Abstract：
UNASSIGNED: Subclinical thyroid diseases are often the subject of debate concerning their clinical significance, the appropriateness of diagnostic testing, and possible treatment. This systematic review addresses the variation in international guidelines for subclinical hyperthyroidism, focusing on diagnostic workup, treatment, and follow-up recommendations.
UNASSIGNED: Following the PRISMA guidelines, we searched PubMed, Embase, and guideline-specific databases and included clinical practice guidelines with recommendations on subclinical hyperthyroidism. Guideline recommendations were extracted, and quality assessment was performed using selected questions of the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument.
UNASSIGNED: Of the 2624 records screened, 22 guidelines were included, which were published between 2007 and 2021. Guideline quality was generally intermediate to low. Diagnostic approaches differed substantially, particularly in the extent of recommended testing. Treatment initiation depended on TSH levels, age, and comorbidities, but the level of detail regarding defining precise comorbidities varied. Recommendations for monitoring intervals for follow-up ranged from 3 to 12 months.
UNASSIGNED: This review underscores the existing variability in (inter)national guidelines concerning subclinical hyperthyroidism. There isa need for clear recommendations in guidelines considering diagnostic workup, treatment, and follow-up of subclinical hyperthyroidism. In order to establish this, future research should focus on determining clear and evidence-based intervention thresholds.
UNASSIGNED: Following the PRISMA guidelines, we searched PubMed, Embase, and guideline-specific databases and included clinical practice guidelines with recommendations on subclinical hyperthyroidism. Guideline recommendations were extracted, and quality assessment was performed using selected questions of the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument.
UNASSIGNED: Of the 2624 records screened, 22 guidelines were included, which were published between 2007 and 2021. Guideline quality was generally intermediate to low. Diagnostic approaches differed substantially, particularly in the extent of recommended testing. Treatment initiation depended on TSH levels, age, and comorbidities, but the level of detail regarding defining precise comorbidities varied. Recommendations for monitoring intervals for follow-up ranged from 3 to 12 months.
UNASSIGNED: This review underscores the existing variability in (inter)national guidelines concerning subclinical hyperthyroidism. There isa need for clear recommendations in guidelines considering diagnostic workup, treatment, and follow-up of subclinical hyperthyroidism. In order to establish this, future research should focus on determining clear and evidence-based intervention thresholds.
摘要：
背景亚临床甲状腺疾病通常是关于其临床意义的辩论主题，诊断测试的适当性和可能的治疗。本系统综述解决了亚临床甲状腺功能亢进症国际指南的变化，专注于诊断工作，治疗,和后续建议。方法遵循系统评价和荟萃分析(PRISMA)指南的首选报告项目，我们搜索了PubMed,Embase,和特定指南的数据库，并纳入了临床实践指南以及亚临床甲状腺功能亢进症的建议。提取了指南建议，并使用《研究与评估指南》（AGREE）II工具的选定问题进行质量评估。在筛选的2624条记录中，包括22条准则，2007年至2021年出版。指南质量通常是中等到低。诊断方法有很大不同，特别是在推荐的测试范围内。治疗开始取决于TSH水平，年龄,和合并症，但是关于定义精确合并症的详细程度各不相同。建议随访监测间隔为3至12个月。结论本综述强调了有关亚临床甲状腺功能亢进的（国际）国家指南中现有的变异性。在考虑诊断工作的指南中需要明确的建议，亚临床甲亢的治疗和随访。为了建立这一点，未来的研究应该集中在确定明确的和循证的干预阈值上.
