Abstract
This cross-sectional descriptive study was aimed at determining the efficiency and cost-effectiveness of four serum lipid screening methods: Method 1 proposed by the Thai Royal Medical Association (TRMA), Method 2 of the National Cholesterol Education Program (NCEP), Method 3 of the British Hyperlipidemia Association (BHA), and Method 4 invented by the first author. Study subjects included 2,000 workers aged 35 years and older who underwent an annual health examination provided at King Chulalongkorn Memorial Hospital during the period July-September 2008. All subjects answered the questionnaires of four screening methods and took blood tests for TC, TG, and HDL. LDL was calculated by Friedewald’s formula. The performance of each screening method was then analyzed, using lipid blood test as the gold standard. Overall sensitivity and specificity of the screening methods were 30 to 99 and 0.5 to 74 percent respectively, with the AUC of 0.506 to 0.671. Method 4 had the highest sensitivity and the lowest specificity at 99.4 percent and 34.3 per cent, respectively. Method 3 and Method 1 had higher AUC of 0.671 and 0.621 respectively. Method 2 had high specificity and low sensitivity (74% and 45.2%). In conclusion, the performance of the four serum lipid screening methods used in Thai adults was modest and therefore the methods need further improvement.
