1 / 8

Hypothyroidism

Hypothyroidism. General Medicine Conference. Screening. Should it be done? Argue for: Common Prevalence = 4-10% for mild thyroid failure in the general population (18% in the elderly) Cost effective

gilles
Télécharger la présentation

Hypothyroidism

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Hypothyroidism General Medicine Conference

  2. Screening • Should it be done? • Argue for: • Common • Prevalence = 4-10% for mild thyroid failure in the general population (18% in the elderly) • Cost effective • Has been estimated to be as cost-effective as other generally recommended screenings such as mammography

  3. Cost-effectiveness

  4. Screening • Should it be done? • Argue for: • Common • Prevalence = 4-10% for mild thyroid failure in the general population (18% in the elderly) • Cost effective • Validated test

  5. Screening • Argue against: • Does it lower morbidity? • (especially compared with “high-risk” screening)

  6. Recommendations for Selective Screening • AACE • Older patients, especially women • ATA • Women over 60 • History of thyroid disease • Autoimmune disease • Unexplained depression • Cognitive dysfunction • Hypercholesterolemia • ACP/ABIM • Women over 50 years old

  7. Screening • What about pre-pregnancy or early pregnancy evaluation? • Hypothyroidism in the mother is associated with: • Placental abruption • Preterm delivery • Perinatal intraventricular hemorrhage • Infant respiratory distress syndrome • Lower child IQ scores

  8. Screening • An “expert panel” has found insufficient evidence to recommend for or against routine TSH testing in pre/early pregnancy but did recommend “high-risk” screening. • JAMA 2004 • A separate “panel of experts” (AACE and Endocrine Society) strongly disagrees with this and does recommend routine TSH testing in all women for pre/early pregnancy evaluations. • J Clin Endo/Metab 2005

More Related