In late 2011, an Expert Panel convened by the National Heart, Lung, and Blood Institute (NHLBI), of which we were members, released a set of integrated guidelines for cardiovascular health in youth comprising numerous clinically useful recommendations.1 However, one new recommendation, about which the 2 of us disagree, merits further scrutiny: to perform lipid screening on all children at 9 to 11 years of age, followed by a comprehensive scheme for further evaluation and treatment. Just 4 years previously, the US Preventive Services Task Force (USPSTF) concluded that evidence is insufficient to recommend for or against screening for lipid disorders in childhood.2 Both of the guideline committees used an explicit evidence-based approach to answer key questions, with extensive literature searches, critical review of relevant studies, and analogous grading schemes. How could the 2 guidelines be so different? The evidence base has advanced in 4 years, but not enough to explain such a discrepancy. What is a clinician who cares for children to do in the face of this ambiguity?
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Purchase Online Access to this article for 24 hours
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
Instructions
Thank you for submitting a comment on this article. It will be reviewed by JAMA editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest* Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 1
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Users' Guides to the Medical Literature Clinical Resolution
Users' Guides to the Medical Literature Clinical Scenario
All results at JAMAevidence.com >
and access these and other features:
Register Now
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Need assistance?
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.