Inferior thyroid artery ligation increases hypocalcemia after thyroidectomy: A meta‐analysis
Bibliographic record
Abstract
OBJECTIVE: To assess the effect of truncal ligation of the inferior thyroid artery in comparison with ligation of secondary branches as a risk factor for postoperative hypocalcemia. DATA SOURCES: A search was conducted using the Medical Subject Headings and free-text terms "thyroid*" and "truncal ligation*" in PubMed Central, PubMed, Embase, and Latin American and Caribbean Health Sciences Literature databases for trials published between January 1985 and October 2016. A Google search with the same terms, and a "snowball" approach was designed to retrieve the largest number of articles. REVIEW METHODS: Controlled trials (randomized or not) of adults who underwent total/bilateral subtotal thyroidectomy were searched, and truncal ligation versus nontruncal ligation of the inferior thyroid artery was compared. Data were acquired following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Methodological quality of randomized controlled trials was assessed in accordance with Cochrane Collaboration guidelines, and for nonrandomized controlled trials, the Newcastle-Ottawa quality assessment scale for cohort studies was used. Pooled results are presented as risk differences with a random effects model. The main outcome was postoperative temporary and definitive hypocalcemia. RESULTS: We found 11 nonrandomized controlled trials and nine randomized controlled trials with 1940 patients: 977 patients in the trunk ligation group and 963 patients in the nontruncal ligation group. The risk difference for biochemical hypocalcemia was 6% (95% confidence interval [CI]: 2% to 11%), for symptomatic hypocalcemia 6% (95% CI: 1% to 10%), and definitive hypocalcemia 0% (95% CI: -1% to 1%) in the whole group. CONCLUSIONS: Truncal ligation of the inferior thyroid artery increases the risk of temporary and symptomatic hypocalcemia but not the risk of definitive hypocalcemia. Laryngoscope, 128:534-541, 2018.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.009 | 0.008 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.002 |
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; both teacher heads agree on what is shown here.
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".