, new diagnosis of type 2 diabetes mellitus [DM] or hypertension) and not on statin therapy. Weak for Reviewed, Deleted Appendix H: Participant List CDR Michael J. Arnold, MD, FAAFP Assistant Professor, Family Medicine Uniformed Services University of the Health Services Bethesda, MD Jennifer Ballard-Hernandez, DNP, FNP-BC Cardiovascular Clinical Nurse Advisor Office of Nursing Services/VACO Cardiology Nurse Practitioner Tibor Rubin VA Medical Center Long Beach, CA Andrew Buelt, DO Internist Bay Pines VA Healthcare System Bay Pines, FL Mark Donahue, MD Associate Professor of Medicine Cardiology Duke University Medical Center Director of Coronary Intensive Care Unit Durham VA Medical Center Durham, NC John R. Rick Downs, MD, FACP Professor of Medicine University of Texas Long School of Medicine South Texas Veterans Health Care System San Antonio, TX Karen Grace, PharmD Pharmacy Analyst Cathy Kelley, PharmD National Clinical Pharmacy Program Manager VA Pharmacy Benefits Management Services Scottsdale, AZ Amanda Logan, MPS, RDN, LD Assistant Chief, NFS Cincinnati VA Medical Center Cincinnati, OH Sundar Natarajan, MD, MSc Associate Professor of Medicine New York University School of Medicine Internist VA New York Harbor Healthcare System New York, NY Lt Col Brian Neubauer, MD, MHPE, FACP Chief, General Internal Medicine Service Walter Reed National Military Medical Center Associate Professor of Medicine Uniformed Services University of the Health Sciences Bethesda, MD COL Patrick G. O Malley, MD, MPH, FACP Associate Dean, Clinical Affairs Division Director and Professor of Medicine, General Internal Medicine Uniformed Services University of the Health Sciences Bethesda, MD Joan Ritter, MD, FACP Assistant Service Chief, General Internal Medicine Walter Reed National Military Medical Center Bethesda, MD LTC Nikki Smith, DNP, FNP-BC USU DNP Phase II Site Director Deputy Chief Education William Beaumont Army Medical Center Fort Bliss, TX Lance Spacek, MD Assistant Professor of Medicine, Primary Care Sports Medicine University of Texas Long School of Medicine South Texas Veterans Health Care System San Antonio, TX Lauren Thomas, MS, RD, LD Registered Dietitian General Internal Medicine Walter Reed National Military Medical Center Bethesda, MD Elena Vagichev, PharmD, BCPS, BCACP Clinical Pharmacy Specialist Walter Reed National Military Medical Center Bethesda, MD Appendix I: Abbreviation List Abbreviation Definition AAA abdominal aortic aneurysm ABI ankle-brachial index ACS acute coronary syndrome AHRQ Agency for Healthcare Research and Quality Apo apolipoproteins ARR absolute risk reduction AUC area under the curve BID twice per day BMI body mass index BP blood pressure CABG coronary artery bypass grafting CAC coronary artery calcium CAD coronary artery disease CDC Centers for Disease Control and Prevention CHF congestive heart failure CI confidence intervals CK creatinine kinase CKD chronic kidney disease COR contracting officer s representative cPCE calibrated Pooled Cohort Equation CPGs clinical practice guidelines CTT Cholesterol Treatment Trialists CV cardiovascular CVA cerebrovascular accident CVD cardiovascular disease DASH Dietary Approaches to Stop Hypertension dL deciliter DM diabetes mellitus DoD Department of Defense EBPWG Evidence-Based Practice Work Group ECG electrocardiogram EF ejection fraction ESRD end-stage renal disease FDA U.S. Food and Drug Administration FH familial hypercholesterolemia FRS Framingham Risk Score g grams GI gastrointestinal Abbreviation Definition GRADE Grading of Recommendations Assessment, Development and