Provider variability in the initial diagnosis and treatment of congenital hypothyroidism

Luke Cielonko; Tyler Hamby; John S. Dallas; Luke Hamilton; Don P. Wilson

doi:10.1515/jpem-2016-0326

Article

Provider variability in the initial diagnosis and treatment of congenital hypothyroidism

Luke Cielonko , Tyler Hamby , John S. Dallas , Luke Hamilton and Don P. Wilson

Published/Copyright: March 22, 2017

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From the journal Journal of Pediatric Endocrinology and Metabolism Volume 30 Issue 5

Abstract

Background:

Early diagnosis and expeditious treatment of newborns with congenital hypothyroidism (CH) is necessary to avoid mental retardation.

Methods:

A survey of 44 practitioners in the southern US was conducted to better understand common practices regarding neonatal CH and the findings were compared with current guidelines in the US and Europe.

Results:

Responses indicated some consensus that 10–15 μg of thyroid hormone/kg/day was the appropriate dosage. However, despite guidelines advocating their use, practitioners reported that they did not commonly use imaging or laboratory tests, though experienced providers apparently used them more often.

Conclusions:

Together, these results show moderate adherence to published guidelines for treating and diagnosing CH. Further research is needed to determine why providers deviate from these guidelines and to generalize these results to other populations.

Keywords: congenital hypothyroidism; diagnosis; practice guidelines; survey research; treatment

Corresponding author: Tyler Hamby, PhD, Department of Research Operations, Cook Children’s Health Care System, 801 7th Ave. Fort Worth, TX 76104, USA; and Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA

Acknowledgments

This study was conducted as part of the University of North Texas Health Science Center and Cook Children’s Pediatric Research Program (PRP). The authors would like to acknowledge Karen Keller, Dena Hanson and Ashley Brock for their assistance in preparing and editing this manuscript.

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2016-8-17

Accepted: 2017-1-30

Published Online: 2017-3-22

Published in Print: 2017-5-1

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https://doi.org/10.1515/jpem-2016-0326

Keywords for this article

congenital hypothyroidism; diagnosis; practice guidelines; survey research; treatment