PA Medical News about Cholesterol Screening; Youth

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Evaluation of AAP Guidelines for Cholesterol Screening in Youth: Project HeartBeat!
American Journal of Preventive Medicine, 07/07/09

Eissa MA et al. - Sensitivity of detecting abnormal total cholesterol, LDL-C, HDL-C, and triglycerides using family history alone ranged from 38% to 43% and significantly increased to 54%–66% using family history and/or BMI. Specificity significantly decreased from approximately 65% to 52%, and there were no notable changes in PPV. In black children, cholesterol screening using the BMI >=85th percentile criterion had higher sensitivity than when using the family history criterion. In nonblacks, family history and/or BMI >=85th percentile had greater sensitivity than family history alone. When the BMI screening criterion was used along with the family history criterion, sensitivity increased, specificity decreased, and PPV changed trivially for detection of dyslipidemia. Despite increased screening sensitivity by adding the BMI criterion, a clinically significant number of children still may be misclassified.