Litaker et al developed a score for identifying those communities in which to conduct a focused screening for lead poisoning in children. The authors are from the Cleveland Clinic.
Parameters:
(1) date housing built
(2) ethnicity of residents
(3) education level
(4) ownership of housing (renters vs owners)
|
Parameters |
Findings |
Points |
|
percent of housing built before 1950 |
< 55% |
0 |
|
|
>= 55% |
11 |
|
percent of residents who are Black, non-Hispanic |
< 35% |
0 |
|
|
>= 35% |
4 |
|
percent of residents with less than a high school education |
< 35 |
0 |
|
|
>= 35% |
6 |
|
percent units occupied by renters |
< 50% |
0 |
|
|
>= 50% |
4 |
where:
• I could not find a definition for education. This could be interpreted as percent of people who failed to complete high school, or those who got no higher than eighth grade. It also could be interpreted as applying only to adults or to the whole population. From the discussion it seems to apply to adults.
• The income-to-poverty ratio was dropped from the final model since it was colinear with other variables. The findings correlate with a poor socioeconomic status.
• The percent Hispanics in Ohio when the study was conducted was fairly low.
• An older house that has had been cleared of lead would not convey an increased risk to the occupants.
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 25
• The higher the score the more likely lead poisoning will be a problem in children living in the community.
• A score of >= 10 was used to identify a community in which to focus lead screening efforts.
Performance at this cutoff:
• Sensitivity 94% and specificity 62%
• Positive predictive value 70% and negative predictive value 92%
Specialty: Toxicology, Emergency Medicine, Critical Care, Pedatrics
