Iodine

Evidence-based effects and studies

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Effects
2276
Total evidences
2596

Effects and Evidences

Detailed analysis of research findings

surgical site infection rate

16 evidences

Compared chlorhexidine to povidone-iodine for skin prep in upper abdominal surgery; chlorhexidine had lower SSI rates though overall difference narrowly missed conventional significance.

Trust comment: Prospective randomized trial with fair sample size showing consistent trend favoring chlorhexidine over povidone-iodine; borderline statistical significance overall.

Study Details

PMID:25381486
Participants:351
Impact:Povidone-iodine group 17.9% vs chlorhexidine 10.8% (difference +7.1 percentage points; overall p=0.06; week-1 difference was significant: 14.1% vs 7.0%, p=0.03)
Trust score:4/5

Large multicenter randomized trial found no difference between chlorhexidine-alcohol and povidone-iodine-alcohol for reoperation, surgical site infection, mediastinitis, or mortality after major cardiac surgery.

Trust comment: Large multicenter RCT with blinded adjudication of outcomes and robust endpoints; high-quality evidence that PVI-alcohol is not inferior to CHX-alcohol in this setting.

Study Details

PMID:39531051
Participants:3242
Impact:4.0% vs 3.3% (risk difference 0.74; P=0.26)
Trust score:5/5

Povidone-iodine (alcohol or aqueous) performed similarly to chlorhexidine-alcohol for 30-day surgical site infection, complications, and hospital stay after colorectal surgery.

Trust comment: Prospective randomized trial with moderate sample size and clinically relevant endpoints, though subset analysis and protocol change in chlorhexidine concentration limit interpretation.

Study Details

PMID:34933316
Participants:482
Impact:+2.2% to +2.4% for povidone-iodine vs chlorhexidine (22.8% and 23.0% vs 20.6%)
Trust score:4/5

In lumbar fusion surgery, intraoperative povidone-iodine soaking reduced superficial tissue bacterial contamination but not deep tissues or implants; chlorhexidine soaked implants showed the greatest reduction of implant contamination; SSI rates were low and similar.

Trust comment: Single-center randomized trial with objective culture and PCR outcomes directly comparing PVP-I and other antiseptics; moderate sample size.

Study Details

PMID:40334990
Participants:105
Impact:low and comparable across NS, PVP-I, and CHG groups (P=0.72)
Trust score:4/5

A bundle including povidone-iodine dabbing after closure plus chlorhexidine measures reduced surgical site infections compared with conventional care.

Trust comment: Double-blinded RCT but small sample and the intervention combined multiple antiseptic measures so iodine-specific effect cannot be isolated.

Study Details

PMID:38358547
Participants:64
Impact:21.8% (bundle) vs 46.8% (conventional); −25.0 percentage points (significant)
Trust score:3/5

Large randomized trial comparing povidone-iodine with alcohol, chlorhexidine with alcohol, or both; no difference in surgical site infection rates among methods.

Trust comment: Large, well-conducted randomized trial with objective outcome measures and adequate sample size, though overall event rate was lower than anticipated.

Study Details

PMID:26551196
Participants:1404
Impact:no significant difference (povidone-iodine with alcohol 4.6% vs chlorhexidine with alcohol 4.5% vs both 3.9%)
Trust score:5/5

Compared two alcohol-based skin preps (one iodine-containing) for surgical site infections after colorectal surgery; iodine prep failed noninferiority.

Trust comment: Large randomized, blinded (laboratory) noninferiority trial with 788 patients and objective SSI outcomes; noninferiority criterion not met.

Study Details

PMID:28277409
Participants:788
Impact:+2.8% (IPA 18.7% vs chlorhexidine-alcohol 15.9%); IPA failed prespecified noninferiority (upper 95% CI 8.9% > 6.6% margin)
Trust score:4/5

Multicenter randomized trial comparing preoperative skin disinfection with 10% povidone-iodine versus 2% chlorhexidine in alcohol found no significant difference in surgical site infection rates.

Trust comment: Large multicenter randomized trial (n=388) but difference between groups was not statistically significant.

Study Details

PMID:26564292
Participants:388
Impact:+2.9 percentage points (povidone-iodine 10% vs chlorhexidine 7.1%; 10% vs 7.1%, p=0.324)
Trust score:4/5

In dirty surgical wounds, packing with oxidized regenerated cellulose reduced bacterial contamination more often than gauze soaked in iodine; no clinical surgical-site infections occurred in either group.

Trust comment: Prospective randomized study with 98 patients and objective swab measures, but absence of SSI events limits clinical outcome conclusions.

Study Details

PMID:21389925
Participants:98
Impact:0% in both groups (no clinically evident superficial or deep SSI)
Trust score:4/5

Compared chlorhexidine-alcohol versus iodine-alcohol for skin prep at cesarean; chlorhexidine led to fewer surgical-site infections than iodine.

Trust comment: Large single-center randomized controlled trial with clear endpoints and intention-to-treat analysis, high internal validity.

Study Details

PMID:26844840
Participants:1147
Impact:7.3% in iodine-alcohol group vs 4.0% in chlorhexidine-alcohol (difference +3.3 percentage points; RR for chlorhexidine 0.55)
Trust score:5/5

Povidone-iodine irrigation did not reduce surgical site infections or hospital stay compared with normal saline after gastrectomy.

Trust comment: Randomized clinical trial with large sample and modified ITT; single-center which limits generalizability.

Study Details

PMID:36415016
Participants:333
Impact:no significant difference (6.59% PVI vs 5.42% NS; OR 1.131, P=0.655)
Trust score:4/5

Compared chlorhexidine–alcohol to povidone–iodine for skin prep before cesarean; chlorhexidine had fewer infections but difference was not statistically significant.

Trust comment: Randomized pilot trial with adequate methods and 300 analyzed patients; limited by pilot size and non-significant primary result.

Study Details

PMID:34404473
Participants:300
Impact:Povidone-iodine group 8.6% vs chlorhexidine–alcohol 5.4% (difference +3.2 percentage points; p=0.276)
Trust score:4/5

Irrigating contaminated/dirty wounds with aqueous povidone‑iodine before closure did not reduce surgical site infections compared with normal saline over 30 days.

Trust comment: Randomized controlled trial (n=180) with clear outcome and 30-day follow-up; single-centre and no blinding details limit generalizability.

Study Details

PMID:38404074
Participants:180
Impact:-3.4 percentage points (28.8% vs 32.2%); p=0.627 (no significant difference)
Trust score:4/5

Cluster-randomized crossover trial found povidone-iodine in alcohol noninferior to chlorhexidine gluconate in alcohol for preventing surgical site infections after cardiac or abdominal surgery.

Trust comment: Large cluster-randomized crossover trial with standardized protocols and adequate sample size showing PVI-alcohol noninferior to CHG-alcohol for SSI prevention.

Study Details

PMID:38884982
Participants:3360
Impact:5.1% povidone-iodine vs 5.5% chlorhexidine; difference 0.4% (95% CI −1.1% to 2.0%); met noninferiority margin
Trust score:4/5

Povidone-iodine with alcohol was non-inferior to chlorhexidine-alcohol for preventing surgical site infection and was not superior to aqueous povidone-iodine.

Trust comment: Large (n=3213), multicenter randomized trial with clinically relevant endpoint and rigorous design supports high trustworthiness.

Study Details

PMID:35129525
Participants:3213
Impact:C-Alc 11.09% vs PI-Alc 10.88% vs PI-Aq 12.56%; PI-Alc non-inferior to C-Alc (mean diff -0.21%, 95% CI -2.85 to 2.44)
Trust score:5/5

Chlorhexidine-alcohol scrub followed by povidone-iodine paint reduced surgical site infections compared with povidone-iodine paint alone.

Trust comment: Randomized prospective quality improvement study with reasonable sample size and a statistically significant outcome.

Study Details

PMID:34942679
Participants:251
Impact:-7.0 percentage points (12.4% -> 5.4% with chlorhexidine scrub + povidone-iodine vs povidone-iodine only; p=0.04)
Trust score:4/5

superficial surgical-site infection rate

1 evidences

Compared chlorhexidine-alcohol versus iodine-alcohol for skin prep at cesarean; chlorhexidine led to fewer surgical-site infections than iodine.

Trust comment: Large single-center randomized controlled trial with clear endpoints and intention-to-treat analysis, high internal validity.

Study Details

PMID:26844840
Participants:1147
Impact:4.9% in iodine-alcohol vs 3.0% in chlorhexidine (higher with iodine; P=0.10)
Trust score:5/5

deep surgical-site infection rate

1 evidences

Compared chlorhexidine-alcohol versus iodine-alcohol for skin prep at cesarean; chlorhexidine led to fewer surgical-site infections than iodine.

Trust comment: Large single-center randomized controlled trial with clear endpoints and intention-to-treat analysis, high internal validity.

Study Details

PMID:26844840
Participants:1147
Impact:2.4% in iodine-alcohol vs 1.0% in chlorhexidine (higher with iodine; P=0.07)
Trust score:5/5

surgical-site infection rate (closed fractures)

1 evidences

Cluster-randomized crossover trial comparing iodine-povacrylex-in-alcohol versus chlorhexidine-in-alcohol for preoperative skin antisepsis; iodine solution reduced infections in closed fractures.

Trust comment: Large multicenter cluster-randomized crossover trial with robust sample size and clinically relevant endpoint (SSI).

Study Details

PMID:38294973
Participants:8485
Impact:2.4% with iodine vs 3.3% with chlorhexidine (OR 0.74; P=0.049)
Trust score:5/5

median urinary iodine concentration (MUIC)

1 evidences

Large multi-province cross-sectional survey in China assessing iodine intake sources, urinary iodine, and thyroid disease prevalence in pregnant women and adults.

