The Effects of Patient Characteristics on the Management of Subclinical Hypothyroidism: A Survey of Faculty and Trainees
Authors' conclusion
The presence of symptoms, thyroid stimulating hormone >10 mIU/L, and desire for fertility were most predictive of the decision to treat in SCH. In several clinical scenarios, both trainee and faculty decision-making demonstrated discordance with general SCH management principles.
Study context
- Population
- Faculty members and medical trainees at multiple academic medical centers; 9 clinical scenarios of women with subclinical hypothyroidism (SCH), 5 management options from most conservative to most aggressive (levothyroxine)
- Participants
- 194 survey respondents
- Exposure
- Faculty members vs trainees
- Facultyn = 95
- Traineesn = 99reference
- Outcome
- Impact of patient characteristics on SCH management decisions (predicted probability of treatment)
Methodological detailsonline survey, multicentre, clinical scenarios
- Online survey
- Multicentre
- Clinical scenarios
Main finding
As reported in the abstract
Hypothyroid symptoms: PP 68.8%, 95% CI
65.7%-71.9%
TSH >10 mIU/L in a 31-year-old: PP 63.9%, 95% CI
60.3%-67.3%
Desire for fertility: PP 52.2%, 95% CI
48.6%-56.0%
Observational data: associations, not effects.
Further findings
Confident or very confident in diagnosing SCH
P < 0.001
Consider patient preference for treatment
P < 0.001
Treatment aggressiveness across scenarios
- Faculty favored more aggressive treatment across all clinical scenarios
Original publication
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