Abnormal lipid values occur in 1 in 5 US children and adolescents,1 and are associated with cardiovascular disease in adulthood.2 Universal pediatric lipid screening is advised by the National Heart, Lung, and Blood Institute (NHLBI)2 for those aged 9 to 11 years and 17 to 21 years, in addition to the selective screening advised by the American Academy of Pediatrics (AAP) and the American Heart Association. In contrast, the US Preventive Services Task Force (USPSTF) did not find sufficient evidence to recommend any pediatric lipid screening.3 Despite substantial controversy,4 little is known about the frequency of cholesterol testing during pediatric health maintenance visits in the United States.5 We used the National Ambulatory Medical Care Survey (NAMCS)6 to examine (1) rates and correlates of testing and (2) trends in testing, including before and after the 2007 USPSTF and 2008 AAP cholesterol statements.
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