We read with great interest the article by Meyerovitch et al1 on the follow-up of thyrotropin (TSH) measurements in the community. Although we share the authors' opinion on patient treatment and we acknowledge the convincing demonstration of the amazing costs of the current clinical bad practices, we think that the study has a major bias that prevents one to draw definitive conclusions. The authors stated that “to study the natural history,” 37% of patients who received treatment with levothyroxine or antithryoid drugs after the initial TSH determination were excluded.1(p1534) It is not mentioned how many of these patients had either increased or decreased TSH levels.
Goichot B, Vinzio S. Whether to Repeat Thyroid Disease Screening. Arch Intern Med. 2008;168(3):330. doi:10.1001/archinternmed.2007.94