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Estimating lifetime risk of developing high serum total cholesterol: adjustment for baseline prevalence and single-occasion measurements.

Publication ,  Journal Article
Pencina, MJ; D'Agostino, RB; Beiser, AS; Cobain, MR; Vasan, RS
Published in: Am J Epidemiol
February 15, 2007

The lifetime risk statistic is a powerful tool in epidemiology. It has been successfully applied to estimate and highlight the risks of numerous diseases, including breast cancer, Alzheimer's disease, stroke, and coronary heart disease and some of its risk factors. Application of this method to health-related conditions that may have an onset early in young adulthood or to measurements that can fluctuate over time introduces problems of under- or overestimation of risk. To correctly quantify the long-term risk of developing high serum total cholesterol (> or =240 mg/dl or use of lipid-lowering medication), the authors propose a key modification of the lifetime risk statistic: adjustment for baseline prevalence. It accounts for the fact that many people already have the condition at a young age (an age often chosen as baseline). The authors derive point estimators and confidence intervals and supply a SAS macro (SAS Institute, Inc., Cary, North Carolina). For assessment of the risk inflation due to single-occasion measurement, the authors suggest two diagnostic tools, one requiring the condition to be present on two consecutive occasions and the other taking into account intrasubject variability. As an illustration, the authors calculate risk estimates for US Caucasians based on hypercholesterolemia incidence (1971-early 2001) from the Framingham Heart Study and prevalence data from the 1999-2000 National Health and Nutrition Examination Survey.

Duke Scholars

Published In

Am J Epidemiol

DOI

ISSN

0002-9262

Publication Date

February 15, 2007

Volume

165

Issue

4

Start / End Page

464 / 472

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Survival Rate
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • Prognosis
  • Prevalence
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
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Pencina, M. J., D’Agostino, R. B., Beiser, A. S., Cobain, M. R., & Vasan, R. S. (2007). Estimating lifetime risk of developing high serum total cholesterol: adjustment for baseline prevalence and single-occasion measurements. Am J Epidemiol, 165(4), 464–472. https://doi.org/10.1093/aje/kwk025
Pencina, Michael J., Ralph B. D’Agostino, Alexa S. Beiser, Mark R. Cobain, and Ramachandran S. Vasan. “Estimating lifetime risk of developing high serum total cholesterol: adjustment for baseline prevalence and single-occasion measurements.Am J Epidemiol 165, no. 4 (February 15, 2007): 464–72. https://doi.org/10.1093/aje/kwk025.
Pencina MJ, D’Agostino RB, Beiser AS, Cobain MR, Vasan RS. Estimating lifetime risk of developing high serum total cholesterol: adjustment for baseline prevalence and single-occasion measurements. Am J Epidemiol. 2007 Feb 15;165(4):464–72.
Pencina, Michael J., et al. “Estimating lifetime risk of developing high serum total cholesterol: adjustment for baseline prevalence and single-occasion measurements.Am J Epidemiol, vol. 165, no. 4, Feb. 2007, pp. 464–72. Pubmed, doi:10.1093/aje/kwk025.
Pencina MJ, D’Agostino RB, Beiser AS, Cobain MR, Vasan RS. Estimating lifetime risk of developing high serum total cholesterol: adjustment for baseline prevalence and single-occasion measurements. Am J Epidemiol. 2007 Feb 15;165(4):464–472.
Journal cover image

Published In

Am J Epidemiol

DOI

ISSN

0002-9262

Publication Date

February 15, 2007

Volume

165

Issue

4

Start / End Page

464 / 472

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Survival Rate
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • Prognosis
  • Prevalence
  • Middle Aged
  • Male