Screening for Thyroid Disease
Authors: Joel M. Schectman
Journal: Annals of Internal Medicine (1990)

Letters1 December 1990Screening for Thyroid DiseaseJoel M. Schectman, MD, MPH, L. Gregory Pawlson, MD, MPHJoel M. Schectman, MD, MPHSearch for more papers by this author, L. Gregory Pawlson, MD, MPHSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-113-11-896 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors:In their recent article, Helfand and Crapo (1) state that total thyroxine (TT4) and sensitive-thyrotropin (TSH) assays have similar sensitivity and specificity in the diagnosis of hypothyroidism. This is open to question. If the normal reference range is used for each test, then the specificities of the tests will, of course, be similar. However, the sensitivity of the TT4 in detecting mildly symptomatic primary hypothyroidism (which would most likely be encountered in a screening or case-finding situation) would be much lower than that of the TSH assay. Two retrospective studies in primary care settings found that only...References1. Helfand M and Crapo L. Screening for thyroid disease. Ann Intern Med. 1990;112:840-9. LinkGoogle Scholar2. Shectman J and Pawlson L. The cost-effectiveness of three thyroid function testing strategies for suspicion of hypothyroidism in a primary care setting. J Gen Intern Med. 1990;5:9-15. CrossrefMedlineGoogle Scholar3. Goldstein B and Mushlin A. Use of a single thyroxine test to evaluate ambulatory medical patients for suspected hypothyroidism. J Gen Intern Med. 1987;2:20-4. CrossrefMedlineGoogle Scholar4. dos Remedios L, Weber P, Feldman R, Schurr D, and Tsoi T. Detecting unsuspected thyroid dysfunction by the free thyroxine index. Arch Intern Med. 1980;140:1045-9. CrossrefMedlineGoogle Scholar5. Nolan J, Tarsa N, and DiBenedetto G. Case-finding for unsuspected thyroid disease: costs and health benefits. Am J Clin Pathol. 1985;83:346-55. CrossrefMedlineGoogle Scholar1. Helfand M and Crapo L. Screening for thyroid disease. Ann Intern Med. 1990;112:840-9. LinkGoogle Scholar2. Davis P and Davis B. Hyperthyroidism in patients over the age of 60 years. Medicine (Baltimore). 1974;53:161-81. CrossrefMedlineGoogle Scholar3. Wartofsky L and Burman K. Alterations in thyroid function in patients with systemic illness. The "euthyroid sick syndrome." Endocr Rev. 1982;3:164-217. CrossrefMedlineGoogle Scholar4. Rajatanvin R and Braverman L. Euthyroid hyperthyroxinemia. J Endocrinol Invest. 1983;6:493-505. CrossrefMedlineGoogle Scholar1. Helfand M and Crapo L. Testing for suspected thyroid disease. In: Sox HC Jr, ed. Common Diagnostic Tests. 2d edition. Philadelphia: American College of Physicians; 1990:148-81. Google Scholar2. Helfand M and Crapo L. Screening for thyroid disease. Ann Intern Med. 1990;112:840-9. LinkGoogle Scholar3. Goldstein B and Mushlin A. Use of a single thyroxine test to evaluate ambulatory medical patients for suspected hypothyroidism. J Gen Intern Med. 1987;2:20-4. CrossrefMedlineGoogle Scholar4. Schectman J and Pawlson L. The cost-effectiveness of three thyroid function testing strategies for suspicion of hypothyroidism in a primary care setting. J Gen Intern Med. 1990;5:9-15. CrossrefMedlineGoogle Scholar5. Ericsson U, Fernlund P, and Thorell J. A prospective critical evaluation of in vitro thyroid function tests. Acta Med Scand. 1986;220:47-56. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Joel M. Schectman, MD, MPH; L. Gregory Pawlson, MD, MPHAffiliations: George Washington University Medical Center Washington, D.C. 20037 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 December 1990Volume 113, Issue 11 Page: 896-897 Keywords Hypothyroidism Retrospective studies Specificity Thyroid diseases Thyroid-stimulating hormone Thyroxine ePublished: 1 December 2008 Issue Published: 1 December 1990 PDF downloadLoading ...