{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T23:18:08Z","timestamp":1780787888880,"version":"3.54.1"},"reference-count":31,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2012,8,1]],"date-time":"2012-08-01T00:00:00Z","timestamp":1343779200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Primary Health Care"],"published-print":{"date-parts":[[2013,4]]},"abstract":"\n Background<\/jats:title>\n Subclinical hypothyroidism (SCHo) is a\n common biochemical diagnosis in older age.\n Evidence of impact is inconclusive and guidelines\n are inconsistent. With increasing numbers of\n thyroid function tests (TFTs) performed, GPs\n frequently have to make management decisions\n regarding this diagnosis. However, little is known\n about how SCHo is currently being managed in\n primary care.<\/jats:p>\n <\/jats:sec>\n \n Aim<\/jats:title>\n To explore management of SCHo in primary\n care and GP reported rationale for treatment of\n SCHo in older individuals.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Descriptive study using retrospective case\n note review and GP survey.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Nineteen General Practices, Central\n England, UK.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Follow-up of a large cohort with\n subsequent detailed review of individuals for whom\n therapy had been initiated following diagnosis of\n SCHo. Data on practice policies, and rationale\n behind treatment were collected via GP\n questionnaire.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Forty-two individuals were treated\n following identification of SCHo. Factors regarded\n as supporting instigation of therapy recorded by\n practitioners included symptoms, a positive\n antithyroid antibody test and history of\n radioiodine therapy. In all, 55% were registered\n at 3\/19 practices suggesting significant between\n practice variation. Reasons for testing included\n chronic disease check-up\n (\n n<\/jats:italic>\n = 14), presenting\n \u2018thyroid symptoms\u2019 (\n n<\/jats:italic>\n =\n 5) and presenting other symptoms\n (\n n<\/jats:italic>\n = 9). Reasons for\n therapy initiation were only recorded in 26 cases\n and included presence of symptoms, persistently\n high or increasing serum thyroid stimulating\n hormone concentration and patient request. Only\n 2\/15 GPs reported having practice guidelines on\n management.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Results suggest that GPs are uncertain how\n to interpret symptoms and TFT results in older\n individuals. There is considerable variation in\n management of SCHo between GPs with some GPs\n treating patients outside of all guideline\n recommendations.<\/jats:p>\n <\/jats:sec>","DOI":"10.1017\/s1463423612000230","type":"journal-article","created":{"date-parts":[[2012,11,22]],"date-time":"2012-11-22T11:24:15Z","timestamp":1353583455000},"page":"175-184","source":"Crossref","is-referenced-by-count":13,"title":["Why are GPs treating subclinical\n hypothyroidism? Case note review and GP\n survey"],"prefix":"10.1017","volume":"14","author":[{"given":"Jack","family":"Allport","sequence":"first","affiliation":[{"name":"University of Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"McCahon","sequence":"additional","affiliation":[{"name":"School of Health and Population Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.D. Richard","family":"Hobbs","sequence":"additional","affiliation":[{"name":"University of Oxford"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesley M.","family":"Roberts","sequence":"additional","affiliation":[{"name":"School of Health and Population Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2012,8,1]]},"reference":[{"key":"S1463423612000230_manual_ref-14","doi-asserted-by":"crossref","first-page":"2591","DOI":"10.1001\/jama.292.21.2591","article-title":"Thyroid status, disability and cognitive function, and survival in old age","volume":"292","author":"Gussekloo","year":"2004","journal-title":"Journal of the American Medical Association"},{"key":"S1463423612000230_manual_ref-29","doi-asserted-by":"publisher","DOI":"10.1001\/jama.291.2.228"},{"key":"S1463423612000230_manual_ref-27","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1001\/jama.2010.1361","article-title":"Subclinical hypothyroidism and the risk of coronary heart disease and mortality","volume":"304","author":"Rodondi","year":"2010","journal-title":"Journal of the American Medical Association"},{"key":"S1463423612000230_manual_ref-31","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1136\/bmj.313.7056.539","article-title":"Consensus statement for good practice and audit measures in the management of hypothyroidism and hyperthyroidism. The Research Unit of the Royal College of Physicians of London, the Endocrinology and Diabetes Committee of the Royal College of Physicians of London, and the Society for Endocrinology","volume":"313","author":"Vanderpump","year":"1996","journal-title":"British Medical Journal"},{"key":"S1463423612000230_manual_ref-22","unstructured":"Noble, M. , Wright, G.\n Dibben, C. 2010: The English indices of\n deprivation 2004 (revised) [online]. 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