2 May 2016
In the 1950s, T3 and T4 testing was still to come. The only available test was protein-bound iodine (PBI), which was fairly unreliable.
In 1960, Sir Edward Wayne described a scale named Wayne’s index to improve the accuracy of diagnosis of hyperthyroidism and also to limit the need for other diagnostic tests [Imam and Ahmad, 2016].
This index of signs and symptoms is a clinical scoring tool to evaluate the presence and degree of hyperthyroidism [M. Galia et al., 2010]. It is also useful in resource challenged regions or when thyroid function tests results are at variance with clinical suspicion. With a score ranging from +45 to -25, a score less than 11 defines “euthyroidism” while scoring above 19 suggests “toxic hyperthyroidism”.
Although this system of scoring has very little relevance today, it is a useful guide to the relative importance of clinical features in the diagnosis of hyperthyroidism.
| Symptoms, in order of importance | Points if present | Points if absent |
| Heat intolerance (cold preference) | 5 | |
| Heat preference | -5 | |
| Appetite – increased | 3 | |
| Weight – decreased | -3 | |
| Excessive sweating | 3 | |
| Palpitations | 2 | |
| Fatigue | 2 | |
| Nervousness (anxiety) | 2 | |
| Dyspnoea | 1 | |
| Signs, in order of importance | ||
| Hyperkinetic movements | 4 | |
| Atrial fibrillation | 4 | |
| Thyromegaly | 3 | -3 |
| Tachycardia | 3 | |
| Bruit | 2 | -2 |
| Exophthalmos | 2 | |
| Hot hands | 2 | |
| Lid retraction | 2 | |
| Lid lag | 1 | |
| Wet/ moist hands | 1 | |
| Tremors | 1 |
- Total score (Kendall-Taylor, 1972): > 19 = toxic
- 11-19 = equivocal
- < 11 = euthyroid
References
- Galia, A., Aimee A. Andag-Silva, A., Sjoberg A. Kho, S., OL San Luis, Jr, T. and Magboo-Gaviola, M. (2010). Validation of the UST Thyroid Scoring Index Against Ultrasensitive Assays for Thyroid-Stimulating Hormone and Free Thyroxine. Phil. Journal of Internal Medicine, 48(1), p.15.
- Imam SK, Ahmad SI (2016). Thyroid disorders: basic science and clinical practice, Springer International Publishing, Switzerland, 2016, pp.76-77.
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