Evaluation HDL-C high-density lipoprotein cholesterol HEC Health Executive Committee HF heart failure hsCRP high-sensitivity C-reactive protein IOM Institute of Medicine JUPITER Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin KQs key questions LDL-C low-density lipoprotein cholesterol LFT liver function tests MACE major adverse cardiac events mg milligrams MHS Military Health System MI myocardial infarction NAM National Academy of Medicine NICE National Institute for Health and Care Excellence NNH number needed to harm NNT number needed to treat OR odds ratio OTC over-the-counter PAD peripheral arterial disease PCE Pooled Cohort Equations PCI percutaneous coronary intervention PCSK9 proprotein convertase subtilisin/kexin type 9 PICOTS the population, intervention, comparison, outcome, timing and setting RCT randomized controlled trial RD registered dietitian RRR relative risk reduction SR systematic review TC total cholesterol TGs triglycerides TIA transient ischemic attack U.K. United Kingdom U.S. United States ULN upper limit of the normal range USPSTF U.S. Preventive Services Task Force VA Department of Veterans Affairs VHA Veterans Health Administration Appendix J: Literature Search Strategy A. EMBASE with EMBASE.com Syntax Question Set # Concept Strategy Question Time to repeat screening for CV risk (Note: this search builds upon the search for Questions and which include specific terms for CV risk) #1 Dyslipidemia dyslipidemia/exp OR 'hypercholesterolemia'/exp OR cholesterol/exp OR lipid/de OR (dyslipidemia* OR dyslipidaemia* OR dyslipidproteinemia* OR dyslipidproteinaemia* OR hyperlipidemia* OR hyperlipidaemia* OR hypercholesterolemia* OR hypercholesterolaemia* OR hyperlipoproteinemia* OR hyperlipoproteinaemia* OR hypertriglyceridemia* OR hypertriglyceridaemia* OR hyperlipemia OR hyperlipaemia):ti,ab OR ((high OR elevated OR low) NEAR/5 (cholesteryl* OR cholesterol* OR lipid* OR lipoprotein* OR tryglycer* OR triaclyglycer* OR "HDL-C" OR "LDL-C" OR "HDL C" OR "LDL C")):ti,ab assessment 'mass screening'/exp OR 'multiphasic screening'/exp OR 'screening test'/exp OR 'risk assessment'/exp OR ((risk or risks) NEAR/4 (stratify or stratifying or stratification or define or defining or predict or prediction or assess* OR classif* OR prioritiz* OR category* OR tier* OR calculat* OR index OR indices OR score OR scores OR marker* OR biomarker* OR profile* OR algorithm* OR factor* OR characteristic*)):ti,ab OR (cardiovascular NEAR/2 risk*) #3 Repeat screening/ monitoring 'time factor'/exp OR 'rescreening'/exp OR monitoring/exp OR (rescreen* OR re-screen* OR surveillance OR re-assess* OR monitor* OR ((repeat or repet* or replicat* or redo or "re-do" or rerun or "re-run" or subsequent* or redundant* or re- assess* or reassess* OR "follow up" OR "follow-up") NEAR/4 (test* or screen* OR assess*))):ti,ab #4 Outcomes of interest 'cardiovascular disease'/exp/mj/dm_pc OR 'primary prevention'/exp OR 'prevention and control'/exp OR 'treatment outcome'/exp OR 'morbidity'/exp OR 'mortality'/exp OR 'all cause mortality'/exp OR 'cerebrovascular accident'/exp OR 'heart infarction'/exp OR 'unstable angina pectoris'/exp OR (stroke* OR (cerebrovascular NEXT/1 accident*) OR morbidity OR mortality OR death OR (heart NEXT/1 attack*) OR (myocardial NEXT/1 infarct*) OR ((vascular OR cardiac OR coronary OR cerebrovascular) NEXT/2 event*) OR (heart NEXT/1 infarct*)):ti,ab OR (morbidity OR mortality OR prevent* OR outcome*):ti,ab OR (primary NEXT/1 prevention):ti,ab OR angina:ti,ab #6 Limit to RCTs/SRs/meta- analysis Randomized controlled trials/systematic review/meta-analysis