Another way of screening for familial hypercholesterolaemia

doi:10.1136/bmj.325.7359.340

BMJ 2002;325:340 ( 10 August )

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Another way of screening for familial hypercholesterolaemia

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EDITOR $---$ We would like to suggest that there is an easier and more cost effective method of screening the population for hyperlipidaemiathan that discussed in Marks et al's paper.¹

The diagnosis of familial hyperlipidaemia requires a family history. In primary care one would expect patients to have a checkof blood pressure at least every five years. A screen of familyhistory might on average add 30 seconds to thisconsultation.

In our practice (list size 5200), using a cost of £25/h, this would produce an additional cost of £436 if the 2097 eligiblepatients (aged over 25 and under 55) were screened. From the 95%we have screened we found 670 patients with a family history ofcoronary heart disease, of whom 22 have a cholesterol concentrationof >7.5 mmol/l. Using the published figure for opportunistic screeningin primary care on the 670, we calculate a cost of £6927, or £2487per case . . . [Full text of this article]

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Relevant Article

Cost effectiveness analysis of different approaches of screening for familial hypercholesterolaemia: Dalya Marks, David Wonderling, Margaret Thorogood, Helen Lambert, Steve E Humphries, and H Andrew W Neil
BMJ 2002 324: 1303. [Abstract] [Full Text] [PDF]

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Gray, J, Jaiyeola, A, Whiting, M, Modell, M, Wierzbicki, A S (2008). Identifying patients with familial hypercholesterolaemia in primary care: an informatics-based approach in one primary care centre. Heart 94: 754-758 [Abstract] [Full text]