A Study Comparing Early Dosage Adjustment Using a Decision Support Tool Versus Standard Practice for Levothyroxine After Total Thyroidectomy

What this Trial Is About

Researchers are evaluating a decision support tool DST designed to help doctors adjust levothyroxine dosage more quickly for patients who have undergone total thyroidectomy. Levothyroxine is a common hormone replacement for people whose thyroid gland is no longer functioning properly. This randomized study compares the DSTs early dosage recommendations with the usual practice of adjusting doses every two months, aiming to see if faster dose optimization improves patient outcomes and work ability. Participants will be randomly assigned to one of four groups standard clinical practice where dosage is adjusted based on thyroid-stimulating hormone TSH levels every 6-8 weeks, or three experimental groups using different versions of the DST that calculate dosage changes based on blood samples taken within the first two weeks after surgery. The DST uses mathematical models with either 2 or 4 blood samples to recommend dosage adjustments. Throughout the study, patients will undergo blood tests to measure biochemical targets at 8 weeks, 6 months, 12 months, and up to 18 months after surgery. Patient-reported outcomes will be collected using the ThyPRO39 and RAND-36 questionnaires before surgery and at intervals afterward. Researchers will also monitor patients time to reach the biochemical target, distance from target, and absence from work. The total participation duration includes follow-up assessments up to 18 months post-surgery.

Patient-centered Dosage of Levothyroxine