The Merck Manual in 2018: double-counting the APOB and PCSK9

In 2011 and 2018, Goldberg does not linguistically conflate the components in the Merck Manual, but in 2018 the quantities for APOB and PCSK9 are double-counted.  In the 2011 JCL series by Goldberg, adding the “s” at the end of the word — IE, making it “familial hypercholesterolemias – left the inclusion of the APOB and PCSK9 technically true. The only way to double “FH” prevalence was to conflate the diseases in this way. This was a large factor in moving the prevalence from 1/500 to 1/200 or 1/300. Any good reason for doing this however was lost in the next move: in the 2018 Merck Manual, Goldberg still keptthe diseases separate, listing the APOB and PCSK9 separately, and specifically defining the FH by the LDL receptor. Nonetheless, she kept the APOB and PCSK9 quantities inflated in a prevalence devoted solely to LDLR mutations, “FH.” In actuality, the only support for an FH prevalence of 1/200 or 1/300 involves sneaking in the APOB and PCSK9 carriers. But they are clearly listed separately here. The linguistic conflation wasexplicitly declared in the 2011 series led by Dr. Goldberg. However, if we unpack that conflation here, we must also unpack the quantities of the components. The APOB and PCSK9 are double-counted in 2018.

The Merck Manual in 2018: double-counting the APOB and PCSK9