To the Editor.
—Congratulations to Havas et al1 for having valued the forest despite the imperfection of a few of its trees. Granted the inevitable minor (3.6%) misclassifications that have bothered Havas et al in past public presentations, results of the Massachusetts Model Systems for Blood Cholesterol Screening Project do confirm the utility of cholesterol screening and counseling in community settings. In screening situations, perhaps the message ("know your numbers... modify your diet and other behaviors... repeat your cholesterol measurement and follow-up with your physician") is more important than the precise number. People in general and physicians in particular should realize that individuals' cholesterol levels often vary widely from day to day. Any single cholesterol determination, whether by finger-stick screening or as part of a fasting lipid profile, is but one point within the person's usual cholesterol range, which may well overlap the boundaries of any finite classification system.The
Record B, Record S. Cholesterol Screening: Hits and Misses. JAMA. 1991;266(19):2701. doi:10.1001/jama.1991.03470190049016