Parathyroid Hormone: An Early Predictor of Postthyroidectomy Hypocalcemia
Bibliographic record
Abstract
OBJECTIVE: To determine whether there is a correlation between the level of parathyroid hormone (PTH) soon after thyroidectomy and the development of hypocalcemia. STUDY DESIGN: Prospective series of 40 consecutive patients undergoing total thyroidectomy or completion thyroidectomy between January 2001 and October 2002. METHOD: Ionized calcium was measured before surgery and at 1, 6, 18, 30, and 42 hours after surgery. PTH was measured before surgery and at 1 and 6 hours after surgery using an assay that accurately measures low levels of PTH. Patients were followed up at 1 week and 3 months after surgery with respect to their symptoms and need for calcium supplementation. Clinically significant hypocalcemia was defined as an ionized calcium level of less than or equal to 0.9 mmol/L. RESULTS: The incidence of postoperative hypocalcemia was 30% (12/40). The mean PTH level 1 hour after surgery was much lower in patients who ultimately became hypocalcemic than in those who remained normocalcemic (3.8+/- 1.9 vs. 33 +/- 21 pg/mL, P =.001). All patients with a PTH level less than or equal to 8 pg/mL 1 hour after surgery developed hypocalcemia, whereas all those with greater than or equal to 9 pg/mL remained normocalcemic. CONCLUSIONS: A single PTH level of less than or equal to 8 pg/mL 1 hour postthyroidectomy is a strong predictor for the development of clinically significant hypocalcemia. Once validated, this test may serve to identify those who require more intensive monitoring, prompt early therapy in those deemed at risk, and enable confident early discharge in the majority of thyroidectomy patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".