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The thyroid is a vitally important hormonal gland, which mainly works for the body’s metabolism. It is located in the front part of the neck below the voice box and is butterfly-shaped. The functions of the thyroid gland include the production of the thyroid hormones triiodothyronine (T3) and tetraiodothyronine, also called thyroxine (T4).

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: December 30, 2016

INTRODUCTION: The severity of critical illness is associated with various patterns of thyroid hormone abnormalities. We sought to evaluate whether the outcome of patients with, specifically, sepsis or septic shock is associated with the thyroid function tests evaluated at diagnosis or admission in the intensive care unit (ICU).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Screening may lead to detection and treatment of asymptomatic subclinical thyroid dysfunction or undiagnosed overt thyroid disease, potentially resulting in improved clinical outcomes.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: October 2014

We conducted this systematic review to support the U.S. Preventive Services Task Force in updating its recommendation on screening for thyroid cancer. Our review addresses the following Key Questions (KQs): 1) Compared with not screening, does screening adults for thyroid cancer lead to a reduced risk of thyroid-specific mortality or morbidity, reduced all-cause mortality, and/or improved quality of life? 2) What are the test performance characteristics of screening tests for detecting malignant thyroid nodules in adults? 3) What are the harms of screening for thyroid cancer in adults? 4) Does treatment of screen-detected thyroid cancer reduce thyroid-specific mortality or morbidity, reduce all-cause mortality, and/or improve quality of life? 5) What are the harms of treating screen-detected thyroid cancer?

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: May 2017

Expert-reviewed information summary about the treatment of childhood thyroid cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: January 11, 2018

Expert-reviewed information summary about the treatment of childhood thyroid cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: January 9, 2018

The evidence base which supported the National Institute for Health and Clinical Excellence (NICE) published Clinical Guideline 3 was limited and 50% was graded as amber. However, the use of tests as part of pre-operative work-up remains a low-cost but high-volume activity within the NHS, with substantial resource implications. The objective of this study was to identify, evaluate and synthesise the published evidence on the clinical effectiveness and cost-effectiveness of the routine use of three tests, full blood counts (FBCs), urea and electrolytes tests (U&Es) and pulmonary function tests, in the pre-operative work-up of otherwise healthy patients undergoing minor or intermediate surgery in the NHS.

Health Technology Assessment - NIHR Journals Library.

Version: December 2012

In 2003, NICE first issued guidance on the use of routine preoperative tests for elective surgery (NICE CG3). The guideline evaluated the practice of routinely performing preoperative diagnostic tests for elective surgery in healthy and comorbid populations.

NICE Guideline - National Guideline Centre (UK).

Version: April 2016

CONTEXT: Serum thyroglobulin (Tg) is an indicator of differentiated thyroid cancer (DTC) relapse.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

BACKGROUND Previous meta-analyses of observational data indicate that pregnant women with subclinical hypothyroidism have an increased risk of adverse pregnancy outcome. Potential benefits of levothyroxine (LT4) supplementation remain unclear, and no systematic review or meta-analysis of trial findings is available in a setting of assisted reproduction technologies (ART). METHODS Relevant trials published until August 2012 were identified by searching MEDLINE, EMBASE, Web of Knowledge, the Cochrane Controlled Trials Register databases and bibliographies of retrieved publications without language restrictions. RESULTS From 630 articles retrieved, we included three trials with data on 220 patients. One of these three trials stated 'live delivery' as outcome. LT4 treatment resulted in a significantly higher delivery rate, with a pooled relative risk (RR) of 2.76 (95% confidence limits 1.20-6.44; P = 0.018; I(2) = 70%), a pooled absolute risk difference (ARD) of 36.3% (3.5-69.0%: P = 0.030) and a summary number needed to treat (NNT) of 3 (1-28) in favour of LT4 supplementation. LT4 treatment significantly lowered miscarriage rate with a pooled RR of 0.45 (0.24-0.82; P = 0.010; I(2) = 26%), a pooled ARD of -31.3% (-48.2 to -14.5%: P < 0.001) and a summary NNT of 3 (2-7) in favour of LT4 supplementation. LT4 treatment had no effect on clinical pregnancy (RR 1.75; 0.90-3.38; P = 0.098; I(2) = 82%). In an ART setting, no data are available on the effects of LT4 supplementation on premature delivery, arterial hypertension, placental abruption or pre-eclampsia. CONCLUSIONS Our meta-analyses provide evidence that LT4 supplementation should be recommended to improve clinical pregnancy outcome in women with subclinical hypothyroidism and/or thyroid autoimmunity undergoing ART. Further research is needed to determine pregnancy outcome after close monitoring of thyroid function to maintain thyroid-stimulating hormone and free T4 levels within the trimester-specific reference ranges for pregnancy.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

