Nonthyroidal Illness Syndrome and Hypothyroidism in Ischemic Heart Disease Population: A Systematic Review and Meta-Analysis
Abstract
Context: The association of non-thyroidal illness syndrome (NTIS) and hypothyroidism with the prognosis in ischemic heart disease (IHD) population is inconclusive. Objective: We aimed to evaluate the influence of NTIS and hypothyroidism on all-cause mortality and major adverse cardiac events (MACE) in IHD population. Data Sources: We searched PubMed, EMBASE, Scopus, Web of Science, and Cochrane Library from inception through February 17, 2020. Study Selection: Original articles enrolling IHD patients, comparing all-cause mortality and MACE of NTIS and hypothyroidism with those of euthyroidism, and providing sufficient information for meta-analysis were considered eligible. Data Extraction: Relevant information and numerical data were extracted for methodological assessment and meta-analysis. Data Synthesis: Twenty-three studies were included. The IHD population with NTIS was associated with higher risk of all-cause mortality (hazard ratio [HR] = 2.61; 95% confidence interval [CI] = 1.89-3.59) and MACE (HR = 2.22; 95% CI = 1.71-2.89) than that without. In addition, the IHD population with hypothyroidism was also associated with higher risk of all-cause mortality (HR = 1.47; 95% CI = 1.10-1.97) and MACE (HR = 1.53; 95% CI = 1.19-1.97) than that without. In the subgroup analysis, the acute coronary syndrome (ACS) subpopulation with NTIS was associated with higher risk of all-cause mortality (HR = 3.30; 95% CI = 2.43-4.48) and MACE (HR = 2.19; 95% CI = 1.45-3.30). The ACS subpopulation with hypothyroidism was also associated with higher risk of all-cause mortality (HR = 1.67; 95% CI = 1.17-2.39). Conclusions: The IHD population with concomitant NTIS or hypothyroidism was associated with higher risk of all-cause mortality and MACE. Future research is required to provide evidence of the causal relationship and to elucidate whether normalizing thyroid function parameters can improve prognosis.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In patients with ischemic heart disease, hypothyroidism (both subclinical and overt) is associated with a higher risk of all-cause mortality (HR = 1.47; 95% CI = 1.10-1.97, p = 0.009).
“The authors included 7 studies in their analysis, showing that hypothyroidism (both subclinical and overt) was associated with a higher risk of all-cause mortality (HR = 1.47; 95% CI = 1.10–1.97, p = 0.009) and MACE (HR = 1.53, CI = 1.19–1.97; p < 0.001).”
From Thyroid and heart, a clinically relevant relationship (2021) · cites this paper as [29]
In patients with ischemic heart disease, hypothyroidism (both subclinical and overt) is associated with a higher risk of MACE (HR = 1.53, CI = 1.19-1.97; p < 0.001).
“The authors included 7 studies in their analysis, showing that hypothyroidism (both subclinical and overt) was associated with a higher risk of all-cause mortality (HR = 1.47; 95% CI = 1.10–1.97, p = 0.009) and MACE (HR = 1.53, CI = 1.19–1.97; p < 0.001).”
From Thyroid and heart, a clinically relevant relationship (2021) · cites this paper as [29]
In the 3 studies separately analyzing overt versus subclinical hypothyroidism, there were no significant differences for overall mortality or MACE between euthyroid and subclinical hypothyroid patients.
“However, the 3 studies separately analyzing the impact of overt versus SC-HT reported no significant differences for overall mortality or MACE between euthyroid and subclinical hypothyroid patients [29].”
From Thyroid and heart, a clinically relevant relationship (2021) · cites this paper as [29]
Cites
R: A Language and Environment for Statistical Computing
R Core Team (2000) · doi:10.32614/r.manuals · Cited by 355,706 · see citing works
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823 · see citing works
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139 · see citing works
Bias in meta-analysis detected by a simple, graphical test
Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997) · BMJ · doi:10.1136/bmj.315.7109.629 · Cited by 56,722 · see citing works
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.
(2009) · PubMed Central · Cited by 44,859 · see citing works
Meta-analysis in clinical trials
DerSimonian, R., & Laird, N. (1986) · Controlled Clinical Trials · doi:10.1016/0197-2456(86)90046-2 · Cited by 39,552 · see citing works
Algorithm AS 136: A K-Means Clustering Algorithm
Hartigan, J. A., & Wong, M. A. (1979) · Applied Statistics · doi:10.2307/2346830 · Cited by 14,523 · see citing works
Duval, S., & Tweedie, R. (2000) · Biometrics · doi:10.1111/j.0006-341x.2000.00455.x · Cited by 14,099 · see citing works
Practical methods for incorporating summary time-to-event data into meta-analysis.
