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Comment & Response
December 2019

Safety of the Use of Radioactive Iodine in Patients With Hyperthyroidism

Author Affiliations
  • 1Division of Nuclear Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
  • 2Departments of Radiology and Medicine, McMaster University, Hamilton, Ontario, Canada
  • 3American College of Nuclear Medicine, North Augusta, South Carolina
JAMA Intern Med. 2019;179(12):1738-1739. doi:10.1001/jamainternmed.2019.5120

To the Editor As representatives of the American College of Nuclear Medicine, we wish to comment on a recent Original Investigation by Kitahara and colleagues1 that has indirectly called into question the safety of the use of sodium iodide I-131, also known as radioactive iodine (RAI).

Safety of RAI therapy for treatment of hyperthyroidism was previously demonstrated using the same large study patient cohort2 as in the study by Kitahara and colleagues. Data presented in the current article1 took a different approach to analysis and did not report on comparison mortality with either the population nor other therapy options, which severely limits this report. The conclusion is highly problematic: the misrepresentation of “modest positive association” as meaning causation is a misleading and dangerous leap.

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