Trust comment: Large, multi-stage representative survey with laboratory measures and ultrasound, but cross-sectional design limits causal inference.

Study Details

PMID:35983514
Participants:3621
Impact:Pregnant women MUIC 164.49 µg/L vs adults 187.30 µg/L (pregnant women lower)
Trust score:4/5

effect of supplement measure (ISFP) on MUIC

1 evidences

Large multi-province cross-sectional survey in China assessing iodine intake sources, urinary iodine, and thyroid disease prevalence in pregnant women and adults.

Trust comment: Large, multi-stage representative survey with laboratory measures and ultrasound, but cross-sectional design limits causal inference.

Study Details

PMID:35983514
Participants:3621
Impact:Pregnant women MUIC with ISFP 229.92 µg/L vs IS 168.90 µg/L (ISFP associated with higher MUIC; P<0.05)
Trust score:4/5

prevalence of thyroid nodules in pregnant women

1 evidences

Large multi-province cross-sectional survey in China assessing iodine intake sources, urinary iodine, and thyroid disease prevalence in pregnant women and adults.

Trust comment: Large, multi-stage representative survey with laboratory measures and ultrasound, but cross-sectional design limits causal inference.

Study Details

PMID:35983514
Participants:3621
Impact:Thyroid nodules prevalence 11.93% (most common thyroid abnormality reported)
Trust score:4/5

iodine load administered

1 evidences

Randomized trial showing that a reduced iodinated contrast protocol (≈43% lower iodine load) plus advanced reconstructions maintained or improved image quality and lesion detection in patients with impaired renal function.

Trust comment: Prospective randomized single-center trial with blinded readers but small sample size and single-vendor imaging, limiting generalizability.

Study Details

PMID:37858212
Participants:52
Impact:RPP group 301.5 mgI/kg vs standard 524 mgI/kg (≈43% reduction; P<0.001)
Trust score:4/5

image contrast and overall image quality

1 evidences

Randomized trial showing that a reduced iodinated contrast protocol (≈43% lower iodine load) plus advanced reconstructions maintained or improved image quality and lesion detection in patients with impaired renal function.

Trust comment: Prospective randomized single-center trial with blinded readers but small sample size and single-vendor imaging, limiting generalizability.

Study Details

PMID:37858212
Participants:52
Impact:Higher arterial and portal-phase image contrast and overall quality with 50-keV or DL-iodine-boosted reconstructions versus standard (e.g., arterial contrast 3.09 vs 3.60; P=0.002)
Trust score:4/5

lesion detection (figure of merit)

1 evidences

Randomized trial showing that a reduced iodinated contrast protocol (≈43% lower iodine load) plus advanced reconstructions maintained or improved image quality and lesion detection in patients with impaired renal function.

Trust comment: Prospective randomized single-center trial with blinded readers but small sample size and single-vendor imaging, limiting generalizability.

Study Details

PMID:37858212
Participants:52
Impact:Arterial-phase FOM higher in RPP 50-keV (0.825) vs standard (0.594); P=0.006; DL-boosting non-significant difference vs standard
Trust score:4/5

child full-scale IQ at 5 years

1 evidences

Secondary analysis of parallel randomized trials found maternal mild iodine insufficiency (UIC ≤150 μg/L) in women with subclinical thyroid disease was not associated with lower offspring IQ or behavioral deficits at age 5 years.

Trust comment: Large multicenter randomized trials with high follow-up rate; secondary analysis but well-powered for the reported comparisons.

Study Details

PMID:38228158
Participants:1203
Impact:No difference: children of iodine-sufficient vs -insufficient mothers with subclinical hypothyroidism had similar scores (95 vs 96; P adj=0.73)
Trust score:4/5

IQ in hypothyroxinemia subgroup

1 evidences

Secondary analysis of parallel randomized trials found maternal mild iodine insufficiency (UIC ≤150 μg/L) in women with subclinical thyroid disease was not associated with lower offspring IQ or behavioral deficits at age 5 years.

Trust comment: Large multicenter randomized trials with high follow-up rate; secondary analysis but well-powered for the reported comparisons.

Study Details

PMID:38228158
Participants:1203
Impact:No adjusted difference at 5–7 years (94 vs 91; P adj=0.11)
Trust score:4/5

effect of levothyroxine treatment by iodine status

1 evidences

Secondary analysis of parallel randomized trials found maternal mild iodine insufficiency (UIC ≤150 μg/L) in women with subclinical thyroid disease was not associated with lower offspring IQ or behavioral deficits at age 5 years.

Trust comment: Large multicenter randomized trials with high follow-up rate; secondary analysis but well-powered for the reported comparisons.

Study Details

PMID:38228158
Participants:1203
Impact:Levothyroxine treatment not associated with neurodevelopmental or behavioral outcomes regardless of maternal iodine status (P>0.05)
Trust score:4/5

urinary iodine concentration (UIC)

12 evidences

Daily supplementation with 150 μg iodine in pregnancy improved maternal urinary iodine and urinary iodine excretion and reduced thyroglobulin compared with control, without changing maternal TSH/FT4 or neonatal TSH.

Trust comment: Randomized double-blind pilot RCT with validated biomarkers; limited by sample size, some tablet compositional confounders, and being a pilot study.

Study Details

PMID:33620551
Participants:158
Impact:third trimester median UIC 136 μg/L (intervention) vs 65 μg/L (control); intervention reached borderline sufficiency (p<0.001)
Trust score:4/5

Double-blind RCT in older adults testing selenium, iodine, their combination, or placebo for 3 months; thyroid function, thyroglobulin, selenium status and urinary iodine measured.

Trust comment: Double-blind, placebo-controlled RCT with clear biochemical outcomes and adequate sample for population studied; results consistent and plausible.

Study Details

PMID:19692495
Participants:100
Impact:increased with iodine supplementation (significant)
Trust score:4/5

Pregnant women randomized to two cod meals/week vs habitual diet; measured maternal urinary iodine (UIC), thyroid function, and infant development at 11 months.

Trust comment: Well-conducted randomized trial with objective biomarker primary outcome and reasonable sample size, though mothers were not blinded and intervention started mid-pregnancy.

Study Details

PMID:32746774
Participants:122
Impact:+25 μg/L median (postintervention median 98 vs 73 μg/L)
Trust score:4/5

Educational program improved knowledge/attitudes but did not change pregnant women's urinary iodine status.

Trust comment: Randomized trial with objective UIC measurement; improved KAP but no biological effect—moderate quality and applicability.

Study Details

PMID:27809707
Participants:100
Impact:No significant difference in UIC between intervention and control at 4-month follow-up
Trust score:3/5

12-week RCT in women of childbearing age: increasing cow milk intake raised urinary iodine concentration but did not change thyroid hormone or selenium measures.

Trust comment: Well-conducted randomized controlled trial with objective biomarkers (UIC) but modest sample size, limiting power for clinical thyroid outcomes.

Study Details

PMID:29546298
Participants:78
Impact:+35.4 µg/L (week 6 vs baseline, intervention vs control); +51.6 µg/L (week 12 vs baseline, intervention vs control)
Trust score:4/5

A 12-week RCT in adolescents comparing fatty fish meals, meat meals, and n-3 supplements found increases in omega-3 biomarkers but no significant change in urinary iodine concentration between groups.

Trust comment: Randomized controlled trial with objective biomarker measurements but limited by dietary compliance variability.

Study Details

PMID:29475446
Participants:478
Impact:no significant change between groups; fish group change −11.6 μg/L, meat +2.4 μg/L, supplement +0.9 μg/L (no between-group significance)
Trust score:4/5

In overweight iodine-deficient women, daily 200 μg iodine for 6 months increased urinary iodine and reduced total cholesterol and the prevalence of hypercholesterolemia.

Trust comment: Randomized controlled trial with clear biochemical outcomes in a defined iodine-deficient population; moderate sample size.

Study Details

PMID:26203098
Participants:163
Impact:median increased from 38 to 77 μg/L
Trust score:4/5

Higher iodine nutrition markers (e.g., serum iodine) were associated with greater risk of lateral lymph node metastasis; including iodine markers improved predictive model performance.

Trust comment: Retrospective single‑center cohort with internal validation and moderate sample size; causality limited by design.

Study Details

PMID:37671703
Participants:476
Impact:higher UIC associated with increased LLNM in univariate analysis (OR 2.255, 95%CI 1.141–4.455)
Trust score:3/5

Daily 150 μg iodine supplementation for 24 weeks raised urinary iodine and reduced thyroglobulin levels in mildly iodine-deficient adults without changing TSH or free T4.

Trust comment: Randomized double-blind placebo-controlled trial with reasonable sample size (n=112) and appropriate biomarker measurements, supporting internal validity.

Study Details

PMID:26891118
Participants:112
Impact:Median UIC at 24 weeks: 168 µg/L (supplement) vs 79 µg/L (placebo); significant increase in supplemented group
Trust score:4/5

20-week RCT in 12–20-month-olds showing iodine-fortified milk substantially increased iodine intake and urinary iodine concentration versus non-fortified milk.

Trust comment: Parallel randomized controlled trial with 135 toddlers, measured dietary intake and UIC with statistically significant effects.

Study Details

PMID:30929067
Participants:135
Impact:UIC increased by +85 µg/L in Fortified vs Non-Fortified (P < 0.001); 20-week median UIC 91 µg/L vs 49 µg/L
Trust score:4/5

Preschool children given fatty fish 3×/week for 16 weeks had higher urinary iodine, higher n‑3 fatty acids, and higher hair mercury than children given meat.

Trust comment: Randomized controlled trial with objective biomarker measurements and adequate sample size; exploratory multiple outcomes limit certainty.