hedge [see Search Limits at the end of this table] #7 Limit to additional study designs 'latin square design'/de OR 'controlled study'/exp OR 'clinical trial'/exp OR 'comparative study'/exp OR 'cohort analysis'/de OR 'follow up'/de OR 'intermethod comparison'/de OR 'parallel design'/de OR 'control group'/de OR 'prospective study'/de OR 'retrospective study'/de OR 'case control study'/exp OR 'major clinical study'/de OR 'evaluation study'/exp OR (cohort* OR longitudinal OR prospective OR retrospective OR "case control" OR compar* OR "control group" OR "controlled study" OR "controlled trial" OR "cross over" OR crossover OR "double blind" OR "double blinded" OR "matched controls" OR placebo* OR random* OR sham):ti,ab OR ((versus OR vs):ti) #9 Apply limits See Search Limits at the end of the table Question Set # Concept Strategy Question Stability of lipid levels over time #1 Dyslipidemia dyslipidemia/exp OR 'hypercholesterolemia'/exp OR cholesterol/exp OR lipid/de OR (dyslipidemia* OR dyslipidaemia* OR dyslipidproteinemia* OR dyslipidproteinaemia* OR hyperlipidemia* OR hyperlipidaemia* OR hypercholesterolemia* OR hypercholesterolaemia* OR hyperlipoproteinemia* OR hyperlipoproteinaemia* OR hypertriglyceridemia* OR hypertriglyceridaemia* OR hyperlipemia OR hyperlipaemia):ti,ab OR ((high OR elevated OR low) NEAR/5 (cholesteryl* OR cholesterol* OR lipid* OR lipoprotein* OR tryglycer* OR triaclyglycer* OR "HDL-C" OR "LDL-C" OR "HDL C" OR "LDL C")):ti,ab #2 CVD 'cardiovascular disease'/exp/mj/dm_pc OR 'cardiovascular disease'/de OR 'hypertension'/exp OR 'ischemic heart disease'/exp OR 'heart disease'/de OR 'coronary artery disease'/exp OR 'peripheral vascular disease'/exp OR 'cerebral artery disease'/exp OR 'brain ischemia'/exp OR 'cerebrovascular accident'/exp OR 'cerebrovascular disease'/exp OR 'heart infarction'/exp OR ((heart* OR cardio* OR cardiac* OR coronary OR vascular OR cerebrovascular OR artery OR arteries) NEAR/5 (disease* OR syndrome* OR event* OR ischem* OR ischaem* OR plaque*)):ti,de OR (hyperten* OR atherosclero* OR arteriosclero* OR angina OR (Heart NEXT/1 attack*) OR (myocardial NEXT/1 infarct*) OR stroke* OR (cerebrovascular #3 Monitoring of lipid levels over time 'lipid blood level'/exp AND (monitoring/exp OR 'time factor'/exp) OR ((cholesteryl* or cholesterol* or lipid* or lipoprotein* or tryglycer* or triaclyglycer* or "HDL-C" or "LDL-C" or "HDL C" or "LDL C" or "non HDL C" or "non-HDL C" or "non-HDL-C") NEAR/5 (level or levels or blood OR value*) NEAR/5 (monitor* OR surveillance OR stable OR stability OR variability OR variable OR "long term" OR "long-term" OR longitud* OR trend*)):ti,ab #5 Limit to RCTs/SRs/meta- analysis Randomized controlled trials/systematic review/meta-analysis hedge [see Search Limits at the end of this table] #6 Limit to additional study designs 'latin square design'/de OR 'controlled study'/exp OR 'clinical trial'/exp OR 'comparative study'/exp OR 'cohort analysis'/de OR 'follow up'/de OR 'intermethod comparison'/de OR 'parallel design'/de OR 'control group'/de OR 'prospective study'/de OR 'retrospective study'/de OR 'case control study'/exp OR 'major clinical study'/de OR 'evaluation study'/exp OR (cohort* OR longitudinal OR prospective OR retrospective OR "case control" OR compar* OR "control group" OR "controlled study" OR "controlled trial" OR "cross over" OR crossover OR "double blind" OR "double blinded" OR "matched controls" OR placebo* OR random* OR sham):ti,ab OR ((versus OR vs):ti) #8 Apply limits See Search Limits at the end of the table Question Set # Concept Strategy Question Methods