Evidence map›Paper›PMID 36889825›Full record

ArticleBMJ open2023

Consequences of early thyroid ultrasound on subsequent tests, morbidity and costs: an explorative analysis of routine health data from German ambulatory care.

Susann Hueber, Valeria Biermann, Johanna Tomandl, Lisette Warkentin, Angela Schedlbauer, Harald Tauchmann, David Klemperer, Maria Lehmann, Ewan Donnachie, Thomas Kühlein

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.4field-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, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
  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

10 authors at 3 institutions in 1 country.

Susann HueberInstitute of General Practice, Universitätsklinikum Erlangen, Erlangen, Bayern, Germany susann.hueber@uk-erlangen.de.ORCID 0000-0003-0844-0919
Valeria BiermannChair of Health Management, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Bayern, Germany.
Johanna TomandlInstitute of General Practice, Universitätsklinikum Erlangen, Erlangen, Bayern, Germany.ORCID 0000-0001-5571-421X
Lisette WarkentinInstitute of General Practice, Universitätsklinikum Erlangen, Erlangen, Bayern, Germany.ORCID 0000-0002-6241-6082
Angela SchedlbauerInstitute of General Practice, Universitätsklinikum Erlangen, Erlangen, Bayern, Germany.
Harald TauchmannProfessorship of Health Economics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Bayern, Germany.ORCID 0000-0002-9179-0671
David KlempererInstitute of General Practice, Universitätsklinikum Erlangen, Erlangen, Bayern, Germany.
Maria LehmannInstitute for Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Bayern, Germany.
Ewan DonnachieBavarian Association of Statutory Health Insurance Physicians, Munich, Germany.
Thomas KühleinInstitute of General Practice, Universitätsklinikum Erlangen, Erlangen, Bayern, Germany.
Universitätsklinikum Erlangen · DEFriedrich-Alexander-Universität Erlangen-Nürnberg · DENational Association of Statutory Health Insurance Physicians · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThis study aims to evaluate whether the use of thyroid ultrasound (US) early in the work-up of suspected thyroid disorders triggers cascade effects of medical procedures and to analyse effects on morbidity, healthcare usage and costs. STUDY

designRetrospective analysis of claims data from ambulatory care (2012-2017).

settingPrimary care in Bavaria, Germany, 13 million inhabitants.

participantsPatients having received a thyroid stimulating hormone (TSH) test were allocated to (1) observation group: TSH test followed by an early US within 28 days or (2) control group: TSH test, but no early US. Propensity score matching was used adjusting for socio-demographic characteristics, morbidity and symptom diagnosis (N=41 065 per group after matching). PRIMARY AND SECONDARY OUTCOME MEASURES: Using cluster analysis, groups were identified regarding frequency of follow-up TSH tests and/or US and compared.

resultsFour subgroups were identified: cluster 1: 22.8% of patients,

conclusionPresumably unnecessary tests in the field of suspected thyroid diseases seem to be frequent, contributing to cascades effects. Neither German nor international guidelines provide clear recommendations for or against US screening. Therefore, guidelines on when to apply US and when not are urgently needed.

Indexed as

Thyroid DiseasesAmbulatory CareFemaleHumansRetrospective StudiesThyrotropinThyrotropinPRIMARY CAREThyroid diseaseULTRASONOGRAPHY

Identifiers

PMID36889825
PMCPMC10008444
OpenAlexW4323544261

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.