Study Details

PMID:33978160
Participants:222
Impact:+0.32 SMD (standardized mean difference)
Trust score:4/5

Daily lipid-based supplement with 250 μg iodine did not raise urinary iodine concentrations in pregnant and postpartum women compared with iron–folic acid.

Trust comment: Large cluster-randomized trial with a large enrolled sample and repeated biomarker sampling in a prespecified subsample, though UIC is a spot measure and was a secondary outcome.

Study Details

PMID:28615379
Participants:4011
Impact:No significant change; median at 36 wk 30.2 vs 27.4 µg/L (LNS-PL vs IFA); at 6 mo 22.2 vs 23.0 µg/L
Trust score:4/5

micronucleus formation

1 evidences

Very small randomized trial testing melatonin vs placebo in hyperthyroid patients receiving iodine-131; measured chromosomal damage and treatment response at 6 months.

Trust comment: Randomized double-blind RCT but small sample (n=52) and outcome for chromosomal damage was non-significant; relevant because it involves therapeutic iodine-131 exposure.

Study Details

PMID:35137935
Participants:52
Impact:no significant change
Trust score:3/5

Treatment response rate

1 evidences

Very small randomized trial testing melatonin vs placebo in hyperthyroid patients receiving iodine-131; measured chromosomal damage and treatment response at 6 months.

Trust comment: Randomized double-blind RCT but small sample (n=52) and outcome for chromosomal damage was non-significant; relevant because it involves therapeutic iodine-131 exposure.

Study Details

PMID:35137935
Participants:52
Impact:+24.2 percentage points (61.5% → 85.7%)
Trust score:3/5

estimated iodine intake

1 evidences

Pregnant women randomized to two cod meals/week vs habitual diet; measured maternal urinary iodine (UIC), thyroid function, and infant development at 11 months.

Trust comment: Well-conducted randomized trial with objective biomarker primary outcome and reasonable sample size, though mothers were not blinded and intervention started mid-pregnancy.

Study Details

PMID:32746774
Participants:122
Impact:+72 μg/day median (218 vs 146 μg/day)
Trust score:4/5

infant cognitive composite score (Bayley-III)

1 evidences

Pregnant women randomized to two cod meals/week vs habitual diet; measured maternal urinary iodine (UIC), thyroid function, and infant development at 11 months.

Trust comment: Well-conducted randomized trial with objective biomarker primary outcome and reasonable sample size, though mothers were not blinded and intervention started mid-pregnancy.

Study Details

PMID:32746774
Participants:122
Impact:-4 points (95 vs 99)
Trust score:4/5

total injected iodine load

1 evidences

Multi-institution RCT comparing low-tube-voltage CT with lower-concentration iodinated contrast (reduced iodine load) versus conventional CTU, focusing on image quality and radiation dose.

Trust comment: Large multi-center RCT with blinded assessors and clear quantitative endpoints, focused on imaging protocol rather than clinical health outcomes.

Study Details

PMID:30386143
Participants:299
Impact:-31.4% (reduced concentration/protocol)
Trust score:4/5

radiation effective dose (excretory phase)

1 evidences

Multi-institution RCT comparing low-tube-voltage CT with lower-concentration iodinated contrast (reduced iodine load) versus conventional CTU, focusing on image quality and radiation dose.

Trust comment: Large multi-center RCT with blinded assessors and clear quantitative endpoints, focused on imaging protocol rather than clinical health outcomes.

Study Details

PMID:30386143
Participants:299
Impact:-32.0% (effective dose reduction)
Trust score:4/5

diagnostic acceptability

1 evidences

Multi-institution RCT comparing low-tube-voltage CT with lower-concentration iodinated contrast (reduced iodine load) versus conventional CTU, focusing on image quality and radiation dose.

Trust comment: Large multi-center RCT with blinded assessors and clear quantitative endpoints, focused on imaging protocol rather than clinical health outcomes.

Study Details

PMID:30386143
Participants:299
Impact:non-inferior (slightly lower mean score but within non-inferiority margin)
Trust score:4/5

positive vaginal cultures at 90 minutes

1 evidences

Randomized trial comparing 4% chlorhexidine vs 10% iodine for preoperative vaginal preparation, measuring bacterial counts and positive cultures up to 90 minutes and postoperative infections.

Trust comment: Randomized clinical trial but smaller than planned (85 randomized) and not powered for clinical infection endpoints; shows clear bacteriologic advantage for chlorhexidine over iodine in short-term counts.

Study Details

PMID:34333502
Participants:85
Impact:-37.8 percentage points (85.4% → 47.6%) for chlorhexidine vs iodine
Trust score:3/5

median bacterial count at 90 minutes

1 evidences

Randomized trial comparing 4% chlorhexidine vs 10% iodine for preoperative vaginal preparation, measuring bacterial counts and positive cultures up to 90 minutes and postoperative infections.

Trust comment: Randomized clinical trial but smaller than planned (85 randomized) and not powered for clinical infection endpoints; shows clear bacteriologic advantage for chlorhexidine over iodine in short-term counts.

Study Details

PMID:34333502
Participants:85
Impact:-21,000 CFU (24,000 → 3,000 CFU) for chlorhexidine vs iodine
Trust score:3/5

postoperative surgical site infection

1 evidences

Randomized trial comparing 4% chlorhexidine vs 10% iodine for preoperative vaginal preparation, measuring bacterial counts and positive cultures up to 90 minutes and postoperative infections.

Trust comment: Randomized clinical trial but smaller than planned (85 randomized) and not powered for clinical infection endpoints; shows clear bacteriologic advantage for chlorhexidine over iodine in short-term counts.

Study Details

PMID:34333502
Participants:85
Impact:no events in either group (no difference)
Trust score:3/5

total nodular volume (T4 + iodine vs placebo)

1 evidences

Large multicenter RCT (LISA) in patients with nodular goiter comparing placebo, iodine, levothyroxine (T4), and T4+iodine over 12 months, assessing nodule and thyroid volume and urinary iodine.

Trust comment: Large, multicenter, randomized, placebo-controlled trial with robust methodology and clinically relevant endpoints; primary analysis included a large sample (n=794).

Study Details

PMID:21715542
Participants:794
Impact:-17.3% relative (T4+I vs placebo); T4+I group mean change −21.6% vs placebo −5.2%
Trust score:5/5

iodine excretion (urinary iodine)

1 evidences

Large multicenter RCT (LISA) in patients with nodular goiter comparing placebo, iodine, levothyroxine (T4), and T4+iodine over 12 months, assessing nodule and thyroid volume and urinary iodine.

Trust comment: Large, multicenter, randomized, placebo-controlled trial with robust methodology and clinically relevant endpoints; primary analysis included a large sample (n=794).

Study Details

PMID:21715542
Participants:794
Impact:increased (I and I+T4 groups; e.g., I+T4 +88.06% over baseline)
Trust score:5/5

thyroid volume

14 evidences

Randomized comparison of two levothyroxine+iodide dose combos showed both reduced goitre size similarly with different TSH responses.

Trust comment: Randomized clinical trial with objective ultrasound measures but small sample and short follow-up.

Study Details

PMID:11256036
Participants:44
Impact:group A −17.3%, group B −14.8%
Trust score:4/5

In iodine-deficient children, salt fortified with iodine plus micronized iron increased hemoglobin and iron stores and improved urinary iodine and thyroid volume over 10 months.

Trust comment: Randomized double-blind controlled trial in 158 children with clear biochemical outcomes; well-conducted though limited to one region.

Study Details

PMID:15447905
Participants:158
Impact:improved (P<0.01)
Trust score:4/5

Postpartum iodine (50 or 250 µg) reduced thyroid size by 3 months and produced few mild transient thyroid dysfunctions.

Trust comment: Randomized intervention with objective measures but modest sample size and relatively short follow-up.

Study Details

PMID:9533929
Participants:126
Impact:decrease from 25.4 ± 1.5 ml to 18.2 ± 1.25 ml at 3 months (−7.2 ml; ~−28%)
Trust score:4/5

Radioiodine reduced thyroid volume substantially; adjunct lithium prevented early radioiodine-induced hyperthyroidism.

Trust comment: Randomized clinical trial with 24-month follow-up and clear objective endpoints.

Study Details

PMID:15871016
Participants:80
Impact:mean decrease 47.2% at 24 months
Trust score:4/5

Adding microencapsulated iron to iodized salt improved iron status and amplified the beneficial effects of iodine on thyroid size and function in goitrous, iron-deficient children.

Trust comment: Large randomized double-blind controlled trial with objective ultrasound and biochemical outcomes.

Study Details

PMID:12457449
Participants:377
Impact:-38% (dual-fortified) vs -18% (iodized) at 40 weeks
Trust score:4/5

Short-term iodine supplementation raised urinary iodine and TSH; higher supplement doses led to reduced thyroid volume at the highest doses and caused subclinical hypothyroidism at and above certain intake levels.

Trust comment: Randomized double-blind placebo-controlled trial with multiple dose arms and objective thyroid outcomes, though short duration (4 weeks) limits long-term conclusions.

Study Details

PMID:22205314
Participants:256
Impact:Decreased in high-iodine groups (1500–2000 μg)
Trust score:4/5

Low-dose iodine intake in endemic-goitre patients markedly increased urinary iodine and induced autoimmune thyroid changes in a subset (antibody rise, lymphocytic infiltration) with some developing hypo- or hyperthyroidism that mostly remitted after withdrawal.

Trust comment: Randomized double-blind trial with objective hormone/antibody measures but modest sample size and specific population (endemic goitre).

Study Details

PMID:9758438
Participants:62
Impact:T4 reduced volume more (32→17 ml) than iodine (33→21 ml); both decreased
Trust score:4/5

In an iodine-deficient region, patients with metabolic syndrome had larger thyroid volumes and more nodules than matched controls.

