Choosing Wisely for Thyroid Conditions: Recommendations of the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism

Dora, José Miguel; Biscolla, Rosa Paula M.; Caldas, Gustavo; Cerutti, Janete M.; Graf, Hans; Hoff, Ana O.; Mazeto, Gláucia Maria Ferreira da Silva; Magalhães, Patrícia Künzle Ribeiro; Mesa, Cléo Otaviano; Scheffel, Rafael Selbach; Teixeira, Patrícia de Fátima dos Santos; Vaisman, Fernanda; Villagelin, Danilo; Maia, Ana Luiza Silva

doi:10.20945/2359-3997000000323

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…Nevertheless, little is known about the consequences due to the unprecedented nature of this pandemic. Thus, in addition to strategies to manage a growing amount of patients, discouragement of thyroid exams/procedures related to low-value care is timely ( 16 , 17 ).…”

Section: Discussionmentioning

confidence: 99%

Effect of COVID-19 pandemic on diagnosis and treatment of thyroid cancer in Brazil

Silveira

Schwengber²,

Hetzel³

et al. 2022

Front. Endocrinol.

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IntroductionThe COVID-19 pandemic delayed the diagnosis, treatment, and follow-up visits of patients with thyroid cancer. However, the magnitude with which these restrictions affected the Brazilian health care is still unknown.MethodsRetrospective analysis of thyroid cancer-related procedures performed in the Brazilian public health system from 2019 to 2021. Data were retrieved from the Department of Informatics of the Unified Health System (DATASUS). The following procedures were evaluated: fine-needle aspiration biopsies (FNABs), oncologic thyroidectomies, and radioiodine (RAI) therapies for thyroid cancer. The year of 2019 served as baseline control.ResultsCompared with 2019, FNABs, oncologic thyroidectomies, and RAI therapies performed in 2020 decreased by 29%, 17% and 28%, respectively. In 2021, compared with 2019, FNABs increased by 2%, and oncologic thyroidectomies and RAI therapies decreased by 5% and 25%, respectively. Most pronounced reductions were observed in the first months of the pandemic. In April 2020, FNABs decreased by 67%, oncologic thyroidectomies by 45%, and RAI therapies by 75%. In 2021, RAI therapies were the only procedure with a statistically significant decrease.ConclusionThe restrictions to public health care during the COVID-19 pandemic resulted in a significant reduction in diagnostic and treatment procedures for thyroid cancer in Brazil. The effects of these transitory gaps in thyroid cancer care, due to COVID-19, are still unclear.

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Section: Discussionmentioning

confidence: 99%

Effect of COVID-19 pandemic on diagnosis and treatment of thyroid cancer in Brazil

Silveira

Schwengber²,

Hetzel³

et al. 2022

Front. Endocrinol.

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“…W e have read with interest the article published by Dora J, which recommends against prescribing liothyronine (L-T3) alone or in combination with levothyroxine (LT4) for hypothyroidism, because the short half-life of triiodothyronine (T3) means multiple daily doses are required, and there is no clear evidence in humans that combination therapy is superior to L-T4 alone (1). No guidelines have recommended thyroid hormone replacement with L-T3 alone, but the question remains whether L-T3 + L-T4 combination therapy may be better than levothyroxine alone in a selected group of patients with hypothyroidism (2).…”

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confidence: 99%

T3 therapy in hypothyroidism. Still more questions than answers

Concepción-Zavaleta

Arroyo

Zavaleta-Gutiérrez³

et al. 2021

Archives of Endocrinology and Metabolism

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“…TO THE EDITOR, W e thank Zavaleta and cols. (1) for their interest in our work and the opportunity to expand the discussion on Choosing Wisely recommendations for managing thyroid-related conditions (2).…”

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confidence: 99%

T3 therapy for hypothyroidism: choosing wisely still requires careful bench to bedside translation

Dora

Scheffel

Maia

2021

Archives of Endocrinology and Metabolism

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Choosing Wisely for Thyroid Conditions: Recommendations of the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism

Cited by 3 publications

References 10 publications

Effect of COVID-19 pandemic on diagnosis and treatment of thyroid cancer in Brazil

Effect of COVID-19 pandemic on diagnosis and treatment of thyroid cancer in Brazil

T3 therapy in hypothyroidism. Still more questions than answers

T3 therapy for hypothyroidism: choosing wisely still requires careful bench to bedside translation

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