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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: Dr Imaizumi and colleagues¹ reported a dose-response relationship between radiation exposure and thyroid disorders using data from a cohort of atomic bomb survivors from Hiroshima and Nagasaki. The strengths of this study include the large population and the accurately defined exposure estimates and end points.

More sophisticated methods to precisely define thyroid disorders might accurately detect radiation effects on the thyroid for diseases other than malignancies. While dose-response associations of radiation exposure with thyroid malignancies, benign nodules, and cysts were consistent over a number of analyses, Imaizumi et al found no significant relation between exposure to radiation and positive levels of antithyroid peroxidase antibody (TPOAb). In their study, a TPOAb cutoff of 10 IU/mL was chosen to define positivity. However, no justification for this choice was given.

Reference values provided by manufacturers might not be sufficiently specific to accurately define autoimmune thyroid disease, and definitions of positive . . . [Full Text of this Article]

Henry Völzke, MD
voelzke@uni-greifswald.de
Institute of Epidemiology and Social Medicine

Wolfgang Hoffmann, MD, MPH
Institute for Community Medicine
Ernst Moritz Arndt University
Greifswald, Germany

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