Doctors Spar Over Cholesterol Screening in Kids

Some question supporting evidence and drug-industry ties, but others say guidelines benefit certain children

By Amanda Gardner
HealthDay Reporter

MONDAY, July 23 (HealthDay News) -- Researchers are debating the merits of recent guidelines that recommend all children aged 9 through 11 be screened for high cholesterol levels, along with certain groups of younger children and teenagers.

The guidelines were written by a panel convened by the U.S. National Heart, Lung, and Blood Institute, endorsed by the American Academy of Pediatrics and published in the journal Pediatrics last November.

But now doctors publishing in the current issue of Pediatrics say the guidelines are too aggressive and not based solidly on evidence. The paper is joined by a rebuttal from the authors of the guidelines.

The critics of the guidelines make many arguments, including that the guidelines were based more on expert opinion than on solid evidence and that many authors of the guidelines reported industry disclosures.

Dr. Stephen Daniels, chairman of the guidelines panel and head of pediatrics at the University of Colorado School of Medicine in Aurora, defended the panel Monday to the Associated Press.

Industry ties "were vetted during the discussions of the panel and I think really did not influence the debate," he told the AP.

Daniels, a co-author of the rebuttal, reported having worked as a consultant or advisory board member for Abbott Laboratories, Merck and Schering-Plough, now part of Merck. Seven other panel members also made disclosures.

But the critics had other objections as well.

"There is expense and inconvenience to the family to have to get to the doctor before breakfast," said Dr. Thomas Newman, co-author of the journal commentary article, referring to the recommendation that higher-risk 2- to 8-year-olds and 12- to 16-year-olds be screened after fasting.

There also is the issue of potentially giving lifetime medication to a large group of people. The guidelines estimated that about 1 percent of kids would be put on cholesterol-lowering medications if the guidelines were followed.