Evidence map›Paper›PMID 31360539›Full record

ArticleClinical diabetes and endocrinology2019

Endocrinology practice patterns of hypothyroidism and osteoporosis management in a U.S. tertiary academic medical center.

Jien Shim, Tiffany Lin, Cody Dashiell-Earp, Meghan Nechrebecki, Angela M Leung

Open access · goldAbstract read
In one paragraph

Article in Clinical diabetes and endocrinology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 36% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 2 countries.

Jien Shim1Division of Endocrinology, Diabetes, and Metabolism; Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA USA.
Tiffany Lin3UCLA David Geffen School of Medicine, Los Angeles, CA USA.
Cody Dashiell-Earp3UCLA David Geffen School of Medicine, Los Angeles, CA USA.
Meghan Nechrebecki3UCLA David Geffen School of Medicine, Los Angeles, CA USA.
Angela M Leung1Division of Endocrinology, Diabetes, and Metabolism; Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA USA.ORCID 0000-0001-8935-9332
APLA Health · USUniversity of California, Los Angeles · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe major published clinical guidelines for the management of hypothyroidism and osteoporosis are not uniformly consistent and may be a significant contributor to variability of clinical care delivered by endocrinologists, in addition to other factors, such as physician experience, physician and patient perceptions, and patient comorbidities. The purpose of this study was to assess practice patterns of hypothyroidism and osteoporosis within an academic endocrine clinic.

methodsA retrospective medical record review of the first 200 adult patients (

resultsMost patients with hypothyroidism (99%) had a serum thyroid stimulating hormone concentration measured. Other thyroid indices measured included serum total thyroxine (10%), serum free thyroxine [T4] (82%), serum free T4 index (6%), serum total triiodothyronine [T3] (9%), and serum free T3 (12%). Forty-eight percent also had serum thyroid antibodies checked. A variety of thyroid hormone supplements were used to treat hypothyroidism, including levothyroxine (83%), levothyroxine and liothyronine combination (8%), and desiccated thyroid extract (6%). In regards to patients with osteoporosis, mean duration of all pharmacologic therapy combined was 73.4 ± 81.9 months. For those with more than one bone density (DXA) scans (64%), the mean time interval between two consecutive DXA scans was variable (mean 32.0 ± 24.7 [SD] months). Sixty eight percent of the patients had bone turnover markers assessed within 7 months of the visit.

conclusionsThis study reports a real-world experience of endocrinology practice patterns at a large U.S. academic healthcare system. For the common diagnoses of hypothyroidism and osteoporosis, there are opportunities for increased standardization of care, particularly regarding the ordering of laboratory testing and radiologic studies. Identifying areas with significant practice variability may improve the quality and health outcomes and reduce the cost of care for patients with these conditions. Increased understanding regarding the reasons behind ordering various studies may help physician and patients further align their goals.

Indexed as

HypothyroidismOsteoporosisPractice patterns

Identifiers

PMID31360539
PMCPMC6637534
OpenAlexW2964043775

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.