Pearson J R, Dusenbury L J, Bakes-Martin R, Loverde M, Johnson J, Byyny R L
Department of Medicine, University of Colorado Health Sciences Center, Denver 80262.
Am J Med. 1988 Sep;85(3):369-74. doi: 10.1016/0002-9343(88)90589-x.
Blood cholesterol is a good estimator of risk for coronary heart disease. Six criteria for a screening cholesterol measurement are: (1) high predictive value of elevated cholesterol compared with a "gold standard" cholesterol measurement; (2) high correlation with the national reference system for cholesterol; (3) acceptable results obtainable by volunteer observers; (4) results available quickly; (5) reproducible results; and (6) low cost. We hypothesized that cholesterol measurements performed on the Reflotron by volunteer nurses would meet these criteria.
We recruited 345 subjects (160 men, 185 women, aged 20 to 84) and measured their blood cholesterol level by a method calibrated under the National Heart, Lung, and Blood Institute Lipid Standardization Program (Lab-chol) and on the Reflotron (R-chol method).
Comparison of the results showed good agreement (slope = 0.937; intercept = 0.27 mmol/liter). Comparison of the risk assignments made by the R-chol method against those made by the Lab-chol method, using the 1987 Adult Treatment Panel classification criteria, showed that the R-chol method has a sensitivity of 0.79 and a specificity of 0.98. Assuming a national prevalence of hypercholesterolemia of 25 percent, the positive predictive value is 0.92 and the negative predictive value is 0.93. The cost per screen was $1.25.
These data show that volunteer observers can obtain screening cholesterol results on the Reflotron that are accurate, reliable, quickly available at a low cost, and have high predictive value for hypercholesterolemia.
血液胆固醇是冠心病风险的良好评估指标。胆固醇筛查测量的六个标准是：（1）与“金标准”胆固醇测量相比，胆固醇升高的预测价值高；（2）与国家胆固醇参考系统高度相关；（3）志愿者观察者可获得可接受的结果；（4）结果可快速获得；（5）结果可重复；（6）成本低。我们假设由志愿者护士使用Reflotron进行的胆固醇测量将符合这些标准。
我们招募了345名受试者（160名男性，185名女性，年龄20至84岁），并通过在美国国立心肺血液研究所脂质标准化计划下校准的方法（实验室胆固醇法）和Reflotron（R-胆固醇法）测量他们的血液胆固醇水平。
结果比较显示出良好的一致性（斜率=0.937；截距=0.27毫摩尔/升）。使用1987年成人治疗小组分类标准，将R-胆固醇法与实验室胆固醇法得出的风险评估进行比较，结果显示R-胆固醇法的灵敏度为0.79，特异性为0.98。假设全国高胆固醇血症患病率为25%，阳性预测值为0.92，阴性预测值为0.93。每次筛查的成本为1.25美元。
这些数据表明，志愿者观察者可以使用Reflotron获得准确、可靠、低成本且可快速获得的胆固醇筛查结果，并且对高胆固醇血症具有较高的预测价值。
