Audit of initial management of congenital hypothyroidism in the United Kingdom--comparison of UK practice with European and UK guidelines.
BACKGROUND
Prompt and adequate management of newly diagnosed congenital hypothyroidism (CH) has been shown to optimise intellectual outcome.


METHODS
A questionnaire survey of the British Society for Paediatric Endocrinology and Diabetes (BSPED) membership was undertaken, examining current clinical practice in neonatal CH. Results were compared with published management guidelines from Europe and the UK.


RESULTS
The response rate was 86%. The majority were largely compliant with both guidelines. 43% review newly referred infants on the day of notification. However, 26% treat severe CH with < 10 microg/kg/day thyroxine and nearly 20% do not follow up until at least 14 days after initiating treatment, in contrast to both guidelines. Despite a new liquid T4 preparation being licensed, respondents preferred tablet T4.


CONCLUSIONS
Rapidity of assessment and adequate follow up of suspected CH is critical to outcome. Existing European and UK guidelines should be reviewed and expanded to incorporate new evidence, together with increased advice on preparation and administration of T4.
Jones
Jeremy H
JH
Department of Child Health, Royal Hospital for Sick Children, Glasgow, UK. jjones@clinmed.gla.ac.uk
Donaldson
Malcolm D C
MD
D003409:Congenital Hypothyroidism / Q000175:diagnosis / Q000628:therapy*; D004304:Dosage Forms; D042241:Early Diagnosis; D019983:Guideline Adherence; D020249:Hormone Replacement Therapy; D006801:Humans; D007231:Infant, Newborn; D008485:Medical Audit; D015997:Neonatal Screening; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D013974:Thyroxine / Q000627:therapeutic use; D006113:United Kingdom
D004304:Dosage Forms; D013974:Thyroxine