Clinical Index of Billewicz et al for Hypothyroidism

Description

Billewicz et al developed a clinical index for evaluating patients for hypothyroidism. This can help decide what laboratory testing is needed to establish the diagnosis and to clinically monitor a patient over time. The authors are from the University of Aberdeen and the Western Infirmary (Glasgow) in Scotland.

Index components:

(1) symptoms (8)

(2) physical signs (6)

Symptoms	Finding	Points
diminished sweating (in a warm room or on a hot summer day)	absent	-2
	present	+6
dry skin	absent	-6
	present	+3
cold intolerance	absent	-5
	present	+4
weight increase	absent	-1
	present	+1
constipation	absent	-1
	present	+2
hoarseness	absent	-6
	present	+5
paresthesias	absent	-4
	present	+5
deafness	absent	0
	present	+2

from Table II, page 259

Physical Signs	Finding	Points
slow movements	absent	-3
	present	+11
coarse skin	absent	-7
	present	+7
cold skin	absent	-2
	present	+3
periorbital puffiness	absent	-6
	present	+4
slow pulse rate	absent	-4
	present	+4
slowing of ankle jerk	absent	-6
	present	+15

from Table II, page 259

where:

• The pulse is counted for 30 seconds, but the cutoff value for slowing was not given.

index =

= SUM(points for all 14 items)

Interpretation:

• minimum score: -53

• maximum score: +72

• A score > 19 was seen only in patients with hypothyroidism.

• The score to indicate definite euthyroid state would affect the number of persons in the indeterminate (doubtful) group. Using the range of –14 to +19 as the indeterminate range resulted in 28.3% of patients being classified as indeterminate, including 2 of 56 hypothyroid patients.

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Description

Specialty

ICD-10