ReviewEuropean journal of endocrinology2017
Are lower TSH cutoffs in neonatal screening for congenital hypothyroidism warranted?
Review in European journal of endocrinology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
44 citing papers in PubMed, 5 syntheses or guidelines pooled it, 98 citations in OpenAlex.
- Increased incidence of congenital hypothyroidism in China: An analysis of 119 million screened newborns.European journal of pediatrics · 2023Pooled it
- [Clinical guideline of «congenital hypothyroidism»].Problemy endokrinologii · 2022Guideline
- Association Between Newborn Thyroid-Stimulating-Hormone Concentration and Neurodevelopment and Growth: a Systematic Review.Biological trace element research · 2022Pooled it
- Congenital Hypothyroidism: A 2020-2021 Consensus Guidelines Update-An ENDO-European Reference Network Initiative Endorsed by the European Society for Pediatric Endocrinology and the European Society for Endocrinology.Thyroid : official journal of the American Thyroid Association · 2021Guideline
- Update on Neonatal Isolated Hyperthyrotropinemia: A Systematic Review.Frontiers in endocrinology · 2021Pooled it
- Prematurity Appears to Be the Main Factor for Transient Congenital Hypothyroidism in Greece, a Recently Iodine-Replete Country.Nutrients · 2025Article
- Approach to Newborns with Elevated TSH: A Different Perspective from the International Guidelines for Iodine-deficient CountriesJournal of clinical research in pediatric endocrinology · 2025Review
- Incidence of Congenital Hypothyroidism Is Increasing in Chile.International journal of neonatal screening · 2025Article
- Impact of Maternal and Neonatal Factors on Thyroid-Stimulating Hormone Concentrations in Newborns in Eastern Morocco.Cureus · 2025Article
- Newborn screening for primary congenital hypothyroidism: past, present and future.European thyroid journal · 2025Review
- Newborn screening and the screening laboratory: past, present and future.European thyroid journal · 2025Review
- Primary congenital hypothyroidism: a clinical review.Frontiers in endocrinology · 2025Review
- Screening of 50,539 newborns for congenital hypothyroidism: optimization of TSH cut-off values and seasonal impact in clinical practice.Frontiers in endocrinology · 2025Article
- High frequency of transient congenital hypothyroidism among infants referred for suspected congenital hypothyroidism from the Turkish National screening program: thyroxine dose may guide the prediction of transients.Journal of endocrinological investigation · 2024Observational
- Impact of Lowering TSH Cut-Off on Neonatal Screening for Congenital Hypothyroidism in Minas Gerais, Brazil.International journal of neonatal screening · 2024Article
- Clinical survey of current practice regarding treatment of children with borderline thyroid abnormalities.Journal of paediatrics and child health · 2023Article
- Guidelines for Newborn Screening of Congenital Hypothyroidism (2021 Revision).Clinical pediatric endocrinology : case reports and clinical investigations : official journal of the Japanese Society for Pediatric Endocrinology · 2023Article
- Newborn screening for genetic disorders: Current status and prospects for the future.Pediatric investigation · 2022Review
- The Role of Iodine for Thyroid Function in Lactating Women and Infants.Endocrine reviews · 2022Review
- Twenty years of newborn screening for congenital adrenal hyperplasia and congenital primary hypothyroidism - experiences from the DGKED/AQUAPE study group for quality improvement in Germany.Medizinische Genetik : Mitteilungsblatt des Berufsverbandes Medizinische Genetik e.V · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 5 institutions in 4 countries.
Funding
Abstract
When newborn screening (NBS) for congenital hypothyroidism (CH) using thyroid-stimulating hormone (TSH) as a primary screening test was introduced, typical TSH screening cutoffs were 20-50 U/L of whole blood. Over the years, lowering of TSH cutoffs has contributed to an increased prevalence of detected CH. However, a consensus on the benefit deriving from lowering TSH cutoffs at screening is lacking. The present paper outlines arguments both for and against the lowering of TSH cutoffs at NBS. It includes a review of recently published evidence from Australia, Belgium and Italy. A section focused on economic implications of lowering TSH cutoffs is also provided. One issue that bears further examination is the extent to which mild iodine deficiency at the population level might affect the association of neonatal TSH values with cognitive and developmental outcomes. A debate on TSH cutoffs provides the opportunity to reflect on how to make NBS for CH more effective and to guarantee optimum neurocognitive development and a good quality of life to babies with mild as well as with severe CH. All authors of this debate article agree on the need to establish optimal TSH cutoffs for screening programs in various settings and to ensure the benefits of screening and access to care for newborns worldwide.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.