Trust comment: Large case-control study with ultrasound outcomes; observational design limits causal inference and setting is iodine-deficient which affects generalizability.

Study Details

PMID:19633072
Participants:539
Impact:mean 17.5 mL (MetS) vs 12.2 mL (controls), P<0.0001
Trust score:3/5

Iodide substitution after thyroid surgery was as effective as L‑thyroxine at preventing goiter recurrence over one year.

Trust comment: Randomized prospective sonographic study with standard biochemical and imaging endpoints; modest sample size but directly human and clinically relevant.

Study Details

PMID:8943171
Participants:107
Impact:slight decrease over 52 weeks in both groups; no significant difference between iodide and L‑thyroxine
Trust score:4/5

Large multicenter RCT (LISA) in patients with nodular goiter comparing placebo, iodine, levothyroxine (T4), and T4+iodine over 12 months, assessing nodule and thyroid volume and urinary iodine.

Trust comment: Large, multicenter, randomized, placebo-controlled trial with robust methodology and clinically relevant endpoints; primary analysis included a large sample (n=794).

Study Details

PMID:21715542
Participants:794
Impact:greater reduction with T4+I (≈ −9.7%) than placebo
Trust score:5/5

In middle-aged and elderly patients with endemic goitre, daily iodide reduced thyroid volume over 12 months by about 16%, similar to levothyroxine, without inducing thyroid antibodies.

Trust comment: Randomized treatment comparison with serial objective measurements (ultrasound, hormones), though sample size modest.

Study Details

PMID:9011485
Participants:67
Impact:decrease ~16.2% at 12 months with iodide (levothyroxine ~15.4%); no significant difference
Trust score:4/5

Low-dose iodide (0.2 mg/day) for 12 months reduced thyroid size in adults with endemic goiter but triggered reversible thyroid autoimmunity/dysfunction in a minority.

Trust comment: Randomized, double-blind, placebo-controlled trial with clear clinical outcomes but modest sample size.

Study Details

PMID:9398711
Participants:62
Impact:Reduced from 29 mL to 18 mL at 12 months (−38%, P=0.0001); effect sustained at 18 months
Trust score:4/5

6-month randomized, double-blind 2x2 trial in children: vitamin A supplementation decreased TSH stimulation, thyroglobulin, and thyroid volume and thus reduced goiter risk in the context of mild-to-moderate iodine deficiency.

Trust comment: Large double-blind randomized factorial trial with clear biochemical and ultrasonographic outcomes and statistically significant effects.

Study Details

PMID:17921382
Participants:404
Impact:Decreased significantly with vitamin A supplementation (P<0.05)
Trust score:5/5

Adding 150 µg iodine to individualized L-thyroxine increased urinary iodine and produced greater (though modest) reductions in thyroid volume and stronger TSH suppression versus L-thyroxine alone.

Trust comment: Controlled clinical comparison (n=94) showing biochemical and modest clinical benefit of iodine supplementation; limited methodological detail reported here.

Study Details

PMID:8965746
Participants:94
Impact:−18.5% (combination) vs −16.8% (L‑T4 alone); difference not significant
Trust score:3/5

maternal urinary iodine concentration (UIC) and breast-milk iodine concentration (BMIC)

1 evidences

Double-blind RCT in lactating mothers randomized to placebo, 150 μg/day, or 300 μg/day iodine; assessed maternal and infant UIC, breast-milk iodine, and infant growth over 12 months in an area with effective salt iodization.

Trust comment: Double-blind RCT with frequent biomarker follow-up and adequate sample size showing maternal biomarker changes but no infant deficiency signal in a population with effective salt iodization.

Study Details

PMID:30272528
Participants:180
Impact:increased in 300 μg/day group (significantly higher than other groups)
Trust score:4/5

infant urinary iodine concentration

1 evidences

Double-blind RCT in lactating mothers randomized to placebo, 150 μg/day, or 300 μg/day iodine; assessed maternal and infant UIC, breast-milk iodine, and infant growth over 12 months in an area with effective salt iodization.

Trust comment: Double-blind RCT with frequent biomarker follow-up and adequate sample size showing maternal biomarker changes but no infant deficiency signal in a population with effective salt iodization.

Study Details

PMID:30272528
Participants:180
Impact:iodine sufficiency in all groups (median UIC ≥100 μg/L); no meaningful difference for infants across groups
Trust score:4/5

infant growth parameters

1 evidences

Double-blind RCT in lactating mothers randomized to placebo, 150 μg/day, or 300 μg/day iodine; assessed maternal and infant UIC, breast-milk iodine, and infant growth over 12 months in an area with effective salt iodization.

Trust comment: Double-blind RCT with frequent biomarker follow-up and adequate sample size showing maternal biomarker changes but no infant deficiency signal in a population with effective salt iodization.

Study Details

PMID:30272528
Participants:180
Impact:no meaningful differences between groups over study period
Trust score:4/5

iodine/contrast volume (iodine load)

1 evidences

Single-center RCT assessing whether dual-energy CT with virtual monoenergetic imaging allows halving the iodinated contrast dose for lower limb CTA while maintaining or improving image quality.

Trust comment: Well-powered single-center randomized trial with objective image-quality metrics showing feasibility of halving iodine load using spectral DECT; external validity limited to similar scanners/protocols.

Study Details

PMID:37071166
Participants:182
Impact:≈-50% (mean contrast volume 104.2 mL → 55.4 mL)
Trust score:4/5

vascular attenuation (VA) at 40 keV VMI

1 evidences

Single-center RCT assessing whether dual-energy CT with virtual monoenergetic imaging allows halving the iodinated contrast dose for lower limb CTA while maintaining or improving image quality.

Trust comment: Well-powered single-center randomized trial with objective image-quality metrics showing feasibility of halving iodine load using spectral DECT; external validity limited to similar scanners/protocols.

Study Details

PMID:37071166
Participants:182
Impact:increased (VA higher at 40 keV vs control; p < 0.0001)
Trust score:4/5

CNR and SNR at 40 keV

1 evidences

Single-center RCT assessing whether dual-energy CT with virtual monoenergetic imaging allows halving the iodinated contrast dose for lower limb CTA while maintaining or improving image quality.

Trust comment: Well-powered single-center randomized trial with objective image-quality metrics showing feasibility of halving iodine load using spectral DECT; external validity limited to similar scanners/protocols.

Study Details

PMID:37071166
Participants:182
Impact:increased (higher CNR/SNR at 40 keV vs control)
Trust score:4/5

duration of oral mucositis

1 evidences

In chemotherapy-induced oral mucositis, the povidone-iodine–containing antiseptic regimen (AA) was associated with longer symptom duration and slower lesion remission than topical GM-CSF.

Trust comment: Small randomized study with limited sample size and AA being a combination therapy rather than povidone-iodine alone.

Study Details

PMID:11597376
Participants:31
Impact:AA (includes povidone-iodine) 8.1 days vs GM-CSF 5.3 days (AA longer by +2.8 days)
Trust score:3/5

24-h urinary iodine concentration (24-UIC)

1 evidences

Randomized 2-year trial: Paleolithic diet reduced iodine intake and urinary iodine excretion vs standard diet.

Trust comment: Randomized controlled trial with objective urinary iodine measures and 2-year follow-up in a defined population.

Study Details

PMID:28901333
Participants:70
Impact:Median decreased from 71 to 36 μg/L at 6 months (≈ −49%, p=0.001)
Trust score:4/5

24-h urinary iodine excretion (24-UIE)

1 evidences

Randomized 2-year trial: Paleolithic diet reduced iodine intake and urinary iodine excretion vs standard diet.

Trust comment: Randomized controlled trial with objective urinary iodine measures and 2-year follow-up in a defined population.

Study Details

PMID:28901333
Participants:70
Impact:Decreased from 134 to 77 μg/d at 6 months (≈ −43%, p=0.001)
Trust score:4/5

Free triiodothyronine (FT3)

2 evidences

Randomized 2-year trial: Paleolithic diet reduced iodine intake and urinary iodine excretion vs standard diet.

Trust comment: Randomized controlled trial with objective urinary iodine measures and 2-year follow-up in a defined population.

Study Details

PMID:28901333
Participants:70
Impact:FT3 lower in PD vs NNR at 6 months (statistically lower; magnitude not specified)
Trust score:4/5

Inhabitants with high cold exposure (hunters, settlement dwellers) showed signs of increased thyroid activity (higher thyroglobulin) and lower fT3 despite higher urinary iodine excretion.

Trust comment: Population-based cross-sectional study with reasonable sample size (n=535), but observational design limits causal inference.

Study Details

PMID:22170797
Participants:535
Impact:↓ fT3 in hunters and settlement dwellers after adjustment (P<0.001)
Trust score:3/5

Knowledge/attitude/practice (KAP) scores

1 evidences

Educational program improved knowledge/attitudes but did not change pregnant women's urinary iodine status.

Trust comment: Randomized trial with objective UIC measurement; improved KAP but no biological effect—moderate quality and applicability.

Study Details

PMID:27809707
Participants:100
Impact:KAP scores increased significantly in the intervention group (p<0.01)
Trust score:3/5

Salt iodine content

1 evidences

Educational program improved knowledge/attitudes but did not change pregnant women's urinary iodine status.

Trust comment: Randomized trial with objective UIC measurement; improved KAP but no biological effect—moderate quality and applicability.

Study Details

PMID:27809707
Participants:100
Impact:No significant change between groups at follow-up
Trust score:3/5

Positive skin cultures after preparation

1 evidences

Randomized trial in elective foot surgery showing both chlorhexidine and iodine skin preps markedly reduce positive skin cultures with similar clinical outcomes.

