Lessons from Randomised Clinical Trials for Triiodothyronine Treatment of Hypothyroidism: Have They Achieved Their Objectives?

Figure 1

Demonstration of bias by data amalgamation in predicted probability of persisting hypothyroid complaints in response to LT4 dose changes depicted by a simulated trial. Group-level effect (a) is not predictive of individual responses with shifted response curves between patients displaying varying conversion rates (GD (b)), and FT3 concentrations (c). Variable patient individuality of response may impact the averaged outcome in a trial and should be accounted for in the analysis. For the purpose of this demonstration, complementing a study, which has been reported elsewhere [11], we resampled 60 follow-up visits from patients who reported relief of former complaints after LT4 dose increase within a range of 100 to 150 μg/d to generate the structure of an extended generalised linear mixed-effects model [18]. GD refers to global deiodinase activity, a measure of T4 to T3 conversion similar to the molar T3-T4 ratio [11].

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