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Variability in cholesterol measurements in a worksite cholesterol screening program.

G M Stave1, B S Winslow, G W Conner

  • 1Division of Occupational and Environmental Medicine, Duke University Medical Center, Durham, North Carolina.

American Journal of Preventive Medicine
|November 1, 1991
PubMed
Summary

Cholesterol screening programs show significant measurement variability. Confidence intervals (CIs) are crucial for accurate interpretation and employee counseling in worksite health programs.

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Area of Science:

  • Clinical Chemistry
  • Occupational Health
  • Biostatistics

Background:

  • Worksite cholesterol screening programs are common.
  • Variability in cholesterol measurements complicates interpretation and counseling.
  • Accurate cholesterol assessment is vital for employee health management.

Purpose of the Study:

  • To quantify cholesterol measurement variability in a corporate screening program.
  • To calculate 90% confidence intervals (CIs) for cholesterol measurements.
  • To assess the impact of variability on employee counseling.

Main Methods:

  • Recruited 30 subjects (15 men, 15 women) with diverse cholesterol levels.
  • Collected duplicate blood samples weekly for three weeks.
  • Performed duplicate total cholesterol measurements twice weekly, totaling 36 measurements per subject.

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  • Utilized a hierarchical random effects analysis of variance (ANOVA) model to estimate variability components.

    • Main Results:

    • Coefficients of variation for biologic and analytic variation were 5.2% and 3.4% (men) and 4.7% and 3.2% (women).
    • Calculated 90% confidence intervals (CIs) were +/- 10.2% for men and +/- 9.3% for women.
    • Demonstrated substantial variability impacting cholesterol measurement interpretation.

    Conclusions:

    • Significant biologic and analytic variability exists in cholesterol measurements.
    • Routine use of confidence intervals (CIs) is recommended for discussing cholesterol results with patients.
    • Implementing CIs can improve the accuracy of employee counseling in screening programs.