Screening for thyroid disease: An update

Mark Helfand, C. C. Redfern

Research output: Contribution to journalArticle

252 Citations (Scopus)

Abstract

Purpose: To review information on the benefits of screening with a sensitive thyroid-stimulating hormone (TSH) test for thyroid dysfunction in asymptomatic patients seeking primary care for other reasons. This paper focuses on whether screening should be aimed at detection of subclinical thyroid dysfunction and whether persons with mildly abnormal TSH levels can benefit. Data Sources: A MEDLINE search for studies of screening for thyroid dysfunction and of treatment for complications of subclinical thyroid dysfunction. Study Selection: Studies of screening with thyroid function tests in the general adult population or in patients seen in the general office setting were selected (n = 33). All controlled studies of treatment in patients with subclinical hypothyroidism or subclinical hyperthyroidism were also included (n = 23). Data Extraction: The prevalence of overt and subclinical thyroid dysfunction, the evidence for the efficacy of treatment, and the incidence of complications in defined age and sex groups were extracted from each study. Data Synthesis: Screening can detect symptomatic but unsuspected overt thyroid dysfunction. The yield is highest for women older than 50 years of age: In this group, 1 in 71 women screened could benefit from relief of symptoms. Evidence of the efficacy of treatment for subclinical thyroid dysfunction is inconclusive. Conclusions: Even though treatment for subclinical thyroid dysfunction is controversial, office-based screening to detect overt thyroid dysfunction may be indicated in women older than 50 years of age. Large randomized trials are needed to determine the likelihood that treatment will improve quality of life in otherwise healthy patients who have mildly elevated TSH levels.

Original languageEnglish (US)
Pages (from-to)144-158
Number of pages15
JournalAnnals of Internal Medicine
Volume129
Issue number2
StatePublished - 1998

Fingerprint

Thyroid Diseases
Thyroid Gland
Thyrotropin
Age Groups
Thyroid Function Tests
Information Storage and Retrieval
Hyperthyroidism
Therapeutics
Hypothyroidism
MEDLINE
Primary Health Care
Quality of Life
Incidence

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Screening for thyroid disease : An update. / Helfand, Mark; Redfern, C. C.

In: Annals of Internal Medicine, Vol. 129, No. 2, 1998, p. 144-158.

Research output: Contribution to journalArticle

Helfand, M & Redfern, CC 1998, 'Screening for thyroid disease: An update', Annals of Internal Medicine, vol. 129, no. 2, pp. 144-158.
Helfand, Mark ; Redfern, C. C. / Screening for thyroid disease : An update. In: Annals of Internal Medicine. 1998 ; Vol. 129, No. 2. pp. 144-158.
@article{a60478d40a2d40c2ba4176a9c3772cee,
title = "Screening for thyroid disease: An update",
abstract = "Purpose: To review information on the benefits of screening with a sensitive thyroid-stimulating hormone (TSH) test for thyroid dysfunction in asymptomatic patients seeking primary care for other reasons. This paper focuses on whether screening should be aimed at detection of subclinical thyroid dysfunction and whether persons with mildly abnormal TSH levels can benefit. Data Sources: A MEDLINE search for studies of screening for thyroid dysfunction and of treatment for complications of subclinical thyroid dysfunction. Study Selection: Studies of screening with thyroid function tests in the general adult population or in patients seen in the general office setting were selected (n = 33). All controlled studies of treatment in patients with subclinical hypothyroidism or subclinical hyperthyroidism were also included (n = 23). Data Extraction: The prevalence of overt and subclinical thyroid dysfunction, the evidence for the efficacy of treatment, and the incidence of complications in defined age and sex groups were extracted from each study. Data Synthesis: Screening can detect symptomatic but unsuspected overt thyroid dysfunction. The yield is highest for women older than 50 years of age: In this group, 1 in 71 women screened could benefit from relief of symptoms. Evidence of the efficacy of treatment for subclinical thyroid dysfunction is inconclusive. Conclusions: Even though treatment for subclinical thyroid dysfunction is controversial, office-based screening to detect overt thyroid dysfunction may be indicated in women older than 50 years of age. Large randomized trials are needed to determine the likelihood that treatment will improve quality of life in otherwise healthy patients who have mildly elevated TSH levels.",
author = "Mark Helfand and Redfern, {C. C.}",
year = "1998",
language = "English (US)",
volume = "129",
pages = "144--158",
journal = "Annals of Internal Medicine",
issn = "0003-4819",
publisher = "American College of Physicians",
number = "2",