Trust comment: Randomized controlled trial with objective culture endpoints though modest sample size.

Study Details

PMID:30612875
Participants:49
Impact:Reduced from ~73% before to 2% (chlorhexidine) and from ~68% to 7% (iodine) immediately after prep
Trust score:4/5

Postoperative complication rate (2 weeks)

1 evidences

Randomized trial in elective foot surgery showing both chlorhexidine and iodine skin preps markedly reduce positive skin cultures with similar clinical outcomes.

Trust comment: Randomized controlled trial with objective culture endpoints though modest sample size.

Study Details

PMID:30612875
Participants:49
Impact:0% (chlorhexidine) vs 8.7% (iodine), p=0.215 (no significant difference)
Trust score:4/5

Postoperative complication rate (6 weeks)

1 evidences

Randomized trial in elective foot surgery showing both chlorhexidine and iodine skin preps markedly reduce positive skin cultures with similar clinical outcomes.

Trust comment: Randomized controlled trial with objective culture endpoints though modest sample size.

Study Details

PMID:30612875
Participants:49
Impact:3.8% vs 4.3% (chlorhexidine vs iodine), p>0.999 (no significant difference)
Trust score:4/5

hemoglobin concentration

3 evidences

Fortified biscuits (including iodine) increased iodine and other micronutrient status and reduced anemia in primary schoolchildren and improved deworming effectiveness.

Trust comment: Large randomized, double-blind, placebo-controlled trial with clear biochemical endpoints and adequate sample size.

Study Details

PMID:19321576
Participants:510
Impact:+1.87 g/L
Trust score:5/5

Double-blind randomized trial in pregnant women showed that a micronutrient-fortified beverage (including iodine) increased hemoglobin and ferritin and reduced risk of anemia and iron deficiency.

Trust comment: Randomized double-blind design with adequate sample size and clear hematologic outcome measures, though iodine-specific effects are not isolated.

Study Details

PMID:12730420
Participants:259
Impact:increase +4.16 g/L
Trust score:4/5

Large randomized double-blind trial: salt fortified with iodine+iron improved iron status and maintained iodine status in schoolchildren.

Trust comment: Large randomized double-blind controlled trial with biochemical outcomes and strong effect sizes for iron endpoints.

Study Details

PMID:12540404
Participants:377
Impact:Mean hemoglobin increased by 14 g/L in DFS group at 40 weeks (P<0.01)
Trust score:5/5

Iron deficiency anemia prevalence

2 evidences

Large randomized double-blind trial: salt fortified with iodine+iron improved iron status and maintained iodine status in schoolchildren.

Trust comment: Large randomized double-blind controlled trial with biochemical outcomes and strong effect sizes for iron endpoints.

Study Details

PMID:12540404
Participants:377
Impact:Decreased from 35% at baseline to 8% at 40 weeks in DFS group (P<0.001)
Trust score:5/5

In iodine-deficient children, salt fortified with iodine plus micronized iron increased hemoglobin and iron stores and improved urinary iodine and thyroid volume over 10 months.

Trust comment: Randomized double-blind controlled trial in 158 children with clear biochemical outcomes; well-conducted though limited to one region.

Study Details

PMID:15447905
Participants:158
Impact:decreased from 30% to 5% (−25 percentage points)
Trust score:4/5

Urinary iodine concentration / thyroid volume

1 evidences

Large randomized double-blind trial: salt fortified with iodine+iron improved iron status and maintained iodine status in schoolchildren.

Trust comment: Large randomized double-blind controlled trial with biochemical outcomes and strong effect sizes for iron endpoints.

Study Details

PMID:12540404
Participants:377
Impact:Urinary iodine concentrations and thyroid volumes improved significantly from baseline in both groups (P<0.001 and <0.05)
Trust score:5/5

RAI therapy success rate

1 evidences

Phase 3 randomized trial comparing recombinant thyrotropin vs thyroid hormone withdrawal prior to radioactive iodine; recombinant thyrotropin was noninferior for ablation success and caused fewer hypothyroid symptoms.

Trust comment: Large multicenter phase 3 RCT with objective imaging/biochemical endpoints and robust statistical analysis.

Study Details

PMID:39509132
Participants:280
Impact:Per-protocol: 43.8% (SNA001) vs 47.1% (THW); difference −3.3 percentage points (95% CI −14.8 to 8.3); noninferior
Trust score:5/5

Weight gain (hypothyroid symptom)

1 evidences

Phase 3 randomized trial comparing recombinant thyrotropin vs thyroid hormone withdrawal prior to radioactive iodine; recombinant thyrotropin was noninferior for ablation success and caused fewer hypothyroid symptoms.

Trust comment: Large multicenter phase 3 RCT with objective imaging/biochemical endpoints and robust statistical analysis.

Study Details

PMID:39509132
Participants:280
Impact:Reduced by 30.7 percentage points with SNA001 vs THW (12.3% vs 43.0%, P<.001)
Trust score:5/5

Radioiodine whole-body radiation at 48 h

1 evidences

Phase 3 randomized trial comparing recombinant thyrotropin vs thyroid hormone withdrawal prior to radioactive iodine; recombinant thyrotropin was noninferior for ablation success and caused fewer hypothyroid symptoms.

Trust comment: Large multicenter phase 3 RCT with objective imaging/biochemical endpoints and robust statistical analysis.

Study Details

PMID:39509132
Participants:280
Impact:Mean 10.6 vs 20.7 μSv/h (SNA001 vs THW), P<.001 (faster clearance/lower exposure)
Trust score:5/5

Urinary iodine concentration (pregnancy)

2 evidences

Large field study showing widespread iodine insufficiency in pregnant women despite iodized salt policy; household salt iodine content often too low.

Trust comment: Large cross-sectional measurements provide reliable prevalence estimates, but observational design limits causal inference.

Study Details

PMID:20977661
Participants:1376
Impact:Median UIC 66 μg/L (early) and 55 μg/L (late) pregnancy (indicative of deficiency)
Trust score:3/5

Pregnant women offered daily iodine had higher urinary iodine and fewer were at risk of deficiency, though >20% of supplemented women remained at risk.

Trust comment: Large cross-sectional comparison with clear biochemical endpoints but non-randomized design and possible selection/confounding bias.

Study Details

PMID:24117002
Participants:365
Impact:Median +41.4 μg/L (169.8 vs 128.4 μg/L; P < 0.01)
Trust score:3/5

Proportion with inadequate iodine

1 evidences

Large field study showing widespread iodine insufficiency in pregnant women despite iodized salt policy; household salt iodine content often too low.

Trust comment: Large cross-sectional measurements provide reliable prevalence estimates, but observational design limits causal inference.

Study Details

PMID:20977661
Participants:1376
Impact:≈80% of women had UIC <150 μg/L at both times
Trust score:3/5

Household salt iodine content

1 evidences

Large field study showing widespread iodine insufficiency in pregnant women despite iodized salt policy; household salt iodine content often too low.

Trust comment: Large cross-sectional measurements provide reliable prevalence estimates, but observational design limits causal inference.

Study Details

PMID:20977661
Participants:1376
Impact:Over 75% of household salt samples contained <15 ppm iodine; median UIC did not reach 150 μg/L until salt ≥32–51 ppm
Trust score:3/5

time to SSI diagnosis

1 evidences

Compared two alcohol-based skin preps (one iodine-containing) for surgical site infections after colorectal surgery; iodine prep failed noninferiority.

Trust comment: Large randomized, blinded (laboratory) noninferiority trial with 788 patients and objective SSI outcomes; noninferiority criterion not met.

Study Details

PMID:28277409
Participants:788
Impact:no difference between groups
Trust score:4/5

length of hospital stay

2 evidences

Povidone-iodine irrigation did not reduce surgical site infections or hospital stay compared with normal saline after gastrectomy.

Trust comment: Randomized clinical trial with large sample and modified ITT; single-center which limits generalizability.

Study Details

PMID:36415016
Participants:333
Impact:no significant difference (P=0.301)
Trust score:4/5

Compared two alcohol-based skin preps (one iodine-containing) for surgical site infections after colorectal surgery; iodine prep failed noninferiority.

Trust comment: Large randomized, blinded (laboratory) noninferiority trial with 788 patients and objective SSI outcomes; noninferiority criterion not met.

Study Details

PMID:28277409
Participants:788
Impact:no difference between groups
Trust score:4/5

urinary iodine concentration (UIC) at 36 weeks

2 evidences

Pregnant women given MMN or small-quantity LNS containing iodine had higher urinary iodine than those given iron+folic acid; MMN/LNS groups achieved WHO-adequate median UIC.

Trust comment: Well-conducted randomized controlled trial with pre-specified outcome (UIC), blinded laboratory analysis, and adequate sample for the UIC substudy (n=292).

Study Details

PMID:29210520
Participants:292
Impact:IFA 113 µg/L vs MMN 162 µg/L and LNS 159 µg/L (MMN and LNS > IFA; p≤0.004)
Trust score:5/5

Provision of supplements containing the WHO-recommended iodine dose (250 μg/day) did not change pregnant women's urinary iodine concentration at 36 weeks compared with iron–folic acid, likely because baseline iodine intakes were already adequate.

Trust comment: Large randomized controlled trial with prespecified analysis and adequate power for secondary outcome; baseline adequate iodine status limits detectable supplement effect.

Study Details

PMID:33054890
Participants:317
Impact:no significant difference between groups (geometric mean UIC ≈197 μg/L IFA, 212 μg/L MMN, 220 μg/L LNS; P=0.53)
Trust score:5/5

change in UIC from baseline to 36 weeks

1 evidences

Pregnant women given MMN or small-quantity LNS containing iodine had higher urinary iodine than those given iron+folic acid; MMN/LNS groups achieved WHO-adequate median UIC.

