title: The effects of iodine blocking following nuclear accidents on thyroid cancer, hypothyroidism, and benign thyroid nodules: design of a systematic review.
abstract: BACKGROUND
  One of the most efficient radiation protection methods to reduce the risk of adverse health outcomes in case of accidental radioactive iodine release is the administration of potassium iodine (KI). Although KI administration is recommended by WHO's guidelines for iodine prophylaxis following nuclear accidents and is also widely implemented in most national guidelines, the scientific evidence for the guidelines lacks as the guidelines are mostly based on expert opinions and recommendations. Therefore, this study will provide evidence by systematically reviewing the effects of KI administration in case of accidental radioactive iodine release on thyroid cancer, hypothyroidism, and benign nodules.
  
  
  METHODS
  We will apply standard systematic review methodology for the identification of eligible studies, data extraction, assessment of risk of biases, heterogeneity, and data synthesis. The electronic database search will be conducted in MEDLINE (via PubMed) and EMBASE, and covers three search blocks with terms related to the health condition, intervention, and occurrence/location. We have no date or language restrictions, but restrictions to humans only. We will include studies comparing the effects of KI administration on thyroid cancer, hypothyroidism, and benign thyroid nodules in a population exposed to radioactive iodine release. The quality of the studies will be graded. If feasible, a meta-analysis will be conducted.
  
  
  CONCLUSIONS
  This proposed systematic review will update the existing WHO guideline from 1999. New evidence on the efficacy of KI administration to reduce thyroid cancer, hypothyroidism, and benign thyroid nodules in the event of an accidental release of radioactive iodine to the environment will provide the basis for an update of the WHO guideline for iodine prophylaxis following nuclear accidents.
  
  
  BACKGROUND
  PROSPERO CRD42015024340.
authors.affiliation: Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology BIPS GmbH (BIPS), Achterstrasse 30, PO Box 28359, Bremen, Germany. dreger@bips.uni-bremen.de.
authors.forename: Steffen
authors.initials: S
authors.lastname: Dreger
authors.affiliation: Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology BIPS GmbH (BIPS), Achterstrasse 30, PO Box 28359, Bremen, Germany. pfinder@bips.uni-bremen.de.|Collaborative Research Group for Evidence-Based Public Health, Leibniz Institute for Prevention Research and Epidemiology BIPS GmbH (BIPS), Bremen, Germany. pfinder@bips.uni-bremen.de.|Institute for Public Health and Nursing Research, Health Sciences Bremen, Bremen University, Bremen, Germany. pfinder@bips.uni-bremen.de.
authors.forename: Manuela
authors.initials: M
authors.lastname: Pfinder
authors.affiliation: Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology BIPS GmbH (BIPS), Achterstrasse 30, PO Box 28359, Bremen, Germany. christianson@bips.uni-bremen.de.
authors.forename: Lara
authors.initials: L
authors.lastname: Christianson
authors.affiliation: Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology BIPS GmbH (BIPS), Achterstrasse 30, PO Box 28359, Bremen, Germany. lhachimi@bips.uni-bremen.de.|Collaborative Research Group for Evidence-Based Public Health, Leibniz Institute for Prevention Research and Epidemiology BIPS GmbH (BIPS), Bremen, Germany. lhachimi@bips.uni-bremen.de.|Institute for Public Health and Nursing Research, Health Sciences Bremen, Bremen University, Bremen, Germany. lhachimi@bips.uni-bremen.de.
authors.forename: Stefan K
authors.initials: SK
authors.lastname: Lhachimi
authors.affiliation: Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology BIPS GmbH (BIPS), Achterstrasse 30, PO Box 28359, Bremen, Germany. zeeb@bips.uni-bremen.de.|Health Sciences Bremen, Bremen University, Bremen, Germany. zeeb@bips.uni-bremen.de.
authors.forename: Hajo
authors.initials: H
authors.lastname: Zeeb
mesh_terms: D019317:Evidence-Based Medicine; D006801:Humans; D007457:Iodine Radioisotopes / Q000633:toxicity*; D011193:Potassium Iodide / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D011832:Radiation Injuries / Q000517:prevention & control*; D011837:Radiation-Protective Agents / Q000627:therapeutic use*; D018788:Radioactive Hazard Release; D012107:Research Design; D013959:Thyroid Diseases / Q000209:etiology / Q000517:prevention & control*
chemical_list: D007457:Iodine Radioisotopes; D011837:Radiation-Protective Agents; D011193:Potassium Iodide