Paul P. Glasziou, MBBS, PhD; Les Irwig, MBBS, PhD; Stephane Heritier, PhD; R. John Simes, MBBS, MD; Andrew Tonkin, MBBS, MD; LIPID Study Investigators
Acknowledgment: The authors thank Tim James for local cholesterol level testing data; Katy Bell, Jorgen Hilden, Martin Turner, Andrew Hayen, and members of the LIPID management committee—David Sullivan, Harvey White, Paul Nestel, and David Colquhoun—for helpful comments; and Rhana Pike for editorial work.
Potential Financial Conflicts of Interest: None disclosed.
Reproducible Research Statement:Study protocol: The original 2-page proposal is available from Dr. Glasziou (e-mail, firstname.lastname@example.org). Statistical code: Available from Dr. Heritier (e-mail, email@example.com). Data set: Not available.
Requests for Single Reprints: Paul P. Glasziou, MBBS, PhD, Centre for Evidence-Based Medicine, Department of Primary Health Care, University of Oxford, Old Road Campus, Oxford OX3 7LF, United Kingdom; e-mail, firstname.lastname@example.org.
Current Author Addresses: Dr. Glasziou: Centre for Evidence-Based Medicine, Department of Primary Health Care, University of Oxford, Old Road Campus, Oxford OX3 7LF, United Kingdom.
Dr. Irwig: Screening and Test Evaluation Program, School of Public Health, University of Sydney, Sydney, Australia.
Drs. Heritier and Simes: NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia.
Dr. Tonkin: Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia.
Author Contributions: Conception and design: P.P. Glasziou, L. Irwig.
Analysis and interpretation of the data: P.P. Glasziou, L. Irwig, S. Heritier, R.J. Simes, A. Tonkin.
Drafting of the article: P.P. Glasziou, L. Irwig, S. Heritier.
Critical revision of the article for important intellectual content: P.P. Glasziou, L. Irwig, R.J. Simes, A. Tonkin.
Final approval of the article: P.P. Glasziou, L. Irwig, S. Heritier, R.J. Simes, A. Tonkin.
Statistical expertise: P.P. Glasziou, S. Heritier.
Obtaining of funding: P.P. Glasziou, A. Tonkin.
Administrative, technical, or logistic support: R.J. Simes.
Collection and assembly of data: P.P. Glasziou.
Glasziou PP, Irwig L, Heritier S, Simes RJ, Tonkin A, LIPID Study Investigators. Monitoring Cholesterol Levels: Measurement Error or True Change?. Ann Intern Med. 2008;148:656-661. doi: 10.7326/0003-4819-148-9-200805060-00005
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Published: Ann Intern Med. 2008;148(9):656-661.
Cholesterol level monitoring is a common clinical activity. Because indications for treatment have been widening over the past decade, cholesterol-lowering medications have become some of the most widely used and expensive pharmaceutical items, and cholesterol screening, treatment, and monitoring have increased. For example, lipid panels were the third highest contributors to Medicare testing growth between 2000 and 2004, with a 61% increase in volume and a 65% increase in cost (1). Previous studies have suggested that, because of measurement error, frequent monitoring is just as likely to mislead when trying to decide whether changes in treatment are needed (2).
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Cardiology, Dyslipidemia, Coronary Risk Factors.
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