Tierney, J. F., Stewart, L. A., Ghersi, D., Burdett, S., & Sydes, M. R. (2007) · Trials · doi:10.1186/1745-6215-8-16 · Cited by 6,208 · see citing works
Schubert, E., Sander, J., Ester, M., Kriegel, H., & Xu, X. (2017) · ACM Transactions on Database Systems · doi:10.1145/3068335 · Cited by 2,789 · see citing works
Thyroid hormone and the cardiovascular system.
Klein, I., & Ojamaa, K. (2001) · New England Journal of Medicine · doi:10.1056/nejm200102153440707 · Cited by 2,300 · see citing works
Peters, J. L., Sutton, A. J., Jones, D. R., Abrams, K. R., & Rushton, L. (2008) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2007.11.010 · Cited by 2,053 · see citing works
Population Trends in the Incidence and Outcomes of Acute Myocardial Infarction
Yeh, R. W., Sidney, S., Chandra, M., Sorel, M. E., Selby, J. V., & Go, A. S. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa0908610 · Cited by 1,732 · see citing works
Current Mechanistic Concepts in Ischemia and Reperfusion Injury
Wu, M., Yiang, G.-T., Liao, W.-T., Tsai, A. P., Cheng, Y., Cheng, P., Li, C.-Y., & Li, C. (2018) · Cellular Physiology and Biochemistry · doi:10.1159/000489241 · Cited by 1,360 · see citing works
Self-citationCardiovascular disease in Europe: epidemiological update
Nichols, M. S., Townsend, N. P., Scarborough, P., & Rayner, M. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht356 · Cited by 1,349 · see citing works
Cardiovascular disease in Europe 2014: epidemiological update
Nichols, M. S., Townsend, N. P., Scarborough, P., & Rayner, M. (2014) · European Heart Journal · doi:10.1093/eurheartj/ehu299 · Cited by 1,294 · see citing works
Subclinical Hypothyroidism and the Risk of Coronary Heart Disease and Mortality
Rodondi, N., den Elzen, W. P. J., Bauer, D. C., Cappola, A. R., Razvi, S., Walsh, J. P., Åsvold, B. O., Iervasi, G., Imaizumi, M., Collet, T.-H., et al. (2010) · JAMA · doi:10.1001/jama.2010.1361 · Cited by 1,216 · see citing works
Intercoder Reliability and Validity of WebPlotDigitizer in Extracting Graphed Data
Drevon, D., Fursa, S. R., & Malcolm, A. L. (2017) · Behavior Modification · doi:10.1177/0145445516673998 · Cited by 1,006 · see citing works
Thyroid hormones and cardiovascular disease
Jabbar, A., Pingitore, A., Pearce, S. H. S., Zaman, A., Iervasi, G., & Razvi, S. (2017) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2016.174 · Cited by 729 · see citing works
Early Expression of Angiogenesis Factors in Acute Myocardial Ischemia and Infarction
Lee, S. H., Wolf, P. L., Escudero, R., Deutsch, R., Jamieson, S. W., & Thistlethwaite, P. A. (2000) · New England Journal of Medicine · doi:10.1056/nejm200003023420904 · Cited by 693 · see citing works
FlexMix: A General Framework for Finite Mixture Models and Latent Class Regression in R
Leisch, F. (2004) · Journal of Statistical Software · doi:10.18637/jss.v011.i08 · Cited by 678 · see citing works
Thyroid Hormones and Cardiovascular Function and Diseases
Razvi, S., Jabbar, A., Pingitore, A., Danzi, S., Biondi, B., Klein, I., Peeters, R., Zaman, A., & Iervasi, G. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.02.045 · Cited by 515 · see citing works
Grant, R. L. (2014) · BMJ · doi:10.1136/bmj.f7450 · Cited by 515 · see citing works
Thyroid function in critically ill patients
Fliers, E., Bianco, A. C., Langouche, L., & Boelen, A. (2015) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(15)00225-9 · Cited by 441 · see citing works
Effects of Thyroid Dysfunction on Lipid Profile
Rizos, C. V., Elisaf, M., & Liberopoulos, E. N. (2011) · The Open Cardiovascular Medicine Journal · doi:10.2174/1874192401105010076 · Cited by 403 · see citing works