Trust comment: Well-conducted randomized controlled trial with pre-specified outcome (UIC), blinded laboratory analysis, and adequate sample for the UIC substudy (n=292).

Study Details

PMID:29210520
Participants:292
Impact:IFA −24 µg/L; MMN +39 µg/L; LNS +14 µg/L
Trust score:5/5

likelihood of adequate iodine status

1 evidences

Pregnant women given MMN or small-quantity LNS containing iodine had higher urinary iodine than those given iron+folic acid; MMN/LNS groups achieved WHO-adequate median UIC.

Trust comment: Well-conducted randomized controlled trial with pre-specified outcome (UIC), blinded laboratory analysis, and adequate sample for the UIC substudy (n=292).

Study Details

PMID:29210520
Participants:292
Impact:increased with MMN or SQ-LNS compared with IFA (median UIC >150 µg/L in MMN/LNS, <150 µg/L in IFA)
Trust score:5/5

child cognitive score (36 months)

1 evidences

Follow-up of RCT where lactating mothers received 0, 150, or 300 µg/day iodine; children at 36 months showed higher cognitive scores in the 150 µg group versus placebo but no language/motor effects.

Trust comment: Randomized clinical trial follow-up with objective neurodevelopmental testing but modest sample size and effect only for the 150 µg dose on cognition.

Study Details

PMID:33974129
Participants:122
Impact:150 µg/d vs placebo: mean 102.8 vs 99.2; adjusted β = +4.43 points (P = 0.032)
Trust score:3/5

child language development

1 evidences

Follow-up of RCT where lactating mothers received 0, 150, or 300 µg/day iodine; children at 36 months showed higher cognitive scores in the 150 µg group versus placebo but no language/motor effects.

Trust comment: Randomized clinical trial follow-up with objective neurodevelopmental testing but modest sample size and effect only for the 150 µg dose on cognition.

Study Details

PMID:33974129
Participants:122
Impact:no significant effect of 150 µg/d or 300 µg/d vs placebo
Trust score:3/5

child motor development

1 evidences

Follow-up of RCT where lactating mothers received 0, 150, or 300 µg/day iodine; children at 36 months showed higher cognitive scores in the 150 µg group versus placebo but no language/motor effects.

Trust comment: Randomized clinical trial follow-up with objective neurodevelopmental testing but modest sample size and effect only for the 150 µg dose on cognition.

Study Details

PMID:33974129
Participants:122
Impact:no significant effect of 150 µg/d or 300 µg/d vs placebo
Trust score:3/5

median urinary iodine concentration

1 evidences

Short-term iodine supplementation raised urinary iodine and TSH; higher supplement doses led to reduced thyroid volume at the highest doses and caused subclinical hypothyroidism at and above certain intake levels.

Trust comment: Randomized double-blind placebo-controlled trial with multiple dose arms and objective thyroid outcomes, though short duration (4 weeks) limits long-term conclusions.

Study Details

PMID:22205314
Participants:256
Impact:Significantly increased in all iodide-supplemented groups vs placebo
Trust score:4/5

dietary iodine intake

3 evidences

20-week RCT in 12–20-month-olds showing iodine-fortified milk substantially increased iodine intake and urinary iodine concentration versus non-fortified milk.

Trust comment: Parallel randomized controlled trial with 135 toddlers, measured dietary intake and UIC with statistically significant effects.

Study Details

PMID:30929067
Participants:135
Impact:increased by 136% in Fortified Milk group vs Non-Fortified (P < 0.001)
Trust score:4/5

Measured iodine in diet, water and salt of schoolchildren and found intake above recommended but below the upper limit.

Trust comment: Cross-sectional survey with standard chemical measures and moderate sample size; useful for population status though observational.

Study Details

PMID:25035191
Participants:159
Impact:higher than RNI, lower than UL
Trust score:3/5

Cluster-randomized cross-over trial in children showing that replacing packed lunches with New Nordic Diet school meals increased intake of fish and other foods, raising iodine intake.

Trust comment: Well-conducted cluster-randomized cross-over trial with validated dietary assessment and large sample of children; moderate-high confidence in dietary intake changes.

Study Details

PMID:24709026
Participants:834
Impact:+11% (95% CI 1.08–1.15)
Trust score:4/5

urinary iodine (iodine status)

1 evidences

Giving fortified biscuits (including iodine) to schoolchildren for 43 weeks improved iodine status, some micronutrients, and short-term memory and reduced some illness-related absences.

Trust comment: Randomized controlled trial in children with clear biochemical and clinical endpoints; well-powered and clinically relevant though iodine was delivered in a multi-nutrient product.

Study Details

PMID:10075336
Participants:228
Impact:prevalence of low urinary iodine decreased from 97.5% to 5.4% (absolute −92.1 percentage points)
Trust score:4/5

anemia (hemoglobin)

2 evidences

Giving fortified biscuits (including iodine) to schoolchildren for 43 weeks improved iodine status, some micronutrients, and short-term memory and reduced some illness-related absences.

Trust comment: Randomized controlled trial in children with clear biochemical and clinical endpoints; well-powered and clinically relevant though iodine was delivered in a multi-nutrient product.

Study Details

PMID:10075336
Participants:228
Impact:anemia prevalence decreased from 29.6% to 15.6% (absolute −14.0 percentage points)
Trust score:4/5

A fortified seasoning powder served with school lunch reduced the prevalence of urinary iodine deficiency and improved zinc status in children; no clear effect on anemia prevalence.

Trust comment: Large randomized efficacy trial with objective biochemical endpoints; cluster/school delivery may influence adherence but results are robust for iodine.

Study Details

PMID:16702330
Participants:569
Impact:no significant effect (OR 1.02; 95% CI 0.69–1.51)
Trust score:4/5

cognitive function (digit span forward)

1 evidences

Giving fortified biscuits (including iodine) to schoolchildren for 43 weeks improved iodine status, some micronutrients, and short-term memory and reduced some illness-related absences.

Trust comment: Randomized controlled trial in children with clear biochemical and clinical endpoints; well-powered and clinically relevant though iodine was delivered in a multi-nutrient product.

Study Details

PMID:10075336
Participants:228
Impact:improved (significant between-group effect, P<0.05)
Trust score:4/5

breast nodularity

2 evidences

Randomized double-blind trial in women with cyclic breast pain: molecular iodine (3.0 and 6.0 mg/day) reduced breast pain and related findings versus placebo.

Trust comment: Well-conducted randomized, double-blind, placebo-controlled multicenter trial with clear patient-reported and physician-assessed endpoints.

Study Details

PMID:15239792
Participants:111
Impact:- reduced in 3.0 and 6.0 mg/day groups (physician-assessed by month 5)
Trust score:4/5

A daily liquid formula containing GLA, iodine (750 μg), and selenium did not reduce peak breast pain versus control but significantly reduced breast nodularity and reduced analgesic use among users.

Trust comment: Randomized double-blind multicenter trial but iodine was given in combination with GLA and selenium and the trial was stopped early, limiting attribution to iodine alone.

Study Details

PMID:29237134
Participants:188
Impact:reduction in severe nodularity by 53% (relative); proportion with no nodules increased by 83% (experimental group, p=0.03)
Trust score:3/5

breast pain (peak pain scores)

1 evidences

A daily liquid formula containing GLA, iodine (750 μg), and selenium did not reduce peak breast pain versus control but significantly reduced breast nodularity and reduced analgesic use among users.

Trust comment: Randomized double-blind multicenter trial but iodine was given in combination with GLA and selenium and the trial was stopped early, limiting attribution to iodine alone.

Study Details

PMID:29237134
Participants:188
Impact:decreased similarly in both groups (~32% experimental vs ~33% control); no between-group difference (p=0.64)
Trust score:3/5

thyroid function (TSH)

1 evidences

A daily liquid formula containing GLA, iodine (750 μg), and selenium did not reduce peak breast pain versus control but significantly reduced breast nodularity and reduced analgesic use among users.

Trust comment: Randomized double-blind multicenter trial but iodine was given in combination with GLA and selenium and the trial was stopped early, limiting attribution to iodine alone.

Study Details

PMID:29237134
Participants:188
Impact:TSH increased in 5 women in the experimental group (mostly mild and transient)
Trust score:3/5

progression-free survival (PFS)

1 evidences

Analysis of the SELECT trial showed lenvatinib improved progression-free survival and response rates in patients with radioiodine-refractory differentiated thyroid cancer across different RAI-refractory definitions.

Trust comment: Large multicenter randomized trial subgroup analysis (n=392) with robust efficacy and safety reporting, though focus is on lenvatinib rather than iodine per se.

Study Details

PMID:28665259
Participants:392
Impact:lenvatinib markedly prolonged PFS versus placebo across groups (examples: 'disease progression despite RAI avidity' median PFS 16.5 vs 3.7 months; 'extensive RAI exposure' 18.7 vs 3.6 months)
Trust score:4/5

overall response rate (ORR)

1 evidences

Randomized prospective study found adding I-125 brachytherapy to chemotherapy improved local control, response rate, and progression-free survival vs chemotherapy alone in locally recurrent stage III NSCLC.

Trust comment: Prospective randomized single-center study (n=52) directly tests I-125 brachytherapy effects; sample size modest and follow-up limited, so moderate trust.

Study Details

PMID:26445227
Participants:52
Impact:69.2% (18/26) combined vs 57.7% (15/26) control (+11.5%)
Trust score:3/5

objective response rate (ORR)

1 evidences

Analysis of the SELECT trial showed lenvatinib improved progression-free survival and response rates in patients with radioiodine-refractory differentiated thyroid cancer across different RAI-refractory definitions.

