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Pediatric cholesterol testing rates low despite guidance
Only about 3% of children and adolescents get their cholesterol tested during health visits, despite guidance from some organizations calling for universal pediatric lipid screening within certain age groups, according findings presented at the Pediatric Academic Societies annual meeting and in JAMA.
According to the study background, approximately one in five US children and adolescents have abnormal lipid values, which can lead to CVD as an adult. Therefore, the NHLBI recommends lipid screening for all children aged 9 to 11 years and all people aged 17 to 21 years, whereas the American Academy of Pediatrics (AAP) and the American Heart Association advocate selective screening, the researchers noted.
However, according to the study background, the US Preventive Services Task Force (USPSTF) did not find enough evidence to recommend any lipid screening among children and adolescents.
Using patient data from the National Ambulatory Medical Care Survey, Samuel R. Vinci, BA, of Boston Children’s Hospital, and colleagues analyzed the frequency of pediatric cholesterol testing, both before and after the USPSTF statement released in 2007 and the AAP statement in 2008.
They found that from 1995 to 2010, cholesterol testing was ordered at 3.4% of 10,159 health maintenance visits reported in the survey. The rate of testing rose slightly during the study period, from 2.5% in 1995 to 3.2% in 2010.
According to the researchers, applying the 2011 NHLBI guideline to 2009 US census data showed that approximately 35% of patients would be eligible for lipid screening during any given year within the 9- to 11-year and 17- to 21-year age groups.
“Testing rates did not appear to increase after 2007-2008, perhaps reflecting the conflicting positions of the AAP and USPSTF,” Vinci and colleagues wrote.
Disclosure: Two researchers report receiving royalties from UpToDate. One researcher reports receiving royalties from Maternal Obesity. One researcher reports receiving funding from the Patient Centered Outcomes Research Institute, and serving on AAP and AHA committees.