New Insights into the Role of Inflammation in the Pathogenesis of Atherosclerosis
Wu, M., Li, C., Hou, M., & Chu, P. (2017) · International Journal of Molecular Sciences · doi:10.3390/ijms18102034 · Cited by 397 · see citing works
Self-citationHazard rate ratio and prospective epidemiological studies
Symons, M., & Moore, D. T. (2002) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(02)00443-2 · Cited by 350 · see citing works
Association between increased mortality and mild thyroid dysfunction in cardiac patients
Iervasi, G. (2007) · Archives of Internal Medicine · doi:10.1001/archinte.167.14.1526 · Cited by 285 · see citing works
GOSH – a graphical display of study heterogeneity
Olkin, I., Dahabreh, I. J., & Trikalinos, T. A. (2012) · Research Synthesis Methods · doi:10.1002/jrsm.1053 · Cited by 270 · see citing works
Simonides, W. S., Mulcahey, M. A., Redout, E. M., Muller, A., Zuidwijk, M. J., Visser, T. J., Wassen, F. W. J. S., Crescenzi, A., da‐Silva, W. S., Harney, J. W., et al. (2008) · Journal of Clinical Investigation · doi:10.1172/jci32824 · Cited by 270 · see citing works
Impact of beta-myosin heavy chain expression on cardiac function during stress
Krenz, M., & Robbins, J. M. (2004) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2004.09.044 · Cited by 259 · see citing works
Thyroid hormone transport in and out of cells
Visser, W. E., Friesema, E. C. H., Jansen, J., & Visser, T. J. (2008) · Trends in Endocrinology and Metabolism · doi:10.1016/j.tem.2007.11.003 · Cited by 236 · see citing works
Kenessey, Á., & Ojamaa, K. (2006) · Journal of Biological Chemistry · doi:10.1074/jbc.m512671200 · Cited by 221 · see citing works
Deten, A., Hölzl, A., Leicht, M., Barth, W., & Zimmer, H. (2001) · Journal of Molecular and Cellular Cardiology · doi:10.1006/jmcc.2001.1383 · Cited by 204 · see citing works
Ning, Y., Cheng, Y. J., Liu, L. J., Sara, J. D. S., Cao, Z. Y., Zheng, W. P., Zhang, T. S., Han, H. J., Yang, Z. Y., Zhang, Y., et al. (2017) · BMC Medicine · doi:10.1186/s12916-017-0777-9 · Cited by 148 · see citing works
Olivares, E. L., Marassi, M. P., Fortunato, R. S., da Silva, A. C. M., Costa-e-Sousa, R. H., Araújo, I. G., Mattos, E. C., Masuda, M. O., Mulcahey, M. A., Huang, S. A., et al. (2007) · Endocrinology · doi:10.1210/en.2007-0043 · Cited by 145 · see citing works
Nagasaki, T., Inaba, M., Henmi, Y., Kumeda, Y., Ueda, M., Tahara, H., Sugiguchi, S., Fujiwara, S., Emoto, M., Ishimura, E., et al. (2003) · Clinical Endocrinology · doi:10.1046/j.1365-2265.2003.01893.x · Cited by 103 · see citing works
Pol, C. J., Muller, A., Zuidwijk, M. J., van Deel, E. D., Kaptein, E., Saba, A., Marchini, M., Zucchi, R., Visser, T. J., Paulus, W. J., et al. (2010) · Endocrinology · doi:10.1210/en.2010-0431 · Cited by 102 · see citing works
Friberg, L., Drvota, V., Bjelak, A. H., Eggertsen, G., & Ahnve, S. (2001) · The American Journal of Medicine · doi:10.1016/s0002-9343(01)00980-9 · Cited by 101 · see citing works
Wang, B., Liu, S., Li, L., Yao, Q., Song, R., Shao, X., Li, Q., Shi, X., & Zhang, J. (2016) · International Journal of Cardiology · doi:10.1016/j.ijcard.2016.10.039 · Cited by 96 · see citing works
On the Hardness and Approximation of Euclidean DBSCAN
Gan, J., & Tao, Y. (2017) · ACM Transactions on Database Systems · doi:10.1145/3083897 · Cited by 84 · see citing works
Huang, S. A., Mulcahey, M. A., Crescenzi, A., Chung, M., Kim, B. W., Barnes, C., Kuijt, W. J., Turano, H., Harney, J. W., & Larsen, P. R. (2005) · Molecular Endocrinology · doi:10.1210/me.2005-0173 · Cited by 73 · see citing works
Thyroid Hormone and Coronary Artery Disease: From Clinical Correlations to Prognostic Implications
