A mathematical representation of the expert panel's guidelines for high blood cholesterol case-finding and treatment.
The National Cholesterol Education Program (NCEP) for high blood cholesterol case-finding and treatment recommended discrete treatments according to the results of sequential measurements of continuous variables (total and low-density lipoprotein cholesterol [LDL-C]). These measurements are subject to intra- and interindividual variability. The authors describe a computer simulation of the NCEP that acknowledges these complexities. The simulation reduces the NCEP into steps, which are represented in a decision tree. The calculation of probabilities at chance nodes takes into account the conditional nature of sequential measurements of blood cholesterol. The simulation tracks medical resource use and estimates LDL-C reductions within 20 strata, each defining 5% of population distribution for LDL-C. This approach enables a detailed representation of the case-finding process--the sequence of blood cholesterol tests and associated cut-off values that identify individuals needing more intensive evaluation and treatment.
Weissfeld
J L
JL
Medical Service, Ann Arbor Veterans Administration Medical Center, MI 48105.
Weissfeld
L A
LA
Holloway
J J
JJ
Bernard
A M
AM
D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D002985:Clinical Protocols; D003198:Computer Simulation; D003663:Decision Trees; D006801:Humans; D006937:Hypercholesterolemia / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011336:Probability; D012307:Risk Factors; D012680:Sensitivity and Specificity
D008078:Cholesterol, LDL; D002784:Cholesterol