LAUSR

of atrial fibrillation in this patient was more likely to be ascribed to an inappropriate starting dose of levothyroxine, which could have been prevented if the clinical practice was compliant with the guidelines. In this case, the current clinical practice guidelines showed excellent guidance for practice but were not well followed. Promoting compliance with these guidelines in primary clinical practice is an efficient and straightforward way to prevent the overdiagnosis and overtreatment of elderly patients with biochemically elevated thyrotropin levels. Meanwhile, studies on guidelines pertaining to overt and subclinical hypothyroidism are very insufficient and further investigations providing quality appraisal, validation, and compliance assessment of these guidelines are warranted.