24.08.2015, 22:10
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Модератор форума по гематологии
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Регистрация: 16.01.2003
Город: Хьюстон, Техас
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Уважаемый Василий,
Несмотря на Ваши личные пожелания (быть или не быть поскринированным в зависимости от расовой или возрастной принадлежности) разные организации/сообщества по разному оценивают необходимость сей процедуры у бессимптомных взрослых:
Recommendations of Six Organizations Regarding Screening of Asymptomatic Adults for Thyroid Dysfunction
American Thyroid Association -> Women and men >35 years of age should be screened every 5 years.
American Association of Clinical Endocrinologists -> Older patients, especially women, should be screened.
American Academy of Family Physicians -> Patients ≥60 years of age should be screened.
American College of Physicians -> Women ≥50 years of age with an incidental finding suggestive of symptomatic thyroid disease should be evaluated.
U.S. Preventive Services Task Force -> Insufficient evidence for or against screening
Royal College of Physicians of London -> Screening of the healthy adult population unjustified
[Ссылки доступны только зарегистрированным пользователям ]
и проблема в том, что диагностическая сила ТТГ (при клин. подозрении на дисфункцию ЩЖ) и скрининговая несколько отличаются и по специфичности и по чувствительности:
When used to confirm suspected thyroid disease in patients referred to a specialty endocrine clinic, TSH has a high sensitivity (98 percent) and specificity (92 percent). When used for screening primary care populations, the positive predictive value of TSH in detecting thyroid disease is low; further, the interpretation of a positive test result often is complicated by an underlying illness or by frailty of the patient... A severe nonthyroid disease can lead to a false-positive TSH test result; in a recent systematic review of TSH used to screen patients admitted to acute care and geriatric hospitals, the positive predictive value of a low TSH was 0.24 for hyperthyroidism and 0.06 for hypothyroidism.
[Ссылки доступны только зарегистрированным пользователям ]
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Искренне,
Вадим Валерьевич.
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