TREATMENT GUIDELINES FOR PATIENTS WITH HYPERTHYROIDISM AND HYPOTHYROIDISM

Objective.-To develop a set of minimum clinical guidelines for use by primary care physicians in the evaluation and management of patients w ith hyperthyroidism and hypothyroidism. Participants.-Guidelines were developed by a nine-member ad hoc Standards of Care Committee of the A merican Thyroid Association (the authors of this article). The partici pants were selected by the committee chair and the president of the Am erican Thyroid Association on the basis of their clinical experience. The committee members represented different geographic areas within th e United States, in order to take. into account different practice sty les. Evidence.-Guideline were developed on the basis of expert opinion of the participants, as well as on available published information. C onsensus Process.-Input was obtained from all of the participants, eac h of whom wrote an initial section of the document. A complete draft d ocument was then written by three participants (P.A.S., D.S.C., and E. G.L.) and resubmitted to the entire committee for revision. The revise d document was then submitted to the entire membership of the American Thyroid Association for written comments, which were then reviewed (m ainly by P.A.S., D.S.C., and E.G.L.). Many of the suggestions of the A merican Thyroid Association members were incorporated into the final d raft, which was then approved by the Executive Council of the American Thyroid Association. The entire process, from initial drafts to final approval, took approximately 18 months. Conclusions.-A set of minimum clinical guidelines for the diagnosis and treatment of hyperthyroidis m and hypothyroidism were developed by consensus of a group of experie nced thyroidologists. The guidelines are intended to be used by physic ians in their care of patients with thyroid disorders, with the expect ation that more effective care can be provided, and at a cost savings.