}

TY - JOUR

T1 - Screening for thyroid disease

T2 - An update

AU - Helfand, Mark

AU - Redfern, C. C.

PY - 1998

Y1 - 1998

N2 - Purpose: To review information on the benefits of screening with a sensitive thyroid-stimulating hormone (TSH) test for thyroid dysfunction in asymptomatic patients seeking primary care for other reasons. This paper focuses on whether screening should be aimed at detection of subclinical thyroid dysfunction and whether persons with mildly abnormal TSH levels can benefit. Data Sources: A MEDLINE search for studies of screening for thyroid dysfunction and of treatment for complications of subclinical thyroid dysfunction. Study Selection: Studies of screening with thyroid function tests in the general adult population or in patients seen in the general office setting were selected (n = 33). All controlled studies of treatment in patients with subclinical hypothyroidism or subclinical hyperthyroidism were also included (n = 23). Data Extraction: The prevalence of overt and subclinical thyroid dysfunction, the evidence for the efficacy of treatment, and the incidence of complications in defined age and sex groups were extracted from each study. Data Synthesis: Screening can detect symptomatic but unsuspected overt thyroid dysfunction. The yield is highest for women older than 50 years of age: In this group, 1 in 71 women screened could benefit from relief of symptoms. Evidence of the efficacy of treatment for subclinical thyroid dysfunction is inconclusive. Conclusions: Even though treatment for subclinical thyroid dysfunction is controversial, office-based screening to detect overt thyroid dysfunction may be indicated in women older than 50 years of age. Large randomized trials are needed to determine the likelihood that treatment will improve quality of life in otherwise healthy patients who have mildly elevated TSH levels.

AB - Purpose: To review information on the benefits of screening with a sensitive thyroid-stimulating hormone (TSH) test for thyroid dysfunction in asymptomatic patients seeking primary care for other reasons. This paper focuses on whether screening should be aimed at detection of subclinical thyroid dysfunction and whether persons with mildly abnormal TSH levels can benefit. Data Sources: A MEDLINE search for studies of screening for thyroid dysfunction and of treatment for complications of subclinical thyroid dysfunction. Study Selection: Studies of screening with thyroid function tests in the general adult population or in patients seen in the general office setting were selected (n = 33). All controlled studies of treatment in patients with subclinical hypothyroidism or subclinical hyperthyroidism were also included (n = 23). Data Extraction: The prevalence of overt and subclinical thyroid dysfunction, the evidence for the efficacy of treatment, and the incidence of complications in defined age and sex groups were extracted from each study. Data Synthesis: Screening can detect symptomatic but unsuspected overt thyroid dysfunction. The yield is highest for women older than 50 years of age: In this group, 1 in 71 women screened could benefit from relief of symptoms. Evidence of the efficacy of treatment for subclinical thyroid dysfunction is inconclusive. Conclusions: Even though treatment for subclinical thyroid dysfunction is controversial, office-based screening to detect overt thyroid dysfunction may be indicated in women older than 50 years of age. Large randomized trials are needed to determine the likelihood that treatment will improve quality of life in otherwise healthy patients who have mildly elevated TSH levels.

UR - http://www.scopus.com/inward/record.url?scp=0032527191&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032527191&partnerID=8YFLogxK

M3 - Article

C2 - 9669977

AN - SCOPUS:0032527191

VL - 129

SP - 144

EP - 158

JO - Annals of Internal Medicine

JF - Annals of Internal Medicine

SN - 0003-4819

IS - 2

ER -