title: [Reliability and validity of palmar and conjunctival pallor for anemia detection purposes].
abstract: OBJECTIVE
  To evaluate the reliability and the validity of the use of simple clinical signs as a method of anemia detection.
  
  
  METHODS
  The study was carried out in a S o Paulo, Brazil, day-care center, and included 135 children from ages 3 months-6 years. Hemoglobin level results and palmar and conjunctival pallor assessment were used. Children with Hb under 11g/dl were considered as anemic; subjective criteria were used for the assessment of palmar and conjunctival pallor. Kappa statistics were used in order to verify agreement, and, in order to evaluate the technique's validity, sensitivity and specificity levels were calculated.
  
  
  RESULTS
  The results show low levels of agreement. There was a greater level of sensitivity to conjunctival pallor than to palmar pallor. Specificity results may be considered as good.
  
  
  CONCLUSIONS
  It is still early to recommend the routine use of this technique. However, it could promote substantial savings if perfected.
authors.affiliation: Secretaria Municipal da Assistência Social, Prefeitura do Município de São Paulo, São Paulo, SP, Brasil.
authors.forename: Mônica Glória N
authors.initials: MG
authors.lastname: Spinelli
authors.forename: José Maria P
authors.initials: JM
authors.lastname: Souza
authors.forename: Sônia B de
authors.initials: SB
authors.lastname: Souza
authors.forename: Edna H
authors.initials: EH
authors.lastname: Sesoko
mesh_terms: D000740:Anemia / Q000150:complications* / Q000175:diagnosis; D002675:Child, Preschool; D003228:Conjunctiva; D005260:Female; D006225:Hand; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007223:Infant; D008297:Male; D008403:Mass Screening; D010167:Pallor / Q000209:etiology*; D010808:Physical Examination / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D006454:Hemoglobins