Subclinical thyroid dysfunction and depressive symptoms: protocol for a systematic review and individual participant data meta-analysis of prospective cohort studies.

Wildisen, Lea; Moutzouri, Elisavet; Beglinger, Shanthi; Syrogiannouli, Lamprini; Cappola, Anne R; Åsvold, Bjørn O; Bakker, Stephan J L; Ceresini, Graziano; Dullaart, Robin; Ferrucci, Luigi; Grabe, Hans; Jukema, J Wouter; Nauck, Matthias; Trompet, Stella; Völzke, Henry; Westendorp, Rudi G J; Gussekloo, Jacobijn; Peeters, Robin P; Klöppel, Stefan; Aujesky, Drahomir; ... (2019). Subclinical thyroid dysfunction and depressive symptoms: protocol for a systematic review and individual participant data meta-analysis of prospective cohort studies. BMJ open, 9(7), e029716. BMJ Publishing Group 10.1136/bmjopen-2019-029716

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INTRODUCTION Prospective cohort studies on the association between subclinical thyroid dysfunction and depressive symptoms have yielded conflicting findings, possibly because of differences in age, sex, thyroid-stimulating hormone cut-off levels or degree of baseline depressive symptoms. Analysis of individual participant data (IPD) may help clarify this association. METHODS AND ANALYSIS We will conduct a systematic review and IPD meta-analysis of prospective studies on the association between subclinical thyroid dysfunction and depressive symptoms. We will identify studies through a systematic search of the literature in the Ovid Medline, Ovid Embase, Cochrane Central Register of Controlled Trials (CENTRAL) and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases from inception to April 2019 and from the Thyroid Studies Collaboration. We will ask corresponding authors of studies that meet our inclusion criteria to collaborate by providing IPD. Our primary outcome will be depressive symptoms at the first available individual follow-up, measured on a validated scale. We will convert all the scores to the Beck Depression Inventory scale. For each cohort, we will estimate the mean difference of depressive symptoms between participants with subclinical hypothyroidism or hyperthyroidism and control adjusted for depressive symptoms at baseline. Furthermore, we will adjust our multivariable linear regression analyses for age, sex, education and income. We will pool the effect estimates of all studies in a random-effects meta-analysis. Heterogeneity will be assessed by I. Our secondary outcomes will be depressive symptoms at a specific follow-up time, at the last available individual follow-up and incidence of depression at the first, last and at a specific follow-up time. For the binary outcome of incident depression, we will use a logistic regression model. ETHICS AND DISSEMINATION Formal ethical approval is not required as primary data will not be collected. Our findings will have considerable implications for patient care. We will seek to publish this systematic review and IPD meta-analysis in a high-impact clinical journal. PROSPERO REGISTRATION NUMBER CRD42018091627.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine
04 Faculty of Medicine > University Psychiatric Services > University Hospital of Geriatric Psychiatry and Psychotherapy

UniBE Contributor:

Wildisen, Lea Franziska; Moutzouri, Elisavet; Beglinger, Shanthi; Syrogiannouli, Lamprini; Klöppel, Stefan; Aujesky, Drahomir; Rodondi, Nicolas; Del Giovane, Cinzia and Feller, Martin

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

2044-6055

Publisher:

BMJ Publishing Group

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Christine Baumgartner

Date Deposited:

07 Aug 2019 10:22

Last Modified:

22 Oct 2019 17:27

Publisher DOI:

10.1136/bmjopen-2019-029716

PubMed ID:

31350252

Uncontrolled Keywords:

depressive symptoms individual participant data (IPD) meta-analysis subclinical hyperthyroidism subclinical hypothyroidism subclinical thyroid dysfunction systematic review

BORIS DOI:

10.7892/boris.132303

URI:

https://boris.unibe.ch/id/eprint/132303

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