Recently published BC guidelines

Thyroid Function Testing in the Diagnosis and Monitoring of Thyroid Function Disorder (2018) 

This is a revision of the 2010 version of the guideline. The guideline’s scope has expanded to include pediatric and pregnant patients.

Key recommendations:

  • Routine thyroid function testing is not recommended in asymptomatic patients (outside of the BC Newborn Screening Program). Testing may be indicated when nonspecific symptoms or signs are present in patients at risk for thyroid disease.
  • A TSH value within the laboratory reference interval excludes the majority of cases of primary thyroid dysfunction.
  • If initial TSH testing is normal, repeat testing is unnecessary unless there is a change in clinical condition.
  • Measurement of fT3 is rarely indicated in suspected thyroid disease.
  • Screening for undiagnosed hyperthyroidism or hypothyroidism should not be performed in hospitalized patients or during acute illness unless hyperthyroidism or hypothyroidism is the suspected cause of the clinical presentation or represents a significant comorbidity.
  • If a woman is pregnant or planning pregnancy, TSH testing is indicated if she has specific risk factors (see Table 3 in the guideline).

Other key changes:

  • A laboratory algorithm has been added to the guideline and outlines changes to ordering. If central hypothyroidism is being investigated “suspicion of pituitary insufficiency” should be included as a clinical indication and a request for fT4 (with or without TSH) should be indicated in the space provided on the standard outpatient laboratory requisition.
  • Thyroid function test reports in BC will include trimester-specific reference intervals on all women of childbearing age.

Ultrasound Prioritization (2018) 

This new guideline summarizes suggested wait times for common indications where ultrasound is the recommended first imaging test. The purpose is to inform primary care practitioners how referrals are prioritized by radiologists, radiology departments, and community imaging clinics across the province. In some cases, notes and alternative tests are provided for additional clinical context. This guideline is an adaptation of the British Columbia Radiological Society (BCRS) Ultrasound Prioritization Guidelines (2016).

See also the one-page overview: Ultrasound Prioritization Guideline Summary.

To stay up to date with BC Guidelines, visit the What’s New section at

. Recently published BC guidelines. BCMJ, Vol. 61, No. 1, January, February, 2019, Page(s) 45 - News.

Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.

For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit

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