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Questions In hospitalised patients with non-thyroidal illness (NTI), are clinical signs and symptoms useful for predicting overt thyroid disease? Is the sensitive thyrotropin (thyroid-stimulating hormone [sTSH]) assay useful for detecting thyroid disease?
Data sources
Studies were identified by searching Medline with the following 2 groups of terms: thyroid diseases, cohort studies, and signs or symptoms; and thyrotropin, hospitalised or medical or inpatient, and sensitivity or specificity. Bibliographies of relevant articles were scanned. Searches were done by 2 different researchers.
Study selection
English-language studies were selected if they enrolled >50 patients. Studies on signs or symptoms were included if they reported sufficient information to allow positive likelihood ratios (+LRs) to be calculated. Studies on sTSH assays were selected if they included patients who were acutely ill or hospitalised with an NTI and if they used second- or third-generation sTSH assays and follow-up after resolution of …