ordered serum ferritin and transferrin saturation and proceeded according to the results. She now follows this path. If both results come back below the laboratory's lower limit of normal, she will make a diagnosis of iron deficiency anemia, and investigate and treat ...

References

  • 1 Guyatt GH, Patterson C, Ali M, et al. Diagnosis of iron-deficiency anemia in the elderly. Am J Med. 1990;88:205-9. Google Scholar
  • 2 Sackett DL, Haynes RB, Guyatt GH, Tugwell P. Clinical Epidemiology, a Basic Science for Clinical Medicine. 2nd ed. Boston: Little, Brown and Company. [In press for 1991]. Google Scholar
  • 3 Guyatt GH, Keller JL, Jaeschke R, et al. The n-of-1 randomized controlled trial: clinical usefulness. Our three-year experience. Ann Intern Med. 1990;112:293-9. Google Scholar

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