Trust comment: Large multicenter randomized trial subgroup analysis (n=392) with robust efficacy and safety reporting, though focus is on lenvatinib rather than iodine per se.

Study Details

PMID:28665259
Participants:392
Impact:substantially higher ORR with lenvatinib (e.g., 71.8% vs 2.0% in 'no RAI uptake' group)
Trust score:4/5

radiologist confidence

1 evidences

Randomized trial comparing three iodinated contrast concentrations (300, 240, 140 mgI/mL) showing non-inferior operator confidence, significantly lower iodine load and less injection pain with the lowest concentration.

Trust comment: Double-blind randomized non-inferiority trial directly manipulating iodine (contrast) concentration in humans; small sample and excluded patients with renal impairment.

Study Details

PMID:26630997
Participants:60
Impact:diagnostic and therapeutic confidence not inferior across 240 and 140 mgI/mL vs 300 mgI/mL (median 100% confidence)
Trust score:4/5

iodine load (total iodine administered)

1 evidences

Randomized trial comparing three iodinated contrast concentrations (300, 240, 140 mgI/mL) showing non-inferior operator confidence, significantly lower iodine load and less injection pain with the lowest concentration.

Trust comment: Double-blind randomized non-inferiority trial directly manipulating iodine (contrast) concentration in humans; small sample and excluded patients with renal impairment.

Study Details

PMID:26630997
Participants:60
Impact:iodine load reduced from 29.7 g (300 mgI/mL) to 17.8 g (140 mgI/mL) (~−40%, p<0.001)
Trust score:4/5

pain during injection

1 evidences

Randomized trial comparing three iodinated contrast concentrations (300, 240, 140 mgI/mL) showing non-inferior operator confidence, significantly lower iodine load and less injection pain with the lowest concentration.

Trust comment: Double-blind randomized non-inferiority trial directly manipulating iodine (contrast) concentration in humans; small sample and excluded patients with renal impairment.

Study Details

PMID:26630997
Participants:60
Impact:severe pain frequency fell to 0 in 140 mgI/mL group (p=0.001 vs control)
Trust score:4/5

diarrhea incidence

1 evidences

School lunch seasoning fortified with multiple micronutrients (including 50 μg iodine per serving) reduced respiratory and diarrheal morbidity and slightly improved a visual recall test, but did not change growth.

Trust comment: Well-powered RCT showing benefits of a multinutrient supplement that included iodine, but effects cannot be attributed to iodine alone.

Study Details

PMID:18541560
Participants:569
Impact:RR 0.38 (62% reduction)
Trust score:3/5

tumour recurrence

1 evidences

Adding percutaneous iodine-125 seed implantation to radiofrequency ablation reduced tumour recurrence and increased long-term survival in hepatocellular carcinoma patients compared with RFA alone.

Trust comment: Prospective randomized controlled trial with clear endpoints and adequate sample size; high internal validity though single clinical context.

Study Details

PMID:25064436
Participants:136
Impact:5-year recurrence reduced from 57.4% to 39.8% (−17.6 percentage points); HR 0.508 (p=0.004)
Trust score:4/5

overall survival

8 evidences

Prospective study of CT‑guided iodine‑125 brachytherapy for bilateral lung metastases from colorectal cancer showed high procedural success, acceptable safety, improved local control and significantly longer overall survival versus symptomatic care.

Trust comment: Prospective randomized single‑center study with modest sample size showing survival benefit, but limited by sample size and center-specific experience.

Study Details

PMID:26406550
Participants:72
Impact:Group A (125I brachytherapy) median OS 18.8 months vs Group B 8.6 months; HR 0.391 (P=0.008)
Trust score:3/5

Open randomized trial comparing I-125 seed interstitial brachytherapy vs local chemotherapy perfusion in advanced pancreatic cancer patients; tumor response, pain, tumor markers, and survival assessed.

Trust comment: Prospective randomized study with a relatively large sample (n=165) and multiple clinically relevant endpoints; open-label design may introduce bias for subjective outcomes.

Study Details

PMID:32865062
Participants:165
Impact:longer in I-125 group (significant)
Trust score:4/5

Compared irradiation stent (125I seeds) versus conventional stent for malignant biliary obstruction; irradiation stent relieved jaundice and extended survival and patency.

Trust comment: Randomized but small single-center preliminary trial; outcomes clinically relevant but limited sample.

Study Details

PMID:22266605
Participants:23
Impact:Median survival 7.40 vs 2.50 months; mean 8.03 vs 3.36 months (irradiation vs control, p=0.006)
Trust score:3/5

Randomized trial comparing 131I-labeled Lipiodol versus chemoembolization for HCC: survival and tumor response were similar but 131I-Lipiodol had markedly better tolerance.

Trust comment: Randomized human trial with 129 patients analyzed directly testing 131I-labeled therapy; well-conducted though older single-study data.

Study Details

PMID:9362356
Participants:129
Impact:no significant difference in actuarial survival curves (6-month to 4-year rates similar between groups)
Trust score:4/5

Large phase III trial found no significant improvement in 2-year progression-free or overall survival from adding I-131 tositumomab consolidation to CHOP+rituximab.

Trust comment: Large, multicenter phase III randomized trial with long follow-up and robust design showing no significant benefit of I-131 RIT consolidation.

Study Details

PMID:23233710
Participants:554
Impact:2-year OS: CHOP-RIT 93% vs CHOP-R 97% (−4 percentage points), P=0.08 (not significant)
Trust score:5/5

Adding percutaneous iodine-125 seed implantation to radiofrequency ablation reduced tumour recurrence and increased long-term survival in hepatocellular carcinoma patients compared with RFA alone.

Trust comment: Prospective randomized controlled trial with clear endpoints and adequate sample size; high internal validity though single clinical context.

Study Details

PMID:25064436
Participants:136
Impact:5-year survival increased from 47.0% to 66.1% (+19.1 percentage points); HR 0.502 (p=0.003)
Trust score:4/5

Randomized trial found that placing an iodine-125 seed-loaded irradiation stent before TACE improved survival and reduced liver failure versus sorafenib+TACE.

Trust comment: Multicentre randomized controlled trial with clear endpoints and statistically significant interim differences, but early stopping and smaller-than-planned sample reduce precision.

Study Details

PMID:37038986
Participants:105
Impact:+3.6 months median OS (ISP-TACE 9.9 mo vs Sora-TACE 6.3 mo); HR=0.64 (36% reduced hazard)
Trust score:4/5

Randomized trial testing intrahepatic 131I-lipiodol after liver cancer surgery found no clear survival benefit and a few radiation-related adverse events.

Trust comment: Prospective multicentre randomized trial but modest sample size and non-significant primary results.

Study Details

PMID:23463394
Participants:103
Impact:HR=0.88 (nonsignificant, p=0.64) — small improvement vs control
Trust score:3/5

local and intrahepatic recurrence

1 evidences

Adding percutaneous iodine-125 seed implantation to radiofrequency ablation reduced tumour recurrence and increased long-term survival in hepatocellular carcinoma patients compared with RFA alone.

Trust comment: Prospective randomized controlled trial with clear endpoints and adequate sample size; high internal validity though single clinical context.

Study Details

PMID:25064436
Participants:136
Impact:local recurrence 7.3% vs 22.0%; intrahepatic recurrence 17.6% vs 32.3% (both p<0.05)
Trust score:4/5

disease resolution time

1 evidences

Topical 0.6% PVP-iodine eye drops shortened disease resolution and reduced corneal complications versus hyaluronate tear substitute in adenoviral keratoconjunctivitis.

Trust comment: Randomized controlled multicentre study but modest sample size; endpoints clinically meaningful and differences statistically significant.

Study Details

PMID:33654316
Participants:59
Impact:resolution time shortened (statistically significant vs control)
Trust score:4/5

subepithelial corneal infiltrates (SEIs) incidence

1 evidences

Topical 0.6% PVP-iodine eye drops shortened disease resolution and reduced corneal complications versus hyaluronate tear substitute in adenoviral keratoconjunctivitis.

Trust comment: Randomized controlled multicentre study but modest sample size; endpoints clinically meaningful and differences statistically significant.

Study Details

PMID:33654316
Participants:59
Impact:present in 8.8% vs 44% in control (−35.2 percentage points, p=0.005)
Trust score:4/5

corneal haze incidence

1 evidences

Topical 0.6% PVP-iodine eye drops shortened disease resolution and reduced corneal complications versus hyaluronate tear substitute in adenoviral keratoconjunctivitis.

Trust comment: Randomized controlled multicentre study but modest sample size; endpoints clinically meaningful and differences statistically significant.

Study Details

PMID:33654316
Participants:59
Impact:0% vs 12% in control (0/34 vs 3/25, p=0.038)
Trust score:4/5

blood culture contamination rate

7 evidences

In adults having blood cultures drawn, skin prep with alcoholic chlorhexidine produced fewer contaminated blood cultures than aqueous 10% povidone-iodine.

Trust comment: Large randomized controlled trial (n=403) with objective microbiological outcome and statistically significant results favoring chlorhexidine over povidone-iodine.

Study Details

PMID:10610628
Participants:403
Impact:povidone-iodine group 3.3% vs chlorhexidine 1.4% (+1.9 percentage points higher with povidone-iodine)
Trust score:5/5

Large randomized crossover study comparing skin antisepsis with chlorhexidine versus iodine tincture for blood cultures; found no difference in contamination rates.

Trust comment: Prospective randomized crossover design with large sample of blood culture sets supports high trustworthiness.

Study Details

PMID:27707940
Participants:6095
Impact:Iodine tincture 3.93% vs chlorhexidine 3.88% (no significant difference, P=1.0)
Trust score:4/5

Iodine tincture for venipuncture site antisepsis led to fewer blood culture contaminations than povidone-iodine.

