Monitoring Thyroglobulin Following Total Thyroidectomy After Lobectomy

Abstract

including frailty, general balance, and mobility, as well as the capacity and willingness to adhere to the recommended PT regimen during and after therapy sessions at home as important covariates. 2 At the same time, we acknowledge constraints in assessing these variables in our analyses due to their unavailability in the administrative dataset we used. We agree with the authors on the necessity for further research to elucidate how these variables may affect PT use and the effects of PT for patients experiencing dizziness.Wu and colleagues reference a 2022 commentary 3 highlighting limitations of using the Charlson Comorbidity Index (CCI), a weighted index, rather than specific individual diagnoses to measure comorbidity, particularly for assessing risk of death or survival time in patients with cancer. We acknowledge the imperfections of grouping predefined comorbidities and the limitations of indices including CCI to capture the full spectrum of patient-specific comorbidities. Despite these imperfections, the CCI remains the most widely used comorbidity index, boasting more than 10 000 citations. Its appeal, especially in administrative studies like ours, 1 lies in its utility and generalizability for large cohorts and its adaptability for use with administrative data. 4,5 We concur with Wu and colleagues that additional work is warranted. The association we observed in the cohort between PT and falls among individuals with dizziness was robust at all time points, and yet inclusion of the variables proposed by our colleagues would add important and practical clinical nuance. Specifically, we propose that future research, ideally using a clinical trial design, is necessary to explore the independent effect of PT on the risk of subsequent falls for adults experiencing dizziness. A prospective trial would best facilitate the measurement of patient-specific covariates of interest that are not captured in claims data. We also contend that further investigation is required to delineate the specific components of PT, such as particular exercises, education, timing and frequency of sessions, duration of therapy, and adherence that are most beneficial.