The American Academy of Pediatrics recommends that children and adolescents with a family history of premature cardiovascular disease (CVD) and/or parental total cholesterol (TC) ≥6.2 mmol/L be screened for hypercholesterolemia. Questionnaires (from children and parents), clinical and blood sample data were collected in a provincially representative sample of 9-, 13-, and 16-year-olds (n = 2217) in Quebec to evaluate the usefulness of parental history (PH) of CVD and/or parental hypercholesterolemia to screen youth for raised low density lipoprotein cholesterol (LDL-C). Mean bias assessed by an external laboratory gold standard ranged from 1.0% to 2.1%, -0.4% to 5.1%, and -1.4% to 0.1% according to TC, triglyceride, and high density lipoprotein cholesterol tertiles. LDL-C was calculated using the Friedewald equation. Positive PH was defined as one/both biological parents diagnosed with a high cholesterol level, and/or taking cholesterol-lowering medication, and/or ever having had a heart attack, angina, stroke, cerebral vascular disease, peripheral vascular disease, and/or taking medication 'for the heart'. Performance statistics were calculated to determine the usefulness of PH in predicting borderline/high LDL-C (LDL-C ≥2.8 mmol/L) and high LDL-C (LDL-C ≥3.4 mmo1/L). 18.3% and 4.8% of subjects had borderline/high LDL-C and high LDL-C; positive predictive value (PPV) was 23.7% and 7.7%, respectively. Therefore PPVs were only marginally higher than the corresponding population prevalences and likelihood ratios were respectively 1.38 and 1.63: close to 1.00. In conclusion, PH offers little improvement over random screening.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.80313 |
| Date | January 2004 |
| Creators | Lauzon, Béatrice |
| Contributors | O'Loughlin, Jennifer (advisor) |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Master of Science (Department of Epidemiology and Biostatistics.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 002031523, proquestno: AAIMQ98682, Theses scanned by UMI/ProQuest. |
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