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From page 1... ... Section 123 of the Consolidated Appropriations Act for 2001 commissioned the National Academy of Sciences, now known as the National Academies, "and as appropriate in conjunction with the United States Preventive Services Task Force, to conduct a study on the addition of coverage of routine thyroid screening using a thyroid stimulating hormone test as a preventive benefit provided to Medicare beneficiaries under Title XVIII of the Social Security Act for some or all Medicare beneficiaries" and to "consider the short-term and long-term benefits, and costs to the Medicare program, of such addition." The serum thyroid stimulating hormone (TSH) assay is a common blood test that is already covered by the Medicare program for the diagnosis and treatment of illness. Read the entire page →
From page 2... ... Hypothyroidism, the lack of adequate production of thyroid hormones, can result in fatigue, lethargy, cold intolerance, slowed speech and intellectual function, slowed reflexes, hair loss, dry skin, weight gain, and constipation. Hyperthyroidism, the production of excessive amounts of thyroid hormones, can cause nervousness, anxiety, heart palpitations, rapid pulse, fatigability, tremor, muscle weakness, weight loss with increased appetite, heat intolerance, frequent bowel movements, increased perspiration, and often thyroid gland enlargement (goiter) Read the entire page →
From page 3... ... However, appropriate therapy has not been proven to alter long-term morbidity or mortality in people with subclinical thyroid dysfunction. Similarly, while it is accepted that treatment will benefit patients with biochemically overt thyroid dysfunction who present with significant symptoms or complications, the lack of well designed studies makes it difficult to determine whether treatment would provide significant net benefit in persons who have biochemically defined overt thyroid dysfunction but little evidence of illness; the potential for harm is similar but potential for benefit is less. Read the entire page →
From page 4... ... If not, the test will not effectively reach its intended target population and fail as a disease prevention measure. If a screening test indicates the possibility of a disease being present, there must be suitable, definitive tests to make a formal diagnosis of that condition. Read the entire page →
From page 5... ... Finally, routine TSH screening of asymptomatic persons over 65 years of age may lead to large numbers of persons receiving thyroid hormone therapy, but no randomized clinical trials have been performed that assess the long-term benefits or adverse effects of early treatment of thyroid dysfunction. Given insufficient evidence about the health benefits of a serum TSH screening program, the net cost implications for the Medicare program are uncertain. Read the entire page →
From page 6... ... This recommendation is based on the lack of sufficient evidence of either net benefit or harm. Additional evidence is required for a definitive conclusion. Read the entire page →

From page 1...

... Section 123 of the Consolidated Appropriations Act for 2001 commissioned the National Academy of Sciences, now known as the National Academies, "and as appropriate in conjunction with the United States Preventive Services Task Force, to conduct a study on the addition of coverage of routine thyroid screening using a thyroid stimulating hormone test as a preventive benefit provided to Medicare beneficiaries under Title XVIII of the Social Security Act for some or all Medicare beneficiaries" and to "consider the short-term and long-term benefits, and costs to the Medicare program, of such addition." The serum thyroid stimulating hormone (TSH) assay is a common blood test that is already covered by the Medicare program for the diagnosis and treatment of illness.

Read the entire page →

From page 2...

... Hypothyroidism, the lack of adequate production of thyroid hormones, can result in fatigue, lethargy, cold intolerance, slowed speech and intellectual function, slowed reflexes, hair loss, dry skin, weight gain, and constipation. Hyperthyroidism, the production of excessive amounts of thyroid hormones, can cause nervousness, anxiety, heart palpitations, rapid pulse, fatigability, tremor, muscle weakness, weight loss with increased appetite, heat intolerance, frequent bowel movements, increased perspiration, and often thyroid gland enlargement (goiter)

Read the entire page →

From page 3...

... However, appropriate therapy has not been proven to alter long-term morbidity or mortality in people with subclinical thyroid dysfunction. Similarly, while it is accepted that treatment will benefit patients with biochemically overt thyroid dysfunction who present with significant symptoms or complications, the lack of well designed studies makes it difficult to determine whether treatment would provide significant net benefit in persons who have biochemically defined overt thyroid dysfunction but little evidence of illness; the potential for harm is similar but potential for benefit is less.

Read the entire page →

From page 4...

... If not, the test will not effectively reach its intended target population and fail as a disease prevention measure. If a screening test indicates the possibility of a disease being present, there must be suitable, definitive tests to make a formal diagnosis of that condition.

Read the entire page →

From page 5...

... Finally, routine TSH screening of asymptomatic persons over 65 years of age may lead to large numbers of persons receiving thyroid hormone therapy, but no randomized clinical trials have been performed that assess the long-term benefits or adverse effects of early treatment of thyroid dysfunction. Given insufficient evidence about the health benefits of a serum TSH screening program, the net cost implications for the Medicare program are uncertain.

Read the entire page →

From page 6...

... This recommendation is based on the lack of sufficient evidence of either net benefit or harm. Additional evidence is required for a definitive conclusion.

Read the entire page →

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Summary Pages 1-6

Summary
Pages 1-6