Individual-, Family-, Community-, and Policy-Level Impact of a School-Based Cardiovascular Risk Detection Screening Program for Children in Underserved, Rural Areas: The CARDIAC Project

Cottrell, Lesley; John, Collin; Murphy, Emily; Lilly, Christa; Ritchie, Susan; Elliott, Eloise; Minor, Valerie; Neal, William A.

doi:10.1155/2013/732579

Cited by 19 publications

(18 citation statements)

References 12 publications

(13 reference statements)

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“…46,47 Additional studies should explore the benefits of childhood screening in identifying adults at high risk of CVD, such as in the CARDIAC project. 22,24 Our review and its included studies have limitations. Evidence for the impact of childhood screening on long-term health may not be possible to obtain.…”

Section: Costs and Cost-effectiveness Of Screeningmentioning

confidence: 99%

“…Twenty-one, including nine new studies published since 2005 [19][20][21][22][23][24][25][26][27] , were eligible for inclusion as shown in Figure 2. Three studies described different components of a large school-based screening intervention (the CARDIAC project) 20,22,24 ; the rest represented separate studies.…”

Section: Description Of Studiesmentioning

confidence: 99%

“…Three studies described different components of a large school-based screening intervention (the CARDIAC project) 20,22,24 ; the rest represented separate studies.…”

Section: Description Of Studiesmentioning

confidence: 99%

“…22,26,31,32,38 Four studies focused on nutrition counseling; none reported children receiving drug therapy for dyslipidemia. In Cottrell et al 2013, 40% of parents reported making changes in their child's diet, and 33% reported making changes in physical activity (N=342 parents). 22 In Skovby et al, 92% of families of children with LDL-C ≥ 155 mg/dl reported participating in nutrition counseling and follow-up at a pediatric lipid clinic (N=2085 children).…”

Section: Follow-up Carementioning

confidence: 99%

“…26 Two studies on the CARDIAC project in West Virginia examined cholesterol screening in family members after child screening. 22,24 Overall, 6.5% of parents participated in free cholesterols screening after their child was screened. Parents whose child had elevated cholesterol were more likely to participate in screening (p not reported).…”

Section: Follow-up Carementioning

confidence: 99%

See 4 more Smart Citations

Universal Cholesterol Screening in Childhood: A Systematic Review

Smith

Turner

Kinra

2016

Academic Pediatrics

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Section: Costs and Cost-effectiveness Of Screeningmentioning

confidence: 99%

Section: Description Of Studiesmentioning

confidence: 99%

“…Three studies described different components of a large school-based screening intervention (the CARDIAC project) 20,22,24 ; the rest represented separate studies.…”

Section: Description Of Studiesmentioning

confidence: 99%

Section: Follow-up Carementioning

confidence: 99%

Section: Follow-up Carementioning

confidence: 99%

See 3 more Smart Citations

Universal Cholesterol Screening in Childhood: A Systematic Review

Smith

Turner

Kinra

2016

Academic Pediatrics

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Screening for Lipid Disorders in Children and Adolescents

Bibbins‐Domingo

Grossman

Curry

et al. 2016

JAMA

153

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IMPORTANCE Elevations in levels of total, low-density lipoprotein, and non-high-density lipoprotein cholesterol; lower levels of high-density lipoprotein cholesterol; and, to a lesser extent, elevated triglyceride levels are associated with risk of cardiovascular disease in adults.OBJECTIVE To update the 2007 US Preventive Services Task Force (USPSTF) recommendation on screening for lipid disorders in children, adolescents, and young adults.EVIDENCE REVIEW The USPSTF reviewed the evidence on screening for lipid disorders in children and adolescents 20 years or younger-1 review focused on screening for heterozygous familial hypercholesterolemia, and 1 review focused on screening for multifactorial dyslipidemia.FINDINGS Evidence on the quantitative difference in diagnostic yield between universal and selective screening approaches, the effectiveness and harms of long-term treatment and the harms of screening, and the association between changes in intermediate outcomes and improvements in adult cardiovascular health outcomes are limited. Therefore, the USPSTF concludes that the balance of benefits and harms cannot be determined.

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Screening for Lipid Disorders in Children and Adolescents

Evans

Coppola

Redmond

et al. 2023

JAMA

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ImportanceLipid screening in childhood and adolescence can lead to early dyslipidemia diagnosis. The long-term benefits of lipid screening and subsequent treatment in this population are uncertain.ObjectiveTo review benefits and harms of screening and treatment of pediatric dyslipidemia due to familial hypercholesterolemia (FH) and multifactorial dyslipidemia.Data SourcesMEDLINE and the Cochrane Central Register of Controlled Trials through May 16, 2022; literature surveillance through March 24, 2023.Study SelectionEnglish-language randomized clinical trials (RCTs) of lipid screening; recent, large US cohort studies reporting diagnostic yield or screen positivity; and RCTs of lipid-lowering interventions.Data Extraction and SynthesisSingle extraction, verified by a second reviewer. Quantitative synthesis using random-effects meta-analysis.Main Outcomes and MeasuresHealth outcomes, diagnostic yield, intermediate outcomes, behavioral outcomes, and harms.ResultsForty-three studies were included (n = 491 516). No RCTs directly addressed screening effectiveness and harms. Three US studies (n = 395 465) reported prevalence of phenotypically defined FH of 0.2% to 0.4% (1:250 to 1:500). Five studies (n = 142 257) reported multifactorial dyslipidemia prevalence; the prevalence of elevated total cholesterol level (≥200 mg/dL) was 7.1% to 9.4% and of any lipid abnormality was 19.2%. Ten RCTs in children and adolescents with FH (n = 1230) demonstrated that statins were associated with an 81- to 82-mg/dL greater mean reduction in levels of total cholesterol and LDL-C compared with placebo at up to 2 years. Nonstatin-drug trials showed statistically significant lowering of lipid levels in FH populations, but few studies were available for any single drug. Observational studies suggest that statin treatment for FH starting in childhood or adolescence reduces long-term cardiovascular disease risk. Two multifactorial dyslipidemia behavioral counseling trials (n = 934) demonstrated 3- to 6-mg/dL greater reductions in total cholesterol levels compared with the control group, but findings did not persist at longest follow-up. Harms reported in the short-term drug trials were similar in the intervention and control groups.Conclusions and RelevanceNo direct evidence on the benefits or harms of pediatric lipid screening was identified. While multifactorial dyslipidemia is common, no evidence was found that treatment is effective for this condition. In contrast, FH is relatively rare; evidence shows that statins reduce lipid levels in children with FH, and observational studies suggest that such treatment has long-term benefit for this condition.

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Individual-, Family-, Community-, and Policy-Level Impact of a School-Based Cardiovascular Risk Detection Screening Program for Children in Underserved, Rural Areas: The CARDIAC Project

Cited by 19 publications

References 12 publications

Universal Cholesterol Screening in Childhood: A Systematic Review

Universal Cholesterol Screening in Childhood: A Systematic Review

Screening for Lipid Disorders in Children and Adolescents

Screening for Lipid Disorders in Children and Adolescents

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