Birth Rates After Radioactive Iodine Treatment for Well Differentiated Cancer in Female Patients With Reproductive Potentials: A Meta- Analysis
Bibliographic record
Abstract
Abstract The association between radioactive iodine (RAI) therapy and reduced fertility has remained controversial, in part because no large-scale randomized clinical trials or prospective studies have been done in this regard. Hence, we performed this meta-analysis to investigate the association between radioactive iodine therapy and birth rates in female patients in their reproductive years diagnosed with well- differentiated thyroid cancer. Relevant articles were retrieved from PubMed Central and PubMed according to the established inclusion criteria, followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Each article was assessed by the Newcastle-Ottawa Scale (NOS). The overall relative risk (RR) and 95% confidence intervals (CI) were calculated to estimate the association between radioactive iodine (RAI) therapy and birth rates. Random effect or fixed-effect model was used to calculate the pooled OR, based on heterogeneity significance. Subgroup analysis was conducted based on different age groups (<25 years old vs. 25-34 years old vs. >35 years old). Sensitivity analysis and publication bias detection were also performed. All statistical analyses were performed using RevMan software (version 5.3; Cochrane library) and STATA 12.0 software (Stata Corp., College Station, TX), and all P values were two-tailed, the test level was 0.05. 105 articles were obtained from the database search, and 6 articles were obtained from other sources. Three articles involving 32237 participants were included. All studies were considered moderate to high quality. Overall, no statistically significant association was observed (RR 1.02; 95% CI: 0.71,1.48, p=0.91, I2=96%). In subgroup analysis, groups with age <24 y/o (RR 0.87; 95% CI:0.76,0.99,p= 0.04, I2=0%), and age >35 y/o (RR 0.71; 95%CI: 0.59, 0.85, p=0.0002, I2=0%), there was an associated reduction in birth rates in patients who received radioactive iodine treatment. In contrast, in the group between 25 and 34 years of age, no statistically significant observation was made (RR 0.99; 95% CI:0.79,1.22, p= 0.89, I2=82%). Sensitivity analysis confirmed the stability of the result. Egger’s test, and Begg’s test found no publication bias of analysis (p= 0.824; p=0.602). This meta-analysis demonstrated that overall, no statistically significant association between RAI treatment and birth rates in female patients within their reproductive ages diagnosed with well- differentiated thyroid cancer. However, in the subgroup analysis, an association was found between RAI treatment and reduced birth rates in females <25 years old and those >35 years old. In contrast, no association of RAI treatment with birth rates in females 25-34 years old was found. More highly powered prospective studies of this topic are needed in the future to further elucidate the impact of RAI treatment on birth rates and fertility.
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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 | 0.010 | 0.021 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.017 | 0.059 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 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".