Intended for healthcare professionals

Education And Debate

Consensus statement for good practice and audit measures in the management of hypothyroidism and hyperthyroidism

BMJ 1996; 313 doi: (Published 31 August 1996) Cite this as: BMJ 1996;313:539
  1. M P J Vanderpump, senior registrara,
  2. J A O Ahlquist, consultant physicianb,
  3. J A Franklyn, professor of medicinec,
  4. R N Clayton a working group of the Research Unit of the Royal College of Physicians of London, the Endocrinology and Diabetes Committee of the Royal College of Physicians of London   and the Society for Endocrinology, professor of medicinea
  1. a Department of Diabetes and Endocrinology, City General Hospital, Stoke on Trent ST4 6QG,
  2. b Southend Hospital, Westcliff on Sea SS0 0RY,
  3. c Department of Medicine, Queen Elizabeth Hospital, Birmingham B15 2TH
  1. Authors of the background papers and members of the working group are listed at the end of this report.Correspondence to: Professor Clayton.
  • Accepted 17 June 1996

Thyroid disease is common and may present to a wide range of doctors. With the widespread availability of thyroid function testing in recent years increasing numbers of patients with symptoms which might be attributable to hypothyroidism and hyperthyroidism are being tested. Many aspects of the management of thyroid disease have not been subjected to controlled clinical trials yet there are established practices which have never been questioned. The Research Unit of the Royal College of Physicians of London, the Endocrinology and Diabetes Committee of the college, and the Society for Endocrinology set up a working group to produce a consensus statement for good practice with associated audit measures which could be used to ensure that purchasers of health care are obtaining an acceptable standard of care for patients with thyroid disease. The working group focused on patient management rather than presenting symptoms and signs, which were detailed in a similar report by the American Thyroid Association.1

This report summarises the consensus views reached by members of the working group.


Recognised United Kingdom authorities with an international reputation for clinical research as thyroid specialists were invited to produce background papers on specific aspects of the topic which summarised the relevant available published evidence from peer reviewed journals (see contributors of background papers listed at the end of this report). Because of the potential for bias in consensus development by small groups the background papers were circulated to members of a larger working group before a workshop held at the Royal College of Physicians of London. The working group consisted of specialists in endocrinology, general physicians, thyroid surgeons, general practitioners, clinical biochemists, representatives of thyroid disease patient groups, and purchasers of health care (see members of the working group listed at the end of this report).

The workshop consisted of a …

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