Endocrine conditions featured prominently in evidence gaps in clinical preventive services for women.
The U.S. Preventive Services Task Force (USPSTF) posted its “Fifth Annual Report to Congress on High-Priority Evidence Gaps for Clinical Preventive Services” on November 18. This year’s report identifies evidence gaps related to preventive services for women and highlights several endocrine-related services such as screening for thyroid dysfunction, vitamin D deficiency and osteoporosis.
The Society joins USPSTF in calling for increased research in these areas. The USPSTF report illustrates the need for Congress to provide increased biomedical research funding so we can advance cures, improve treatments, and prevent disease. The Society urges Congress to provide at least $32 billion for the National Institutes of Health in Fiscal Year 2016.
The Patient Protection and Affordable Care Act of 2010 charges the USPSTF with making an annual report to Congress that identifies gaps in the evidence base and recommends priority areas that deserve further examination. In its previous reports to Congress, the Task Force identified screening tests, behavioral interventions and preventive medications with significant evidence gaps deserving further research.
The Endocrine Society supports the specific focus on women’s health and further recommends including females and males in all phases of biomedical research. Ensuring that preclinical and clinical research studies can be analyzed by sex will help address the evidence gaps listed in the USPSTF report, and ensure that other gaps in women’s health research are promptly identified. The Endocrine Society has advocated for the appropriate consideration of sex as a critical biological variable and established journal policies that require reporting of the sex of research subjects.
Thyroid conditions, which disproportionately affect women, are an important area the USPSTF flagged for additional research. Thyroid function testing is normal practice in caring for patients who have symptoms or signs suggestive of hypothyroidism or hyperthyroidism, or goiter, or a history of thyroid irradiation. Because of this, the Endocrine Society does not recommend universal screening for thyroid disorders. The Society strongly supports screening for thyroid dysfunction in specific situations, especially in relation to pregnancy.
Because of the significant incidence of thyroid disorders among pregnant women and the known adverse effects on pregnancy, the Society strongly supports testing all pregnant women for elevated TSH concentrations by the ninth week or at the time of their first visit before and during pregnancy, or at a minimum, aggressive case finding to identify and test high-risk women.
The Endocrine Society also supports the USPSTF recommendation to prioritize addressing the evidence gaps for vitamin D deficiency screening. Vitamin D helps the body absorb calcium and plays an important role in bone health. As a member of the Partnership for the Accurate Testing of Hormones (PATH), the Endocrine Society acknowledges that inaccurate and unreliable lab tests for vitamin D can potentially lead to large numbers of women being misdiagnosed. Through PATH, the Society supports coordinated efforts by federal agencies and other stakeholders to improve and ensure the accuracy of vitamin D testing in patient care and clinical research.