Quality of life in patients with overt hypothyroidism: a systematic review
Bibliographic record
Abstract
OBJECTIVE: Persistent symptoms and impaired quality of life (QoL) in hypothyroidism despite treatment with levothyroxine (LT4) receive increasing attention. We aimed at reviewing QoL in long-term treated hypothyroidism. DESIGN: This is a systematic review and meta-analysis. METHODS: The systematic literature search "hypothyroidism AND quality of life" was conducted in PubMed and Embase. We considered studies on QoL in adults with Hashimoto's thyroiditis (HT) or congenital hypothyroidism (CH), treated with levothyroxine for 6 months. Seven hundred and ninety-seven articles were screened for title-abstract, and 52 were assessed by full-text evaluation. Seventeen articles met eligibility criteria and were included. We summarize study finding within the domains mental well-being, physical well-being, and social role supported by meta-analyses. Studies were evaluated using Newcastle-Ottawa Scale. Two meta-analyses were performed using random effects model. RESULTS: Fourteen studies included patients with HT, and 3 evaluated QoL in CH. Mental and physical well-being was impaired in 10 studies, and social role impairments were detected in 7 studies. Study design was to some degree flawed in 13 studies, potentially hampering conclusions. The most frequent methodological issues were incomparable groups or lack of information on potential confounders like body mass index or comorbidity. However, when focusing on the methodologically most robust studies, conclusions remained and were supported by meta-analyses. CONCLUSION: Based on this systematic review and meta-analysis, despite methodological concerns in the available literature, QoL in patients with hypothyroidism is impaired. Future studies should address potential residual bias displayed and explore the impact of disease etiology, duration, and timing of diagnosis in relation to comorbidity, to reveal groups of patients susceptible to inadequate treatment response and guide our way to improve QoL in 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 | 0.007 | 0.023 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.010 | 0.014 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| 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".