In light of the above review and another review which focused on screening for multifactorial dyslipidemia, the US Preventative Services Task Force’s (USPSTF) 2016 recommendation on screening for lipid disorders in children adolescents and young adults remains unchanged since 2007 and concluded that the current evidence is insufficient to assess the balance of benefits and harms of screening for lipid disorders in children and adolescents 20 years or younger.
An editorial aims to provide additional context for clinicians, policy makers, patients and their families deciphering the meaning of the USPSTF’s conclusion bringing together recommendations from other expert panels. The authors of this editorial conclude “considering that all newborns undergo screening for phenylketonuria, which has a prevalence of 1 in 10 000, it seems reasonable that clinicians should also perform screening to detect FH (and pediatric lipid disorders), a disease that is far more common and is known to cause early morbidity and mortality. The USPSTF rightfully acknowledges that clinical decisions involve more considerations than evidence alone. Accordingly, when high-quality RCT data are lacking, clinicians who provide care for children and adolescents should make the best use of the available evidence to make reasonable inferences that can inform decision making for their patients and their families.”
Another editorial, published in JAMA Internal Medicine, disputes the USPSTF’s recommendation suggesting that they have not considered cost-effectiveness in making their decision. The authors of this editorial note they and others have highlighted the lack of evidence—either direct or indirect via modeling—that the benefits of screening and intervention in children will exceed harms and costs.