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A Cost Analysis of Universal versus Targeted Cholesterol Screening in Pediatrics.

Publication ,  Journal Article
Smith, AJ; Turner, EL; Kinra, S; Bodurtha, JN; Chien, AT
Published in: J Pediatr
May 2018

OBJECTIVE: To compare the number of children needed to screen to identify a case of childhood dyslipidemia and estimate costs under universal vs targeted screening approaches. STUDY DESIGN: We constructed a decision-analytic model comparing the health system costs of universal vs targeted screening for hyperlipidemia in US children aged 10 years over a 1-year time horizon. Targeted screening was defined by family history: dyslipidemia in a parent and/or early cardiovascular disease in a first-degree relative. Prevalence of any hyperlipidemia (low-density lipoprotein [LDL] ≥130 mg/dL) and severe hyperlipidemia (LDL ≥190 mg/dL or LDL ≥160 mg/dL with family history) were obtained from published estimates. Costs were estimated from the 2016 Maryland Medicaid fee schedule. We performed sensitivity analyses to evaluate the influence of key variables on the incremental cost per case detected. RESULTS: For universal screening, the number needed to screen to identify 1 case was 12 for any hyperlipidemia and 111 for severe hyperlipidemia. For targeted screening, the number needed to screen was 7 for any hyperlipidemia and 49 for severe hyperlipidemia. The incremental cost per case detected for universal compared with targeted screening was $1980 for any hyperlipidemia and $32 170 for severe hyperlipidemia. CONCLUSIONS: Our model suggests that universal cholesterol screening detects hyperlipidemia at a low cost per case, but may not be the most cost-efficient way to identify children with severe hyperlipidemia who are most likely to benefit from treatment.

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Published In

J Pediatr

DOI

EISSN

1097-6833

Publication Date

May 2018

Volume

196

Start / End Page

201 / 207.e2

Location

United States

Related Subject Headings

  • Prevalence
  • Pediatrics
  • Pediatrics
  • Mass Screening
  • Male
  • Hyperlipidemias
  • Humans
  • Health Care Costs
  • Female
  • Dyslipidemias
 

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Smith, A. J., Turner, E. L., Kinra, S., Bodurtha, J. N., & Chien, A. T. (2018). A Cost Analysis of Universal versus Targeted Cholesterol Screening in Pediatrics. J Pediatr, 196, 201-207.e2. https://doi.org/10.1016/j.jpeds.2018.01.027
Smith, Anna Jo, Elizabeth L. Turner, Sanjay Kinra, Joann N. Bodurtha, and Alyna T. Chien. “A Cost Analysis of Universal versus Targeted Cholesterol Screening in Pediatrics.J Pediatr 196 (May 2018): 201-207.e2. https://doi.org/10.1016/j.jpeds.2018.01.027.
Smith AJ, Turner EL, Kinra S, Bodurtha JN, Chien AT. A Cost Analysis of Universal versus Targeted Cholesterol Screening in Pediatrics. J Pediatr. 2018 May;196:201-207.e2.
Smith, Anna Jo, et al. “A Cost Analysis of Universal versus Targeted Cholesterol Screening in Pediatrics.J Pediatr, vol. 196, May 2018, pp. 201-207.e2. Pubmed, doi:10.1016/j.jpeds.2018.01.027.
Smith AJ, Turner EL, Kinra S, Bodurtha JN, Chien AT. A Cost Analysis of Universal versus Targeted Cholesterol Screening in Pediatrics. J Pediatr. 2018 May;196:201-207.e2.
Journal cover image

Published In

J Pediatr

DOI

EISSN

1097-6833

Publication Date

May 2018

Volume

196

Start / End Page

201 / 207.e2

Location

United States

Related Subject Headings

  • Prevalence
  • Pediatrics
  • Pediatrics
  • Mass Screening
  • Male
  • Hyperlipidemias
  • Humans
  • Health Care Costs
  • Female
  • Dyslipidemias