Document Detail


Assessing the validity of childhood blood pressure screening: unbiased estimates of sensitivity, specificity, and predictive values.
MedLine Citation:
PMID:  1554809     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Blood pressure measurement in childhood can be considered as a screening test for future blood pressure levels. Evaluating this test involves calculating sensitivities, specificities, and predictive values for a blood pressure measurement at an initial time for predicting underlying true blood pressure at a subsequent time. We demonstrate the use of childhood blood pressure tracking correlations that are corrected for within-person variability to calculate unbiased estimates of these test characteristics. In a cohort of 333 schoolchildren, we measured blood pressure on multiple visits in each of 4 successive years. Using these data for within-person variances and corrected tracking correlations, and U.S. population data for means and total variances, we tabulated positive predictive values, sensitivities, and specificities for the case of predicting a 9-year-old male's true systolic blood pressure 3 years later. For example, if a 9-year-old's average blood pressure from 4 visits is 115 mmHg, the probability of his true blood pressure being greater than 116 mmHg (90th percentile) at age 12 is 0.50. With longer follow-up, the use of predictive values, sensitivities, and specificities that incorporate corrected correlations should allow determination of the accuracy of predicting adult blood pressure from childhood values, and therefore the usefulness of screening children for those at high risk of developing hypertension.
Authors:
M W Gillman; N R Cook; B Rosner; D A Evans; M E Keough; J O Taylor; C H Hennekens
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Epidemiology (Cambridge, Mass.)     Volume:  3     ISSN:  1044-3983     ISO Abbreviation:  Epidemiology     Publication Date:  1992 Jan 
Date Detail:
Created Date:  1992-05-07     Completed Date:  1992-05-07     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9009644     Medline TA:  Epidemiology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  40-6     Citation Subset:  IM    
Affiliation:
Channing Laboratory, Brigham and Women's Hospital, Boston, MA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Age Factors
Blood Pressure Determination*
Child
Female
Humans
Hypertension / prevention & control*
Male
Mass Screening*
Prognosis
Risk Factors
Sex Factors
Grant Support
ID/Acronym/Agency:
HL 25268/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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