Evaluation of a simple method for measuring blood cholesterol levels using non-laboratory observers.
OBJECTIVE
Blood cholesterol is a good estimator of risk for coronary heart disease. Six criteria for a screening cholesterol measurement are: (1) high predictive value of elevated cholesterol compared with a "gold standard" cholesterol measurement; (2) high correlation with the national reference system for cholesterol; (3) acceptable results obtainable by volunteer observers; (4) results available quickly; (5) reproducible results; and (6) low cost. We hypothesized that cholesterol measurements performed on the Reflotron by volunteer nurses would meet these criteria.


METHODS
We recruited 345 subjects (160 men, 185 women, aged 20 to 84) and measured their blood cholesterol level by a method calibrated under the National Heart, Lung, and Blood Institute Lipid Standardization Program (Lab-chol) and on the Reflotron (R-chol method).


RESULTS
Comparison of the results showed good agreement (slope = 0.937; intercept = 0.27 mmol/liter). Comparison of the risk assignments made by the R-chol method against those made by the Lab-chol method, using the 1987 Adult Treatment Panel classification criteria, showed that the R-chol method has a sensitivity of 0.79 and a specificity of 0.98. Assuming a national prevalence of hypercholesterolemia of 25 percent, the positive predictive value is 0.92 and the negative predictive value is 0.93. The cost per screen was $1.25.


CONCLUSIONS
These data show that volunteer observers can obtain screening cholesterol results on the Reflotron that are accurate, reliable, quickly available at a low cost, and have high predictive value for hypercholesterolemia.
Department of Medicine, University of Colorado Health Sciences Center, Denver 80262.
J R
JR
Pearson
L J
LJ
Dusenbury
R
R
Bakes-Martin
M
M
Loverde
J
J
Johnson
R L
RL
Byyny
D000328:Adult; D000368:Aged; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011933:Reagent Kits, Diagnostic; D012016:Reference Values; D014280:Triglycerides / Q000097:blood
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D011933:Reagent Kits, Diagnostic; D014280:Triglycerides; D002784:Cholesterol