Screening for thyroid disease

Mark Helfand, Lawrence M. Crapo

Research output: Contribution to journalArticle

141 Citations (Scopus)

Abstract

Purpose: To evaluate the usefulness of screening for thyroid dysfunction in various clinical settings. Design: Review and synthesis of the literature. Main Results: Screening in the community detects new overt thyrotoxicosis or hypothyroidism in approximately 0.5% of the general population. The yield is best among women over 40 years of age (1%) and is lowest among young men (0%). Case-finding (testing clinic patients who are seeing a physician for unrelated reasons) has a better yield and is less expensive than screening in the community. Patients hospitalized with acute illnesses do not benefit from routine thyroid function testing. However, patients who are admitted to specialized geriatric units because of general disability, failure to thrive, and other indications may benefit. In various studies, from 2% to 5% of patients admitted to geriatric units have treatable thyroid disease. The serum total thyroxine, free thyroxine index, free thyroxine, and sensitive thyrotropin assay are all effective as initial tests for screening. The sensitive thyrotropin assay is less cost-effective than the other choices. Recommendations: Case-finding in some women over 40 years of age can be useful. Patients admitted to specialized geriatric units may also benefit from routine testing. Thyroid function tests are not indicated for community screening programs or for patients hospitalized with acute medical or psychiatric illnesses.

Original languageEnglish (US)
Pages (from-to)840-849
Number of pages10
JournalAnnals of Internal Medicine
Volume112
Issue number11
StatePublished - Jun 1 1990
Externally publishedYes

Fingerprint

Thyroid Diseases
Thyroxine
Geriatrics
Thyrotropin
Thyroid Gland
Thyroid Function Tests
Failure to Thrive
Thyrotoxicosis
Hypothyroidism
Psychiatry
Physicians
Costs and Cost Analysis
Serum
Population

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Helfand, M., & Crapo, L. M. (1990). Screening for thyroid disease. Annals of Internal Medicine, 112(11), 840-849.

Screening for thyroid disease. / Helfand, Mark; Crapo, Lawrence M.

In: Annals of Internal Medicine, Vol. 112, No. 11, 01.06.1990, p. 840-849.

Research output: Contribution to journalArticle

Helfand, M & Crapo, LM 1990, 'Screening for thyroid disease', Annals of Internal Medicine, vol. 112, no. 11, pp. 840-849.
Helfand, Mark ; Crapo, Lawrence M. / Screening for thyroid disease. In: Annals of Internal Medicine. 1990 ; Vol. 112, No. 11. pp. 840-849.
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