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Created: Aug 30, 2019
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Hemoglobin Levels in Children
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Introduction

Hemoglobin is a protein in the red blood cells whose main job is to transport oxygen throughout the body. Hemoglobin counts can be slightly lower than normal and not cause any issues, however if a person’s hemoglobin is significantly low, it could indicate a condition called anemia. Causes of anemia can vary based on age, however “twenty percent of American children will have anemia at some point in their childhood.” (Janus & Moerschel, 2010) We have examined children in this study to determine if there is a difference between the hemoglobin levels in healthy children and children with anemia.

Anemia can present from three different variations; anemia from red blood cells breaking down to fast, anemia from bleeding, or anemia from red blood cells being made to slowly. Regardless of how anemia presents in a child, it can produce developmental delays or behavioral problems if not addressed and treated within a timely manner. (Miller, 2019) Normal hemoglobin levels for children are 11g/dL to 13 g/dL.

Data/Methods

For this study, a convenience sample of one thousand children were taken; from 500 children with iron deficiency and from 500 reportedly healthy children. Hemoglobin levels were recorded for each child and listed in measurements of g/dL.

We will conduct an independent, two-sample T-test for this data. Our sample seems to have been collected in a reasonable manner with no obvious biases. There are no evident relationships between the samples and sample sizes are large enough to satisfy normality conditions. Based on comparative box plots, we did not see any evidence of differing variability.

Analysis

A two sample T-test was conducted and showed that the average hemoglobin level in the healthy children group was higher than the average hemoglobin level of the children with anemia group (T = 62.4, p-value = <0.0001).

Result 1: Two sample T hypothesis test   [Info]

Two sample T hypothesis test:


μ1 : Mean of Hemoglobin where Group=Healthy
μ2 : Mean of Hemoglobin where Group=Anemia
μ1 - μ2 : Difference between two means
H0 : μ1 - μ2 = 0
HA : μ1 - μ2 > 0
(with pooled variances)

Hypothesis test results:
DifferenceSample Diff.Std. Err.DFT-StatP-value
μ1 - μ26.07020.09726502899862.408865<0.0001

We then performed a confidence interval to determine by how much the difference in the two groups was measured. It is with 95% confidence that the average hemoglobin level in the healthy children group is between 5.87 g/dL and 6.26 g/dL higher than those in the children with anemia group.

Result 2: Two sample T confidence interval   [Info]

Two sample T confidence interval:


μ1 : Mean of Hemoglobin where Group=Healthy
μ2 : Mean of Hemoglobin where Group=Anemia
μ1 - μ2 : Difference between two means
(with pooled variances)

95% confidence interval results:
DifferenceSample Diff.Std. Err.DFL. LimitU. Limit
μ1 - μ26.07020.0972650289985.87933266.2610674

Conclusion

The results from our study support our research hypothesis that there is a difference in the group means between healthy children and children with anemia. Children with anemia are likely to have hemoglobin levels that are half of the hemoglobin levels of healthy children. This would be concerning for both healthcare individuals and parents of children with anemia due to the potential complications; fatigue, weakened immune system, irregular heartbeat, heart conditions, etc. Hemoglobin levels should be regularly monitored in children and corrected with either medication or blood transfusions if they continue to be low.

Referenes

Janus, J. M., & Moerschel, S. M. (2010). Evaluation of Anemia in Children. American Family Physician, 1462-1471.

Mayo Clinic. (2019). Low Hemoglobin Count. Retrieved from Mayo Clinic: https://www.mayoclinic.org/symptoms/low-hemoglobin/basics/definition/sym-20050760

 

Miller, R. M. (2019). Anemia. Retrieved from Kids Health: https://kidshealth.org/en/parents/anemia.html

HTML link:
<A href="https://www.statcrunch.com/5.0/viewreport.php?reportid=88976">Hemoglobin Levels in Children</A>

Comments
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By nku.dr.nolan
Aug 31, 2019

Hi Kelsey - a few comments to assist:

1. What was your basis for using pooled variances (standard deviations)? This might be a bit aggressive in this case (see solutions), though it doesn't seem to actually matter here.
2. Your statistical conclusions are well written, I'm happy to see that!

Pretty strong report overall.
By cari.hollenkamp13
Aug 30, 2019

Kelsey,
I agree with the statistical method you chose. With that large of a sample size and the variables not be dependent, the two-sample method was a good choice. I also agree with your conclusion that from this study, it is important to continue to monitor anemic children's' hemoglobin levels for safety reasons. Good job creating a well thought out report.
By laura.boettcher24
Aug 30, 2019

Kelsey,
I enjoyed your report. I like how you noted that 20% of children will have anemia at some point in their life - it just goes to show how important it is to educate the public on the topic. Young patients would need to be monitored for possible transfusion need. But how Teagin stated below, it would be better to get iron from food or supplements before it reaches the need of transfusion.
By teagin.woodrum11
Aug 30, 2019

I also did my report on hemoglobin levels in children. Knowing that anemic children's hemoglobin levels may be reasonably lower than healthy children, I agree that health care professionals should monitor this patient population frequently. And to go along with walker's comment and a suggestion for your conclusion: It is my opinion that these children should receive nutrition education upon diagnosis w/ anemia. This education should explore the different types of iron rich foods (heme and nonheme) and eating these in combination w/ vitamin C to help with better absorption. When possible, it is always best to get nutrients from food FIRST. If we can avoid the possibility of low measurements, that is better than needing to supplement or transfuse.
By walkerj10
Aug 30, 2019

What clinical suggestions can be made from this data? Is the 5.87g/dL - g/dL significant enough to warrant some sort of medical prevention/assistance to help those with anemia? Or is the difference small enough that it doesn't warrant any change to medical care or preventative measures?

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