Anemia is a disease, not a number

Abstract

Anemia is one of the most common health conditions in the world but remains widely underrecognized and undertreated. This is largely due to the lack of recognition of anemia as a disease worthy of prevention and treatment. In clinical practice, anemia is identified by reference population-based hemoglobin concentration cutoff values.  While simple to use, these reference values are based on limited data, oversimplify anemia diagnosis to a single hemoglobin value at which intervention such as transfusion may be warranted, do not incorporate patient signs and symptoms, lack clinical context, fail to provide information on underlying disease drivers, and ignore the complex relationships between oxygen delivery and consumption.  Hence, there is an urgent need to recognize anemia as a disease that should be identified and addressed in each patient rather than as another laboratory value falling outside of a reference range. To improve anemia diagnosis, we must enhance our understanding of the relationships between hemoglobin concentrations and other laboratory and physiological markers with patient symptoms and patient-centered outcomes across a variety of clinical settings.