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Debate over who needs a thyroid check in pregnancy


5 Star


Debate over who needs a thyroid check in pregnancy

Our Review Summary

The article gives extensive context to the recent Journal of Clinical Endocrinology & Metabolism study and refers to other research done in the field.


Why This Matters

The article effectively breaks down and explains a complex debate in the physician community – whether all pregnant women should be screened for thyroid function and whether women with milder cases of hypothyroidism should be diagnosed and treated. The story says this will “add pressure” for science to settle this issue, but that pressure already exists from endocrinologists and obstetricians – with, as the study shows, about 1 in 5 pregnant women being tested from 2005-8.



Does the story adequately discuss the costs of the intervention?


The story states that a $25 blood test can identify someone with a thyroid disorder. The costs associated with daily hormone therapy are not discussed.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?


The article does an excellent job explaining the importance of thyroid hormones during pregnancy for fetal brain development, especially during the first trimester. It also points out the role in preventing miscarriage and premature birth. Furthermore, the story thoroughly details the risks that come with an overactive or an underactive thyroid gland for the average person.

Does the story adequately explain/quantify the harms of the intervention?


The article mentions that, for mild cases of hypothyroidism, scientists are unsure whether diagnoses and subsequent treatment sufficiently help pregnant patients or, instead, waste money on blood testing and thyroid medication. This is appropriately stated high up (in the first third) in the report.

Does the story seem to grasp the quality of the evidence?


The article briefly mentions that the Quest Diagnostics study looked at records and surveys from half a million pregnant women, but apart from this fact, the story does not outline any more research methods or protocol. We could interpret the findings better if we knew, for example:

  • how do the women who were tested at Quest reflect the general population of pregnant women?
  • how did changes in the definition of what is abnormal affect the results, compared to older studies?

Does the story commit disease-mongering?


There is no disease mongering in this story. The article gives appropriate and sufficient background information on various thyroid disorders and how they could affect pregnant women.

Does the story use independent sources and identify conflicts of interest?


The comment from Dr. Dena Goffman of New York’s Montefiore Medical Center offers an outside perspective on the research and the “long-running controversy” regarding thyroid testing for pregnant women. However, researchers at Quest Diagnostics – one of the world’s biggest companies for diagnostic services – conducted this study, which found a “higher-than-expected” number of pregnant women with underactive thyroids. Whether Quest Diagnostics funded the study, or whether Dr. Elizabeth Pearce had ties to the company, were not explicitly discussed.

Does the story compare the new approach with existing alternatives?


The story offers different perspectives and guidelines on thyroid screening from the American College of Obstetricians and Gynecologists and the American Thyroid Association.

Does the story establish the availability of the treatment/test/product/procedure?


The story makes it clear that “nearly a quarter of pregnant women are getting the simple thyroid blood test regardless of whether they have symptoms.”

Does the story establish the true novelty of the approach?


Thyroid function screening via a blood test is not a new concept. The question is whether milder cases of hypothyroidism in pregnant women should be treated with daily hormone therapy. In general, the article does an excellent job laying out both sides of the issue.

Does the story appear to rely solely or largely on a news release?


There was no evidence that the story relied solely on a press release.

Total Score: 10 of 10 Satisfactory


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