Barely Significant
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may be significant

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In the literature

Despite the low incidence rate of these recessive mutations, their medical relevance may be significant, because some heterozygous cases occur together with epigenetic allele silencing of the wild type allele resulting in a pseudo-recessive phenotype, including severe facial and proximal weakness, scoliosis, opthalmoplegia and respiratory impairment 42 , 43 .
However, in some instances, a notable decrease in MCV may be significant, and the coexistence of both Fe deficiency and thalassemia is not uncommon.[ 7 ] When the Hb level is <9 g/dl in patients with microcytic anemia and the level of Fe is normal, hemoglobinopathy should be suspected, and Hb-electrophoresis must be performed to evaluate Hb A2 and F levels.
Furthermore, some studies have shown that interhospital transfers are not without risk, as they may cause depression, pain, and loss of independence, functional status may worsen, patient satisfaction may diminish, the cost of transfer may be significant, and quality of care issues may arise (pressure ulcers, falls, transitions of care leading to medication errors). 17 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 Without understanding the risks of iatrogenic harm, the likelihood of intervention at the receiving hospital and alternative care options, patients and informal caregivers cannot select the care most consistent with their goals and values.