1. P Lynch P Lynch United Kingdom says:

    Available medical evidence to the contrary has been ignored in the new guidelines issued by the Royal College of Physicians. Because of this, the Royal College is currently reviewing all the evidence, references etc sent to them by doctors, scientists and members of the public in response to the new guidelines.

    In 2007, a General Medical Council Panel, GMC v G. Skinner, Fitness to Practise, declared that, "The Panel could not be satisfied, on the basis of all the evidence presented that a therapeutic trial of thyroxine therapy was inapropriate for a patient with clinical features of hypothyroidism and with thyroid function tests within the reference range." (General Medical Council: 5th September, 2007, (P3)).

    Also, on Page 68 of the 2006 BTA Guidelines it states, "Routine thyroid function tsting has been available for more than thirty years.  Therefore, it may seem surprising that the quality of evidence to support the recommendations in these guidelines is generally poor.  The main reason for this finding is that the early studies that were used to assess the value, validity and effectiveness of thyroid function tests in a variety of clinical situations were performed before the requirements for evidence based medicine were adopted.  There is a real need to conduct new studies that conform to the rules of evidence based medicine in order to provide answers to some common but contentious issues in the use of thyroid function testing."
    UK Guidelines for the Use of Thyroid Function Tests (July, 2006)
    The Association of Clinical Biochemistry, The British Thyroid Association and The British Thyroid Foundation.

    These are three of the Associations as co-authors of the Royal College of Physicians guidelines!

    Many thousands of patients in the UK have regained their health after being prescribed thyroid hormone when their thyroid blood tests were within the reference range, but their symptoms have pointed to hypothyroidism.

    How are we to have faith in a system where doctors themselves say that the quality of evidence to support the recommendations is generally poor?

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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