Abstract P133: National and Regional Lipid Screening Rates in Youth: A Synthesis of Available Evidence
Background: Lipid screening rates in U.S. youth are very low compared to screening for other risk factors such as hypertension. As a result, few youth with familial hypercholesterolemia, which substantially increases the risk of developing Atherosclerotic Cardiovascular Disease (ASCVD) in adulthood, are identified. Published studies have reported greater than a two-fold variation in lipid screening rates. The purpose of this study is to examine the variation and temporal trends in national and regional lipid screening rates from 2002 - 2012 in order to ascertain key variables that impact screening.
Methods: Lipid screening rates among 78k youth from the National Ambulatory Medical Care Survey (NAMCS), and among 660k youth from 5 sites participating in the Pediatric Cardiovascular Research Network (P-CVRN), a practice-based cohort, were used in our analyses. The annual proportion of youth, ages 2 to 21 years, receiving cholesterol screening was calculated for each year over the study period, 2002-2012.
Results: These data show an eight- to three-fold variation in lipid screening rates over the past decade.. Site-level variation, and the departure from national NAMCS estimates, suggests significant differences in practice patterns across the United States. NAMCS national estimates are significantly lower in each year of the study compared to each of the 5 P-CVRN sites. And, while lipid trends are generally decreasing across P-CVRN sites, the NAMCS screening rates have remained constant over the same period.
Figure 1: Cholesterol Screening Rates among Youth, 2002-2012
Conclusions: There are health-system factors contributing to a high variation in lipid screening rates among U.S. youth. Such data also serve as a benchmark to measure the uptake of the 2011 lipid screening guidelines which recommend the addition of universal screening. P-CVRN site estimates from a practice-based cohort suggest screening rates are higher than those determined through the NAMCS sample.
Author Disclosures: S. Gregory: A. Employment; Significant; Texas A&M University. C. McNeal: None. J. Zachariah: None. D. Tan: None. A. Cassidy-Bushrow: None. J. Tom: None. J. VanWormer: None. E. Wright: None. L. Copeland: None.
- © 2015 by American Heart Association, Inc.