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Rimon et al¹ studied the transferrin receptor–ferritin index (TR-F index) in the evaluation of iron deficiency anemia (IDA) in the elderly. The authors concluded that "routine blood tests [have] a very low sensitivity" and that "the TR-F index is much more sensitive." Furthermore, they suggested that a positive TR-F index can eliminate the need for bone marrow evaluation.

Including the serum ferritin with multiple "routine laboratory tests" for IDA caused the authors to come to an erroneous conclusion. Table 1 of the article reveals that the mean ± SD serum ferritin level was 13.7 ± 5.2 ng/mL among patients with anemia and those without anemia had a mean ± SD serum ferritin level of 363.9 ± 222.2 ng/mL. A serum ferritin level of less than 19 ng/mL virtually established the diagnosis of IDA in the study group. In a study by Guyatt et al,² the authors demonstrated that a serum . . . [Full Text of this Article]