Navigation Links
New lipid screening guidelines for children overly aggressive, UCSF researchers say
Date:7/22/2012

Recent guidelines recommending cholesterol tests for children fail to weigh health benefits against potential harms and costs, according to a new commentary authored by three physician-researchers at UCSF.

Moreover, the recommendations are based on expert opinion, rather than solid evidence, the researchers said, which is especially problematic since the guidelines' authors disclosed extensive potential conflicts of interest.

The guidelines were written by a panel assembled by the National Heart, Lung and Blood Institute (NHLBI) and published in Pediatrics, in November 2011. They also were endorsed by the American Academy of Pediatrics. The guidelines call for universal screening of all 9 to 11-year-old children with a non-fasting lipid panel, and targeted screening of 30 to 40 percent of 2 to 8-year-old and 12 to 16-year old children with two fasting lipid profiles. Previous recommendations called only for children considered at high risk of elevated levels to be screened with a simple non-fasting total cholesterol test.

The call for a dramatic increase in lipid screening has the potential to transform millions of healthy children into patients labeled with so-called dyslipidemia, or bad lipid levels in the blood, according to the commentary by Thomas Newman, MD, MPH, Mark Pletcher, MD, MPH and Stephen Hulley, MD, MPH, of the UCSF Department of Epidemiology and Biostatistics and e-published on July 23 in Pediatrics.

"The panel made no attempt to estimate the magnitude of the health benefits or harms of attaching this diagnosis at this young age," said Newman. "They acknowledged that costs are important, but then went ahead and made their recommendations without estimating what the cost would be. And it could be billions of dollars."

Some of the push to do more screening comes from concern about the obesity epidemic in U.S. children. But this concern should not lead to more laboratory testing, said Newman.

"You don't need a blood test to tell who needs to lose weight. And recommending a healthier diet and exercise is something doctors can do for everybody, not just overweight kids," he said

The requirement of two fasting lipid panels in 30 to 40 percent of all 2 to 8-year olds and 12 to 16 year- olds represents a particular burden to families, he said.

"Because these blood tests must be done while fasting, they can't be done at the time of regularly scheduled 'well child' visits like vaccinations can," said Newman. "This requires getting hungry young children to the doctor's office to be poked with needles on two additional occasions, generally weekday mornings. Families are going to ask their doctors, 'Is this really necessary?' The guidelines provide no strong evidence that it is."

The authors note that the panel chair and all members who drafted the lipid screening recommendations disclosed an "extensive assortment of financial relationships with companies making lipid lowering drugs and lipid testing instruments." Some of those relevant relationships include paid consultancies or advisory board memberships with pharmaceuticals that produce cholesterol-lowering drugs such as Merck, Pfizer, Astra Zeneca, Bristol-Myers Squibb, Roche and Sankyo.

"The panel states that they reviewed and graded the evidence objectively," said Newman. "But a recent Institute of Medicine report recommends that experts with conflicts of interest either be excluded from guideline panels, or, if their expertise is considered essential, should have non-voting, non-leadership, minority roles."

Evidence is needed to estimate health benefits, risks and costs of these proposed interventions, and experts without conflicts of interest are needed to help synthesize it, according to Newman. He said that "these recommendations fall so far short of this ideal that we hope they will trigger a re-examination of the process by which they were produced."


'/>"/>

Contact: Juliana Bunim
juliana.bunim@ucsf.edu
415-502-6397
University of California - San Francisco
Source:Eurekalert  

Related medicine news :

1. Lipid helps cells find their way by keeping their antennae up
2. Spinal cord injury researchers win Apple Award for article on niacin for dyslipidemia
3. HPV testing in HIV-positive women may help reduce frequent cervical cancer screening
4. Study reveals optimal interval for stomach cancer screening
5. No Dip in Cancer Screening for Rheumatoid Arthritis Patients
6. Cancer screening rates comparable for those with and without rheumatoid arthritis
7. Study suggests new screening method for sudden death in athletes
8. New screening test to help people with hearing loss in China
9. SingleSource Background Screening Company Calls On Adults To Take Proactive Approach To Stop Child Sexual Abuse
10. Better Health Screening Urged for Female College Athletes
11. Task force recommends new lung cancer screening guidelines
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
New lipid screening guidelines for children overly aggressive, UCSF researchers say
(Date:8/18/2017)... ... ... Pastor and Overseer at The House of Yahweh in Abilene, Texas, has released a new ... the mother of the Savior whom the world calls “Mother Mary”. Yisrayl says when compared ... of this historical woman. , “The world bows, kisses the feet of, cries out ...
(Date:8/18/2017)... CARMEL, IN (PRWEB) , ... August 18, 2017 , ... ... 36th annual list, the most prestigious ranking of the nation's fastest-growing private companies. This ... in the exclusive Inc. 5000 ranking . This year’s ranking reflects ASH’s 76 ...
(Date:8/18/2017)... ... 18, 2017 , ... “Our Mountains to Climb: A Journey of Love and ... stronger together through the faith they shared to overcome struggles in life. “Our Mountains ... published author, Barbara J. Corcoran, a retired teacher and happily married since 1999; the ...
(Date:8/18/2017)... ... ... “Three Narrow Roads”: a vivid and provocative look into the narrow path toward ... Sr., is currently the pastor-teacher-visionary at Simply the WORD Church, a global prayer ministry ... program geared towards youth. , King shares, “When I take time to think about ...
(Date:8/18/2017)... ... August 18, 2017 , ... “Depressed: Super Heroes of the Bible”: ... reflect upon the stories and the relevance these tales may have on the reader’s ... Linhart, a former special education teacher, Jessica spends much of her time enjoying nature ...
Breaking Medicine News(10 mins):
(Date:7/31/2017)... July 31, 2017 7D Surgical, developer of ground ... purchased the 7D Surgical System to support its strategic sales ... D.C. and Virginia.  7D Surgical has entered into ... of the premier medical facilities within those markets. ... ...
(Date:7/28/2017)... --EnvoyHealth, a Diplomat company, has partnered with Compliance Meds ... a technology designed to improve patient medication adherence. ... solutions and services that help track and improve patients, ... LITE offers medication monitoring and control for patients and ... Records date and time of bottle ...
(Date:7/27/2017)... Pa., July 27, 2017  West Pharmaceutical Services, Inc. ... results for the second-quarter 2017 and updated financial guidance ... Second-Quarter 2017 Highlights Reported net ... over the prior-year quarter. Net sales at constant currency ... reported-diluted EPS was $0.51, compared to $0.60 in the ...
Breaking Medicine Technology: