Development and use of evidence-based clinical practice guidelines for thyroid disease

Belin, Ruth M.; Ladenson, Paul W.; Robinson, Karen A.; Powe, Neil R.

doi:10.1016/s0889-8529(02)00023-3

Cited by 5 publications

(5 citation statements)

References 51 publications

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“…Tab. 1 Recommendations of NorthAmericanand Germanthyroid cancerguidelines on radioiodine therapy (RIT): timing relativ to surgery,optimumTSH forRIT or diagnostic whole-body scintigraphy(WBS),radioiodine uptake (RIU),ablativeRIT,diagnostic WBSand TSHunder suppression therapy.The typeofguideline is classified according to (5) Them ethodology of the trial hasb een describedi nd etail ( 11,12). Stated briefly, MSDS wasd esigneda sac omprehensive cohortt rialw ith randomization ando bservation arms (44).P atients were enrolleda t the time of the firsta blativer adioiodine therapy (RIT).…”

Section: Discussionmentioning

confidence: 99%

“…founded on asystematicmetaanalysis of the availables cientific literature ( 47). Beline t al.reviewed21North American andBritish guidelines for thyroiddisease andfound that only7-none of the 5thyroid cancer-related guidelines -i ncluded as ystematicm etaanalysis while the remainingwerebased on narrativel iteraturer eviews only (5). None of the German guidelines on the diagnosis (24) or treatment of thyroid cancer issued before 2004 includedaliteraturereview, the firstf ullyr eferenced guideline being published by the Thyroid Section of the German SocietyofEndocrinology in 2004 (35).…”

Section: Discussionmentioning

confidence: 99%

“…This includesvalue judgments made by the guideline development group when benefits are weighed againstharms (56).This maylead to conflicting guideline recommendations between different expert groups (30), for example regarding the role of adjuvantRTx of DTC (8,18,46) or recommendationsfor treating thyroid microcarcinoma (22,25,26,53). Therei sa lsoaconflict whether guidelines should be "user-friendly" and simple,o rh avem ore regard to special circumstances (5). Thus,itmay be arguedthat DTCguidelines should at least provide the option for WBSwith a 131 Iactivity ≥ 3GBq in patients with persistent hTg elevation afterthe firstfraction of RIT (13).…”

Section: Discussionmentioning

confidence: 99%

“…WBSwas performed afteramedianof96 h(72-144) andafter ≥ 72 hin93%. Of the 6 patients treated with activities<2.0GBq, 5 hadabasal TSH< 30 mU/l (5,12,22, and 24; n=4 )o rR IU ≥ 10% (10, 10, 16, 23; n=4)orboth (n =3), indicating largethyroid remnants aftersurgery.…”

Section: Figmentioning

confidence: 99%

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Guidelines on radioiodine therapy for differentiated thyroid carcinoma

Biermann

Pixberg²,

Dörr³

et al. 2005

Nuklearmedizin

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Figmentioning

confidence: 99%

See 2 more Smart Citations

Guidelines on radioiodine therapy for differentiated thyroid carcinoma

Biermann

Pixberg²,

Dörr³

et al. 2005

Nuklearmedizin

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“…Conducting a systematic review, however, is complex and costly. Most practice guidelines in thyroidology rely on narrative literature reviews and expert opinion; few are based on the systematic evaluation of the published literature and few explicitly acknowledge the underlying values of protecting the vulnerable persons and limiting health care expenditures (6).…”

Section: "Methods To Evaluate Scientific Evidence" -Dr Paul Ladensonmentioning

confidence: 99%

Methods and Criteria Used in Evidence-Based Decisions in Public Health

Boyle

Ladenson²,

Haddow

2005

Thyroid

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A workshop entitled, "The Impact of Maternal Thyroid Diseases on the Developing Fetus: Implications for Diagnosis, Treatment, and Screening," was held in Atlanta, Georgia, January 12-13, 2004. This paper reports on the session that examined methods and criteria used for decisions in public health. For this session the following papers were presented: "Methods to Evaluate Scientific Evidence," "Criteria for Screening," and "Public Health Considerations." Development of evidence-based guidelines, strengthened by rigorous systematic reviews, will improve the quality, efficiency, and cost effectiveness of management of thyroid dysfunction among reproductive-age women. Maternal and fetal benefits that have been hypothesized to result from screening pregnant and pre-pregnant women for hypothyroidism include reduced incidences of peripartum maternal complications and fetal loss and optimization of fetal and neonatal neuropsychological development. Screening should be considered as the initial step in a comprehensive program that includes appropriate diagnostic and therapeutic interventions. The actual benefits and potential risks (i.e., iatrogenic thyrotoxicosis) of implementing a thyroid function screening program have not been demonstrated in a prospective randomized clinical trial or prospective cohort study. Consequently, it is difficult to develop consensus and secure resources for a comprehensive thyroid function screening and therapeutic intervention program in women who are or anticipate becoming pregnant. Marshalling support for performance of both a clinical trial and high-quality observational studies should be a high priority.

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