Evidence
This page contains a snapshot of featured content which highlights evidence addressing key clinical questions including areas of uncertainty. Please see the main topic reference list for details of all sources underpinning this topic.
BMJ Best Practice evidence tables
Evidence tables provide easily navigated layers of evidence in the context of specific clinical questions, using GRADE and a BMJ Best Practice Effectiveness rating. Follow the links at the bottom of the table, which go to the related evidence score in the main topic text, providing additional context for the clinical question. Find out more about our evidence tables.
This table is a summary of the analysis reported in a Cochrane Clinical Answer that focuses on the above important clinical question.
Confidence in the evidence is moderate or low to moderate where GRADE has been performed and the intervention may be more effective/beneficial than the comparison for key outcomes.
Population: Adults with Graves’ disease
Intervention: Total thyroidectomy ᵃ
Comparison: Bilateral subtotal thyroidectomy ᵃ
| Outcome | Effectiveness (BMJ rating)? | Confidence in evidence (GRADE)? |
|---|---|---|
Recurrent hyperthyroidism at 6 months to 6 years | Favours intervention | Moderate |
Surgical complications: permanent hypocalcaemia/hypoparathyroidism at 6 months to 6 years | No statistically significant difference | Low |
Surgical complications: permanent recurrent laryngeal nerve palsy at 6 months to 6 years | No statistically significant difference | Low |
Regression of Graves' ophthalmopathy at 6 months to 6 years | No statistically significant difference | Low |
All‐cause mortality at 6 months to 6 years | See note ᵇ | GRADE assessment not performed for this outcome |
Surgical complications requiring return to theatre; health‐related quality of life | - | None of the studies identified by the review assessed this outcome |
Note ᵃ This evidence table summarises the findings for the comparison of total thyroidectomy versus bilateral subtotal thyroidectomy, which reflects the evidence from the Cochrane Clinical Answer (CCA) that fits the clinical question in BMJ Best Practice. See the full CCA for information on other comparisons (total thyroidectomy versus subtotal thyroidectomy; bilateral subtotal thyroidectomy versus the Dunhill procedure). ᵇ One RCT (N=200) reported one death (myocardial infarction three years post surgery) in the total thyroidectomy group.
This evidence table is related to the following section/s:
Cochrane Clinical Answers
Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically focused entry point to rigorous research from Cochrane systematic reviews. They are designed to be actionable and to inform decision making at the point of care and have been added to relevant sections of the main Best Practice text.
- In people with Graves' hyperthyroidism, what are the benefits and harms of different antithyroid drug regimens?
- How do different thyroid surgery techniques compare for people with Graves’ disease and Graves’ ophthalmopathy?
Use of this content is subject to our disclaimer