Hypothyroidism

Sawka, Anna M.; Jonklaas, Jacqueline

doi:10.1503/cmaj.141596

Cited by 1 publication

(2 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As such, clinicians refer to the normal reference ranges provided by their provincial health ministries or laboratories [14–18] or refer to guidelines produced by other organizations [5, 11, 13, 19, 20]. Canadian sources report upper limits of normal TSH in adults ranging from 4.0 to 5.5 milliunits per liter (mU/L) [14–20], with one source recommending an upper limit of 6.0 mU/L in older adults (> 65 years of age) [19]. Lower limits of normal TSH in adults range from 0.20 to 0.45 mU/L [14–17, 19, 20].…”

Section: Introductionmentioning

confidence: 99%

“…Canadian sources report upper limits of normal TSH in adults ranging from 4.0 to 5.5 milliunits per liter (mU/L) [14–20], with one source recommending an upper limit of 6.0 mU/L in older adults (> 65 years of age) [19]. Lower limits of normal TSH in adults range from 0.20 to 0.45 mU/L [14–17, 19, 20]. Hence estimates for the prevalence of TD would vary depending on the TSH reference ranges used, which may potentially lead to an over-estimation in the adult population ≥ 60 years of age, if age-specific TSH ranges are appropriate and were not used [21, 22].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Screening for thyroid dysfunction and treatment of screen-detected thyroid dysfunction in asymptomatic, community-dwelling adults: a systematic review

Domingo

Doull

2019

Syst Rev

View full text Add to dashboard Cite

BackgroundThis systematic review was conducted to inform the Canadian Task Force on Preventive Health Care recommendations on screening for thyroid dysfunction (TD). The review sought to answer key questions on the benefits and harms of screening for TD, patients’ values and preferences for screening, and the benefits and harms of treating screen-detected TD.MethodsThis review followed Canadian Task Force on Preventive Health Care methods, which include the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The search strategy used for benefits and harms of screening and treatment was an update to the 2014 review by the US Preventive Services Task Force and searched MEDLINE and the Cochrane Library. MEDLINE, Embase, ProQuest Public Health, and SCOPUS were searched for patients’ values and preferences for screening. Outcomes of interest included all-cause mortality, deaths due to cardiovascular diseases, fatal and non-fatal cardiovascular events, atrial fibrillation, fractures, quality of life, cognitive function, and harms due to TD treatment. Two reviewers independently screened abstracts and full texts according to pre-determined inclusion criteria and assessed the risk of bias for each study included. Strength and quality of the evidence was assessed for each outcome. A narrative synthesis was conducted due to heterogeneity of the included studies.ResultsNo studies were found on screening for TD, treatment of subclinical hyperthyroidism, or patients’ values and preferences for screening for TD. Twenty-two studies (from 24 publications) on the treatment of TD in patients with screen-detected subclinical hypothyroidism were included. Results from the included randomized controlled trials suggested no benefit of treatment for subclinical hypothyroidism for the large majority of outcomes. We found very low-quality evidence (from two cohort studies) for a small reduction in all-cause mortality among adults < 65 or 40–70 years who were treated for TD compared to those who were not.ConclusionsThis review found moderate to very low-quality evidence on the benefits and harms of treatment for subclinical hypothyroidism, with most of the evidence showing no benefit of treatment.

show abstract