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Mark Helfand, MD, MS
Portland Veterans Affairs Medical Center and Oregon Health Sciences University Portland, Ore

JAMA. 1997;277(6):458-459.

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

To the Editor.

—In trying to replicate the results of the article on screening for mild thyroid failure by Mr Danese and colleagues,¹ I found a mathematical error in one of the assumptions of the cost-effectiveness model. Consequently, the analysis overestimates the effect of levothyroxine sodium on symptom relief and underestimates the costs of screening.

Danese and colleagues assumed there was "symptomatic improvement in 28% of patients with mild thyroid failure." This estimate comes from 2 randomized trials of treatment for mild thyroid failure.^2,3 In one of these trials,² treatment with levothyroxine sodium relieved symptoms in 8 of 17 patients vs 3 of 16 patients in the placebo group. The difference of 8 of 17 (0.47) less 3 of 16 (0.19), or 0.28, is the net benefit or effect size of treatment. Its reciprocal, approximately 4, is the number needed to treat to benefit 1 patient. However, . . . [Full Text PDF of this Article]

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