Coceani, M. A., Iervasi, G., Pingitore, A., Carpeggiani, C., & L’Abbate, A. (2009) · Clinical Cardiology · doi:10.1002/clc.20574 · Cited by 72 · see citing works
Mechanism of subclinical hypothyroidism accelerating endothelial dysfunction (Review)
Lu, M. H., Yang, C., Gao, L., & Zhao, J. (2014) · Experimental and Therapeutic Medicine · doi:10.3892/etm.2014.2037 · Cited by 66 · see citing works
A low fT3 level as a prognostic marker in patients with acute myocardial infarctions
Zhang, B., Peng, W., Wang, C., Li, W., & Xu, Y. (2012) · Internal Medicine · doi:10.2169/internalmedicine.51.7902 · Cited by 59 · see citing works
Clinical outcomes of patients with hypothyroidism undergoing percutaneous coronary intervention
Zhang, M., Sara, J. D. S., Matsuzawa, Y., Gharib, H., Bell, M. R., Gulati, R., Lerman, L. O., & Lerman, A. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehv737 · Cited by 58 · see citing works
Cardiac Thyroid Hormone Metabolism and Heart Failure
Janssen, R., Muller, A., & Simonides, W. S. (2017) · European Thyroid Journal · doi:10.1159/000469708 · Cited by 55 · see citing works
Özcan, K. S., Osmonov, D., Toprak, E., Güngör, B., Tatlısu, A., Ekmekçi, A., Kaya, A., Tayyareci, G., & Erdinler, İ. (2014) · Cardiology Journal · doi:10.5603/cj.a2013.0108 · Cited by 50 · see citing works
Up-regulation of type 2 iodothyronine deiodinase in dilated cardiomyopathy
Wang, Y.-Y., Morimoto, S., Du, C., Lu, Q.-W., Zhan, D., Tsutsumi, T., Ide, T., Miwa, Y., Takahashi‐Yanaga, F., & Sasaguri, T. (2010) · Cardiovascular Research · doi:10.1093/cvr/cvq133 · Cited by 44 · see citing works
Su, W., Zhao, X.-Q., Wang, M., Chen, H., & Li, H. (2018) · Journal of Cardiology · doi:10.1016/j.jjcc.2018.02.013 · Cited by 42 · see citing works
Gerber, Y., Jaffe, A. S., Weston, S. A., Jiang, R., & Roger, V. L. (2012) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2011.11.013 · Cited by 37 · see citing works
Janssen, R., Zuidwijk, M. J., Kuster, D. W. D., Muller, A., & Simonides, W. S. (2014) · Frontiers in Endocrinology · doi:10.3389/fendo.2014.00171 · Cited by 37 · see citing works
Marraccini, P., Bianchi, M., Bottoni, A., Mazzarisi, A., Coceani, M., Molinaro, S., Lorenzoni, V., Landi, P., & Iervasi, G. (2013) · Acta Radiologica · doi:10.1258/ar.2012.120326 · Cited by 35 · see citing works
Nazer, B., Ray, K. K., Sloan, S., Scirica, B. S., Morrow, D. A., Cannon, C. P., & D, E. B. M. (2011) · European Heart Journal · doi:10.1093/eurheartj/ehr032 · Cited by 33 · see citing works
Seo, S. M., Koh, Y., Park, H., Kim, D., Her, S., Lee, J. M., Park, C. S., Kim, P.-J., Kim, H.-Y., Yoo, K., et al. (2018) · Clinical Cardiology · doi:10.1002/clc.23062 · Cited by 32 · see citing works
Effects of thyroid dysfunction on the severity of coronary artery lesions and its prognosis
Bai, M., Gao, C., Yang, C.-K., Wang, X., Liu, J., Qi, D., Zhang, Y., Hao, P., & Li, M. (2014) · Journal of Cardiology · doi:10.1016/j.jjcc.2014.03.009 · Cited by 31 · see citing works
Lee, Y., Lim, Y., Shin, J., Park, J., & Shin, J. (2018) · International Journal of Cardiology · doi:10.1016/j.ijcard.2017.09.192 · Cited by 26 · see citing works
Prevalence of Subclinical Hypothyroidism among Patients with Acute Myocardial Infarction
Okuyan, E., Uslu, A., Asim, E., Gulcin, H. E., Ayça, B., Avşar, M., Sezai, Y. S., Biter, H. İ., & Hakan, D. M. (2011) · ISRN Endocrinology · doi:10.5402/2011/810251 · Cited by 25 · see citing works
Advanced Evolution of Pathogenesis Concepts in Cardiomyopathies
Li, C., Chen, C., Yiang, G., Tsai, A. P., Liao, W., & Wu, M. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8040520 · Cited by 23 · see citing works
