Is a desk-top analyzer the answer to cholesterol screening?

Abstract

This is the first evaluation study on the acceptability and accuracy of the Reflotron, a desktop analyzer for cholesterol screening in general practice in Hong Kong. Patients aged 21-60 attending a Government general outpatient clinic in Hong Kong were randomly selected. The acceptance rate of screening was 69%. A total of 1113 subjects had their cholesterol levels screened by the Reflotron. The accuracy of the Reflotron was assessed by comparing its results to laboratory blood cholesterol (BC) results in 125 subjects. The mean error of the Reflotron cholesterol measurements was 6% which was larger than that recommended by the American National Cholesterol Education Programme. Therefore, the diagnosis or treatment of hypercholesterolaemia should not be based on the Reflotron result alone. There was a good linear correlation between the Reflotron cholesterol (RC) and blood cholesterol (BC) with a negative bias in the Reflotron results. Blood cholesterol could be predicted from RC by the regression equation: BC = 0.8395 + 0.8995 x RC. The Reflotron is useful as an initial screening test for hypercholesterolaemia in the low risk population. The threshold levels need to be adjusted accordingly, and abnormal results should be confirmed by standard laboratory tests. It is estimated that one could save H.K.$51.6 million if the Reflotron instead of the laboratory were used to screen all people aged 40 to 60 years old in Hong Kong once.