Determinants for Thyroid Hormone Replacement Therapy in Subclinical Hypothyroidism: A Multicenter Electronic Health Records-Based Study
Authors' conclusion
Among patients with SCH, female sex and index TSH level were associated with higher odds of treatment. Moreover, in our population, the decision to treat or not to treat SCH was often based on only one set of abnormal TFTs, and thyroid autoimmunity assessment was underused.
Study context
- Population
- Adults diagnosed with subclinical hypothyroidism (SCH) at four academic centers (US and Mexico), January 1, 2016 to December 31, 201865.2% women
- Participants
- 796 adults
- Exposure
- Treated vs untreated SCH
- Treatedn = 165
- Outcome
- Determinants of thyroid hormone replacement therapy for SCH and frequency of treated SCH
Methodological detailselectronic health records-based, observational, multicenter
- Electronic health records-based
- Observational
- Multicenter
Main finding
As reported in the abstract
Treated with thyroid hormone replacement therapy
165
20.7%
Female sex, multivariable OR for treatment
OR = 1.71
CI 1.13–2.59p = 0.01
Index TSH level, multivariable OR for treatment per SD (2.75 mIU/L) change
OR = 1.97
CI 1.56–2.49p < 0.001
Observational data: associations, not effects.
Further findings
Age · treated younger
P = 0.008
Women
P = 0.03
Confirmatory TFTs before treatment decision
Thyroid autoimmunity evaluation and positive test · positive test more frequent in treated · per_group values are positive autoimmunity test
P < 0.001
Thyroid autoimmunity evaluation and positive test
- No difference in frequency of thyroid autoimmunity evaluation
Original publication
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