title: Non-high-density lipoprotein cholesterol calculation and goal awareness among physicians-in-training.
abstract: BACKGROUND
  Non-high density lipoprotein cholesterol (non-HDL-C) goal attainment per Adult Treatment Panel III (ATP III) guidelines remains low.
  
  
  OBJECTIVE
  To understand gaps in knowledge and practices of physicians-in-training (internal medicine, family medicine, cardiology, endocrinology) towards non-HDL-C.
  
  
  METHODS
  A survey based on a conceptual model to assess the trainee's knowledge, attitudes, and practice regarding non-HDL-C was developed and administered to physicians-in-training (n = 655) at 26 training programs in the United States. Responses of those in internal medicine and family medicine (residents-in-training; n = 418) were compared with those in cardiology and endocrinology (fellows-in-training; n = 124).
  
  
  RESULTS
  Response rate was 83.7%. Fifty-three percent of residents and 31% of fellows-in-training had not read the ATP III guidelines (P < .001). Thirty-three percent of the residents and 35% fellows-in-training could not calculate non-HDL-C from a standard lipid panel (P = .7). Sixty-seven percent of the residents and 52% of fellows were not aware of treatment goals for non-HDL-C (P = .004 for comparison between residents and fellows). Both residents and fellows reported infrequent calculation of non-HDL-C levels in patients with elevated triglycerides (≥200 mg/dL; 32.5% vs 35.4%, respectively, P = .6). Lack of familiarity with ATP III guidelines, lack of knowledge regarding importance of non-HDL-C, lack of institutional mandate to calculate non-HDL-C, and lack of emphasis on non-HDL-C by teaching staff were reported as barriers to non-HDL-C use in routine clinical practice.
  
  
  CONCLUSIONS
  At least one-third of physicians-in-training could not calculate non-HDL-C from a standard lipid panel, and a large number were not aware of ATP III treatment goals pertaining to non-HDL-C. This area represents one for improvement if non-HDL-C is to be retained as a treatment target in the forthcoming ATP-IV guidelines.
authors.affiliation: Section of Atherosclerosis and Vascular Medicine, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Smita I
authors.initials: SI
authors.lastname: Negi
authors.forename: Lynne
authors.initials: L
authors.lastname: Steinberg
authors.forename: Venkateshwar R
authors.initials: VR
authors.lastname: Polsani
authors.forename: Saqib A
authors.initials: SA
authors.lastname: Gowani
authors.forename: Vijay
authors.initials: V
authors.lastname: Nambi
authors.forename: Varinder
authors.initials: V
authors.lastname: Kumar
authors.forename: Victor
authors.initials: V
authors.lastname: Marinescu
authors.forename: Peter H
authors.initials: PH
authors.lastname: Jones
authors.forename: Laura A
authors.initials: LA
authors.lastname: Petersen
authors.forename: Christie M
authors.initials: CM
authors.lastname: Ballantyne
authors.forename: Salim S
authors.initials: SS
authors.lastname: Virani
mesh_terms: D000328:Adult; D002784:Cholesterol / Q000097:blood*; D005260:Female; D006040:Goals; D019538:Health Care Surveys; D006801:Humans; D007396:Internship and Residency; D008297:Male; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires
chemical_list: D002784:Cholesterol