Self-citationSong, Y., Li, J., Bian, S., Qin, Z., Song, Y., Jin, J., Zhao, X., Song, M., Chen, J., & Huang, L. (2018) · BioMed Research International · doi:10.1155/2018/9803851 · Cited by 22 · see citing works
Relation of Low T3 to One-Year Mortality in Non-ST-Elevation Acute Coronary Syndrome Patients
Yazıcı, S., Kırış, T., Ceylan, U. S., Terzi, S., Erdem, A., Atasoy, I., Emre, A., & YEŞİLÇİMEN, K. (2016) · Journal of Clinical Laboratory Analysis · doi:10.1002/jcla.22036 · Cited by 21 · see citing works
Mantzoros, C. S., Evagelopoulou, K., & Moses, A. C. (1995) · Thyroid · doi:10.1089/thy.1995.5.383 · Cited by 18 · see citing works
Cao, Q., Jiao, Y., Yu, T., & Sun, Z. (2018) · Cardiology Journal · doi:10.5603/cj.a2018.0097 · Cited by 18 · see citing works
Adawiyah, J., Norasyikin, A. W., Mat, N., Shamsul, A. S., & Azmi, K. N. (2010) · Heart Asia · doi:10.1136/ha.2009.001503 · Cited by 16 · see citing works
Wang, J., Ren, Y., Lu, Z., Gao, J., Zhao, C.-C., Li, L., & Wei, M. (2019) · BMC Cardiovascular Disorders · doi:10.1186/s12872-019-1027-1 · Cited by 16 · see citing works
Chang, X., Zhang, S., Zhang, M., Wang, H., Fan, C., Gu, Y., Wei, J., & Qiu, C. (2018) · Lipids in Health and Disease · doi:10.1186/s12944-018-0881-7 · Cited by 15 · see citing works
Is There Any Relationship between TSH Levels and Prognosis in Acute Coronary Syndrome?
Soeiro, A. D. M., Araújo, V. A., Vella, J. P., Bossa, A. S., Biselli, B., Leal, T. D. C. A. T., Soeiro, M. C. F. D. A., Junior, C. V. S., Mueller, C. E., & de Oliveira, M. T. (2018) · Arquivos Brasileiros de Cardiologia · doi:10.5935/abc.20180019 · Cited by 14 · see citing works
Zhu, L., Gao, C., Wang, X., et al. (2014) · Coronary Artery Disease · doi:10.1097/mca.0000000000000095 · Cited by 12 · see citing works
Razvi, S., Leng, O., Jabbar, A., Bano, A., Ingoe, L. E., Addison, C., Thomas, H. E., Carey, P. E., Junejo, S., Austin, D., et al. (2019) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgz143 · Cited by 8 · see citing works
Lin, K., Wang, S.-Y., Jiang, H., et al. (2019) · BMC Nephrology · doi:10.1186/s12882-019-1386-y · Cited by 6 · see citing works
Lin, C. (2018) · The Anatolian Journal of Cardiology · doi:10.14744/anatoljcardiol.2018.38228 · Cited by 5 · see citing works
Long term prognostic effect of low T3 syndrome in patients with acute anterior myocardial infarction
Le, Z. (2014) · Dalian Yike Daxue xuebao · Cited by 1 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Thyroid and heart, a clinically relevant relationship
Corona, G., Croce, L., Sparano, C., Petrone, L., Sforza, A., Maggi, M., Chiovato, L., & Rotondi, M. (2021) · Journal of Endocrinological Investigation · doi:10.1007/s40618-021-01590-9 · Cited by 60 · see citing works
- Authors
- Chang, C.-Y., Chien, Y.-J., Lin, P.-C., Chen, C.-S., & Wu, M.-Y.
- Affiliations
- Tzu Chi University (TW)
- Taipei Tzu Chi Hospital (TW)
- Corresponding author
- Wu, Meng-Yu
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2020-05-27
- Volume
- 105
- Issue
- 8
- Pages
- 2830-2845
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W3030861532
- Cited by
- 20
- References
- 72
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 2 · 2023: 6 · 2022: 4 · 2021: 3 · 2020: 1
- FWCI
- 0.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Taipei Tzu Chi Hospital (TCRD-TPE-109-02, TCRD-TPE-109-03)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Keywords
- low T3 syndrome, hypothyroidism, ischemic heart disease, all-cause mortality, major adverse cardiac events, acute coronary syndrome, prognosis, euthyroidism, thyroid function
- MeSH terms
- Cause of Death, Euthyroid Sick Syndromes, Humans, Hypothyroidism, Prognosis, Risk Factors, Myocardial Ischemia
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
