L‐T<sub>3</sub> preparation for whole‐body scintigraphy: a randomized‐controlled trial
Bibliographic record
Abstract
BACKGROUND: Patients with thyroid cancer often need whole-body scintigraphy (WBS) under TSH stimulation after 4-6 weeks withdrawal from levothyroxine (L-T(4)). Patients often become severely hypothyroid with impaired quality of life. Liothyronine (L-T(3)) substitution is used empirically to prepare patients; however, no data exist to prove its benefit. Objectives To compare the hypothyroid state in patients receiving either placebo or L-T(3) following L-T(4) withdrawal and to evaluate the time needed for adequate TSH elevation in preparation for WBS. METHODS: At the time of L-T(4) withdrawal, patients were randomized to receive L-T(3 )(50 microg qd) or placebo for 3 weeks, after which treatment was stopped. A validated evaluation of hypothyroidism (Billewicz score) was administered in a double-blind fashion every 2 weeks until the WBS. TSH, fT(4) and fT(3) were measured weekly. RESULTS: A total of 20 patients were randomized between September 2003 and May 2005. There was no difference in the Billewicz score at any time between the two groups. Before WBS, both groups were profoundly hypothyroid. TSH at time of WBS was similar in both groups. The time needed to reach a TSH level of more than 30 mUI/l was longer in L-T(3) group (mean +/- SD: 32 +/- 4 days vs. 17 +/- 9 days in placebo group, P = 0.006). CONCLUSION: Preparation for WBS with L-T(3) does not prevent profound hypothyroidism and delays TSH elevation required for WBS. L-T(4) withdrawal alone for 2-3 weeks is simpler and sufficient to allow TSH to reach a level of more than 30 mUI/l in the majority of patients without increasing morbidity from hypothyroidism.
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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 | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.012 | 0.001 |
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".