for risk stratification #1 Dyslipidemia dyslipidemia/exp OR 'hypercholesterolemia'/exp OR cholesterol/exp OR lipid/de OR (dyslipidemia* OR dyslipidaemia* OR dyslipidproteinemia* OR dyslipidproteinaemia* OR hyperlipidemia* OR hyperlipidaemia* OR hypercholesterolemia* OR hypercholesterolaemia* OR hyperlipoproteinemia* OR hyperlipoproteinaemia* OR hypertriglyceridemia* OR hypertriglyceridaemia* OR hyperlipemia OR hyperlipaemia):ti,ab OR ((high OR elevated OR low) NEAR/5 (cholesteryl* OR cholesterol* OR lipid* OR lipoprotein* OR tryglycer* OR triaclyglycer* OR "HDL-C" OR "LDL-C" OR "HDL C" OR "LDL C")):ti,ab #2 CVD 'cardiovascular disease'/exp/mj OR 'hypertension'/exp/mj OR 'ischemic heart disease'/exp/mj OR 'heart disease'/mj OR 'coronary artery disease'/exp/mj OR 'peripheral vascular disease'/exp/mj OR 'cerebral artery disease'/exp/mj OR 'brain ischemia'/exp/mj OR 'cerebrovascular accident'/exp/mj OR 'cerebrovascular disease'/exp/mj OR 'heart infarction'/exp/mj OR ((heart* OR cardio* OR cardiac* OR coronary OR vascular OR cerebrovascular OR artery OR arteries) NEAR/5 (disease* OR syndrome* OR event* OR ischem* OR ischaem* OR plaque*)):ti OR (hyperten* OR atherosclero* OR arteriosclero* OR angina OR (Heart NEXT/1 attack*) OR (myocardial NEXT/1 infarct*) OR stroke* OR (cerebrovascular NEXT/1 accident*)):ti #3 Risk prediction/ stratification 'risk factor'/exp/mj OR 'risk assessment'/exp/mj OR 'cardiovascular risk'/exp/mj OR ((risk or risks) NEAR/4 (stratify or stratifying or stratification or define or defining or predict or prediction or assessment OR classif* OR prioritiz* OR category* OR tier* OR calculat* OR index OR indices OR score OR scores OR marker* OR biomarker* OR profile* OR algorithm* OR factor* OR characteristic*)):ti OR (cardiovascular NEAR/2 risk*):ti #4 Risk stratification tools lipid analysis /exp OR 'lipid blood level'/exp OR 'framingham risk score'/exp OR 'ankle brachial index'/exp OR 'coronary artery calcium score'/exp OR 'galectin 3'/exp OR 'c reactive protein'/exp OR 'apolipoprotein b'/exp OR 'lipoprotein a'/exp OR 'arterial wall thickness'/exp OR 'troponin I'/exp OR ((framingham NEXT/2 risk*) OR 'ankle brachial index' OR (coronary NEXT/4 calcium) OR ('c reactive' NEXT/2 protein*) OR 'hs-crp' OR 'hs crp' OR 'hscrp' OR 'ntprobnp' OR 'nt-probnp' OR 'hs- tnl' OR 'hs tnl' OR 'galecton 3' OR 'galecton-3' OR 'pooled cohort' OR (particle NEXT/2 size*) OR (high NEXT/1 sensitiv* NEXT/1 troponin*) OR apolipoprotein* OR lipoprotein* OR (carotid NEXT/1 intima* NEXT/3 thickness*)):ti,ab OR ((cholesteryl* OR cholesterol* OR lipid* OR lipoprotein* OR tryglycer* OR triaclyglycer* OR "HDL-C" OR "LDL-C" OR "HDL C" OR "LDL C" OR "non HDL C" OR "non-HDL C" OR "non-HDL-C") NEXT/5 (level OR levels)):ti #5 Outcomes of interest 'cardiovascular disease'/exp/mj/dm_pc OR 'primary prevention'/exp OR 'prevention and control'/exp OR 'treatment outcome'/exp OR 'morbidity'/exp OR 'mortality'/exp OR 'all cause mortality'/exp OR 'cerebrovascular accident'/exp OR 'heart infarction'/exp OR 'unstable angina pectoris'/exp OR (stroke* OR (cerebrovascular NEXT/1 accident*) OR morbidity OR mortality OR death OR (heart NEXT/1 attack*) OR (myocardial NEXT/1 infarct*) OR ((vascular OR cardiac OR coronary OR cerebrovascular) NEXT/2 event*) OR (heart NEXT/1 infarct*)):ti,ab OR (morbidity OR mortality OR prevent* OR outcome*):ti,ab OR (primary NEXT/1 prevention):ti,ab OR angina:ti,ab #6 Combine sets dyslipidemia terms plus CV outcomes #7 Combine sets CV terms without the outcomes string Question Set # Concept Strategy Question Methods for risk stratification (cont.) 