OBJECTIVE: To review the evidence regarding thyroid function and thyroid autoimmunity (TAI) changes in women undergoing ovarian stimulation (OS).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

BACKGROUND: Thyroid dysfunction is the commonest endocrinopathy associated with HCV infection due to interferon-based treatment. This comprehensive and systematic review presents the available evidence for newly developed thyroid antibodies and dysfunctions during interferon treatment (both single and combination) in HCV patients.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

The Coverage and Analysis Group at the Centers for Medicare and Medicaid Services (CMS) requested that the Technology Assessment Program (TAP) of the Agency for Healthcare Research and Quality (AHRQ) conduct an update of genetic tests for cancer conditions that were identified since the 2011 horizon scan report on Genetic Testing for Cancer. AHRQ assigned this project to the Tufts Medical Center Evidence-based Practice Center (Contract Number: HHSA 290 2007 10055 I, Task Order #11).

Technology Assessment Report - Agency for Healthcare Research and Quality (US).

Version: July 19, 2013

Cancer is an important condition, both in terms of the number of people affected and the impacts on those people and the people close to them. Around one third of a million new cancers are diagnosed annually in the UK, across over 200 different cancer types. Each of these cancer types has different presenting features, though there may be overlap. More than one third of the population will develop a cancer in their lifetime. Although there have been large advances in treatment and survival, with a half of cancer sufferers now living at least ten years after diagnosis, it remains the case that more than a quarter of all people alive now will die of cancer.

NICE Guideline - National Collaborating Centre for Cancer (UK).

Version: June 2015

How do we know whether a particular treatment really works? How reliable is the evidence? And how do we ensure that research into medical treatments best meets the needs of patients? These are just a few of the questions addressed in a lively and informative way in Testing Treatments. Brimming with vivid examples, Testing Treatments will inspire both patients and professionals.

Pinter & Martin.

Version: 2011

There are a number of existing guidelines, for epilepsy, falls and cardiac arrhythmias; which all relate to transient loss of consciousness (TLoC), but there is no guideline which addresses the initial assessment and management of patients who blackout. As such patients may come under the care of a range of clinicians, the lack of a clear pathway contributes to their misdiagnosis, and inappropriate treatment.

NICE Clinical Guidelines - National Clinical Guideline Centre for Acute and Chronic Conditions (UK).

Version: August 2010

Study finds that faecal calprotectin can be a highly sensitive way of detecting inflammatory bowel disease (IBD); in most cases, a negative calprotectin test result rules out IBD, thereby sparing most people with irritable bowel syndrome from having to undergo invasive investigations, such as colonoscopy.

Health Technology Assessment - NIHR Journals Library.

Version: November 2013

This guideline covers adult patients (18 years and older) in a hospital setting and adults (18 and older) in long-term residential care. The guideline addresses: modifiable risk factors (‘clinical factors’) to identify people at risk of developing delirium; diagnosis of delirium in acute, critical and long-term care; as well as pharmacological and non-pharmacological interventions for a) reducing the incidence of delirium and its consequences, and b) to reduce the severity, duration and consequences of delirium in people who develop the condition.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: July 2010

Study found that one-step nucleic acid amplification is not cost-effective for the intraoperative diagnosis of sentinel lymph nodes metastases in breast cancer and that the evidence on Metasin is insufficient to evaluate its cost-effectiveness.

Health Technology Assessment - NIHR Journals Library.

Version: January 2015

The guideline covers the identification and assessment of suspected cirrhosis, monitoring to detect complications and management of complications such as ascites and hepatorenal syndrome and referral for tertiary care.

NICE Guideline - National Guideline Centre (UK).

Version: July 2016

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