Should thyroid function tests be ordered routinely in the evaluation of dementia-a decision analysis perspective

While thyroid disease can be present when too much or too little thyroid hormone is present, only the latter is reported in the literature as a cause of dementia. The author used decision analysis to evaluate whether thyroid function testing has a reasonable expectation of finding treatable disease. There is certain to be wide range of opinions on what is reasonable. He tried to think of what would be reasonable from the standpoint of the caregiver of the demented patient. In the decision tree, the utilities assigned to the various outcomes reflect those a caregiver might assign. Where there might be a lot variability among caregivers, a range of utilities was used and a sensitivity analysis is included to show how that range effects the decision