Odds and Ends

Hello all - I am being a bit stubborn with myself this evening as I do not have the time to post well and as a perfectionist, posting poorly is anathema.  However, I want to write because Dinahsoar had a great question and because I may not get many more chances to post this month - finals (papers, proposals, exams etc).  So without further ado, here are a couple of notes - saving the cholesterol testing to the end.

NIH:  The National Institutes of Health has released its final report on a strategy to address obesity through research.  This indicates which topics of research they are willing to fund.  The highlights are as follows and the press release is available here.  I am excited because the proposals that I have been working on address many of the areas of interest noted in this report.  The full report itself  is very specific, but here is a highlight of the research recommendations:
•discover key processes that regulate body weight and influence behavior

•understand the factors that contribute to obesity and its consequences

•design and test new approaches for achieving and maintaining a healthy weight

•evaluate promising strategies to prevent and treat obesity in real-world settings and diverse populations

•use technology to advance obesity research and improve health care delivery
 
Lung Cancer:  Out this week - the rates of death from lung cancer among women have been decreasing at a steady pace.  Lung cancer, most often but not always associated with smoking, takes decades to develop and only a few years to kill.  Deaths from lung cancer for men have declined before that of women.  Here is why.  Men began to smoke first, and to smoke more, at first.  At about the time women began to smoke, evidence came out to suggest that smoking kills men.  Men began to quit and as time passed they had less cases of death from lung cancer.  Then reports came out that smoking also kills women, and then women began to quit, though there is some evidence to suggest that women have more difficulty in quitting.
 

Watch those Packages:  My environmental level obesity prevention strategy still includes labeling initiatives.  I would like to see nutrient content available for meals/foods at work, school, restaurants and grocers.  This includes steam tables and vending machines.  So, I am a label reader.  I know that I have alerted my readers to this before, but I have a perfect example to back up this advice.  Even when you buy a product on a regular basis you should review the label periodically.  Content can change for many reasons, but it can change - that is the point.  I noticed that the bread I usually buy for my french toast has gone back and forth in calories per slice.  It is not enough to make a difference, but enough to make a point.  I imagine that there was an error and someone called them on it - but I could be wrong :)
 
Cholesterol Testing:  The question that I was asked has to do with why a fingerstick cholesterol test might differ from a venous draw and if one was better than the other at detecting high cholesterol and triglyceride levels.  First I want to take a moment to share some epidemiology 101, because I love that subject so much.  There are several terms associated with diagnostic tests.  They include, reliability, validity, sensitivity, specificity, positive predictor value and negative predictor value.  A test is reliable if it gives the same results over time.  For example, a food scale tells you the weight in grams of a certain item.  The same amount of grams is provided each time you weigh it.  Validity has to do with whether or not that is the correct weight.  A test can be reliable and not valid.  (there is also reliability among testers and between them)  Test sensitivity has to do with how accurate a test is in detecting who HAS a disease and test specificity is related to determing who does NOT have the disease.  Thus we have true positives and false positives, true negatives and false negatives.  The positive predictor value is more individualized.  How accurate is the test is finding the disease in this certain person, and vice versa?  This was not exactly the question that Dinahsoar asked however.  She wanted to know if one of the tests were more accurate than the other.  It is exactly that type of question that gets at sensitivity and specificity.  How would we know the accuracy of a test if we could not compare it to something?  The something is considered the gold standard.  I did find some information about this issue and I think that Dinahsoar and some of you may really like to read this article by Dr. Mark Deeg, but in summary:  There are some things that can have an impact on cholesterol levels from time one to time two even if the same test is used.  That is important.  Most of the time the difference is just a few percentage points, but triglyceride levels can vary by 20 to 30%.  The fingerstick total cholesterol level is often 2-4 % higher than a venous blood draw.  The way the test is conducted, the time of day, the condition of the patient and of course, the lab itself can all affect the levels.  I would not compare my results from two different types of tests.  I would think that the venous blood draw was more accurate - if there was not lab error.  I would repeat the blood test, same conditions, same lab etc if I had a concerning result.  If you are going to have your blood fats checked, I would check out this article, it is informative.