Trust comment: Large randomized trial with objective microbiological outcome and clear cost implications; single-hospital setting but robust data.

Study Details

PMID:10460041
Participants:3851
Impact:contamination 2.4% (iodine tincture) vs 3.8% (povidone-iodine); absolute −1.4 percentage points, P=0.01
Trust score:4/5

In hospitalized adults, skin prep with alcohol+tincture of iodine yielded low blood culture contamination rates similar to alcohol+chlorhexidine.

Trust comment: Prospective, blinded clinical trial with a moderate sample (215 patients) and clear objective endpoint; well-conducted though single-center.

Study Details

PMID:12138980
Participants:215
Impact:1.4% with tincture of iodine (3/215); no significant difference vs chlorhexidine (0.5%, P=0.62)
Trust score:4/5

2% alcoholic chlorhexidine reduced blood-culture contamination compared with 10% aqueous povidone‑iodine.

Trust comment: Large randomized investigator-blinded trial (2146 cultures) with clear, significant differences in contamination rates.

Study Details

PMID:18407355
Participants:2146
Impact:higher contamination with povidone‑iodine (6.9%) vs chlorhexidine (3.2%); P<0.001
Trust score:4/5

In children, chlorhexidine-alcohol skin prep led to fewer contaminated blood cultures than povidone-iodine preparations.

Trust comment: Randomized single-center pediatric trial with objective microbiological endpoint, but open-label design and culture-level (not patient-level) counts limit generalizability.

Study Details

PMID:38092334
Participants:400
Impact:povidone-iodine group 12.0% vs chlorhexidine group 5.3% (difference +6.7 percentage points for povidone-iodine)
Trust score:3/5

Crossover randomized trial evaluating 10% povidone iodine, 2% iodine tincture, and 2% chlorhexidine for blood culture skin antisepsis across 12,904 culture sets; no significant differences in contamination rates among agents.

Trust comment: Large randomized crossover study with blinded adjudication of positives; robust design though outcome is rare and context-specific.

Study Details

PMID:23221187
Participants:12904
Impact:0.58% with povidone iodine, 0.76% with iodine tincture, 0.93% with chlorhexidine — no significant differences
Trust score:4/5

intracoronary contrast enhancement (attenuation)

1 evidences

When iodine delivery rate was held constant, contrast medium iodine concentration did not alter intracoronary enhancement or heart rate, but higher concentration/viscosity increased injection pressure.

Trust comment: Large multicenter randomized trial with objective imaging metrics and physiologic measures; strong methodology and sample size.

Study Details

PMID:31016447
Participants:1024
Impact:no significant difference across concentrations (mean ~384–395 HU, p=0.079)
Trust score:5/5

heart rate change

1 evidences

When iodine delivery rate was held constant, contrast medium iodine concentration did not alter intracoronary enhancement or heart rate, but higher concentration/viscosity increased injection pressure.

Trust comment: Large multicenter randomized trial with objective imaging metrics and physiologic measures; strong methodology and sample size.

Study Details

PMID:31016447
Participants:1024
Impact:no significant change between groups (p=0.974)
Trust score:5/5

injection pressure

1 evidences

When iodine delivery rate was held constant, contrast medium iodine concentration did not alter intracoronary enhancement or heart rate, but higher concentration/viscosity increased injection pressure.

Trust comment: Large multicenter randomized trial with objective imaging metrics and physiologic measures; strong methodology and sample size.

Study Details

PMID:31016447
Participants:1024
Impact:injection pressure higher with higher iodine concentration/viscosity (197.4 psi at 300 mg I/ml to 243.7 psi at 400 mg I/ml; p<0.0001)
Trust score:5/5

estimated urinary iodine excretion (eUIE)

1 evidences

Daily supplementation with 150 μg iodine in pregnancy improved maternal urinary iodine and urinary iodine excretion and reduced thyroglobulin compared with control, without changing maternal TSH/FT4 or neonatal TSH.

Trust comment: Randomized double-blind pilot RCT with validated biomarkers; limited by sample size, some tablet compositional confounders, and being a pilot study.

Study Details

PMID:33620551
Participants:158
Impact:third trimester eUIE 173 μg/day (intervention) vs 86 μg/day (control), p<0.001
Trust score:4/5

serum thyroglobulin (Tg)

2 evidences

Daily 150 μg iodine supplementation for 24 weeks raised urinary iodine and reduced thyroglobulin levels in mildly iodine-deficient adults without changing TSH or free T4.

Trust comment: Randomized double-blind placebo-controlled trial with reasonable sample size (n=112) and appropriate biomarker measurements, supporting internal validity.

Study Details

PMID:26891118
Participants:112
Impact:Decreased in supplemented vs placebo by 12% (8 wk), 20% (16 wk), and 27% (24 wk)
Trust score:4/5

Daily supplementation with 150 μg iodine in pregnancy improved maternal urinary iodine and urinary iodine excretion and reduced thyroglobulin compared with control, without changing maternal TSH/FT4 or neonatal TSH.

Trust comment: Randomized double-blind pilot RCT with validated biomarkers; limited by sample size, some tablet compositional confounders, and being a pilot study.

Study Details

PMID:33620551
Participants:158
Impact:third trimester Tg 22 μg/L (intervention) vs 31 μg/L (control), p=0.003
Trust score:4/5

change in UIC from baseline

1 evidences

Provision of supplements containing the WHO-recommended iodine dose (250 μg/day) did not change pregnant women's urinary iodine concentration at 36 weeks compared with iron–folic acid, likely because baseline iodine intakes were already adequate.

Trust comment: Large randomized controlled trial with prespecified analysis and adequate power for secondary outcome; baseline adequate iodine status limits detectable supplement effect.

Study Details

PMID:33054890
Participants:317
Impact:median change negative in all groups (overall median −84 μg/L); no group effect detected
Trust score:5/5

acute adverse reactions after Lugol staining

1 evidences

Spraying vitamin C solution after Lugol iodine staining reduced acute adverse reactions and sped decolorization of the esophageal mucosa compared with distilled water and performed similarly to sodium thiosulfate.

Trust comment: Large multicenter randomized trial with objective clinical and visual endpoints; high sample size though specifics of subgroup allocation varied by LIS concentration.

Study Details

PMID:34406172
Participants:2965
Impact:VCS significantly reduced acute adverse reactions compared with distilled water (P<0.05); effect similar to sodium thiosulfate
Trust score:4/5

heartburn within 1 week

1 evidences

Spraying vitamin C solution after Lugol iodine staining reduced acute adverse reactions and sped decolorization of the esophageal mucosa compared with distilled water and performed similarly to sodium thiosulfate.

Trust comment: Large multicenter randomized trial with objective clinical and visual endpoints; high sample size though specifics of subgroup allocation varied by LIS concentration.

Study Details

PMID:34406172
Participants:2965
Impact:reduced incidence with VCS vs control for 0.5% LIS (P<0.05)
Trust score:4/5

decolorization rate of iodine-stained mucosa

1 evidences

Spraying vitamin C solution after Lugol iodine staining reduced acute adverse reactions and sped decolorization of the esophageal mucosa compared with distilled water and performed similarly to sodium thiosulfate.

Trust comment: Large multicenter randomized trial with objective clinical and visual endpoints; high sample size though specifics of subgroup allocation varied by LIS concentration.

Study Details

PMID:34406172
Participants:2965
Impact:~90% fading after 120 s with VCS (vs ~51% with distilled water; P<0.05)
Trust score:4/5

superficial wound complications

1 evidences

Using iodine-alcohol skin antisepsis before elective hip/knee replacement led to fewer surgical site infections than chlorhexidine-alcohol; no difference in superficial wound complications.

Trust comment: Large cluster RCT with assessor-blinded outcome adjudication; primary outcome null but secondary infection endpoints favor iodine, single-center study.

Study Details

PMID:31238121
Participants:780
Impact:no significant change (4.9% vs 3.8%; p=0.50)
Trust score:4/5

surgical site infection

7 evidences

Large multicentre cluster-randomized trial found no meaningful difference in surgical-site infection risk between aqueous 10% povidone-iodine and aqueous 4% chlorhexidine for open-fracture surgery.

Trust comment: Large, multicentre, randomized cluster-crossover trial with blinded adjudication and robust sample gives high confidence in results.

Study Details

PMID:36244384
Participants:1638
Impact:7% (povidone-iodine, 59/787) vs 7% (chlorhexidine, 58/784); OR 1.11, p=0.61; risk difference 0.6% (95% CI −1.4 to 3.4) — no significant difference
Trust score:5/5

Large RCT comparing povidone-iodine wound irrigation versus no irrigation at cesarean section: no reduction in surgical site infection.

Trust comment: Large, well-powered randomized trial with clear negative result and appropriate follow-up.

Study Details

PMID:26847398
Participants:3027
Impact:9.5% (PVI) vs 9.8% (no PVI); RR 0.97 (95% CI 0.78–1.21), no benefit
Trust score:5/5

Using iodine-alcohol skin antisepsis before elective hip/knee replacement led to fewer surgical site infections than chlorhexidine-alcohol; no difference in superficial wound complications.

Trust comment: Large cluster RCT with assessor-blinded outcome adjudication; primary outcome null but secondary infection endpoints favor iodine, single-center study.

Study Details

PMID:31238121
Participants:780
Impact:lower with iodine-alcohol (1.0% vs 3.1%; p=0.014)
Trust score:4/5

Applying povidone-iodine to the incision after skin closure did not reduce surgical site infections compared with no application.

Trust comment: Well-powered randomized controlled trial, registered, with clear outcomes; directly applicable to humans.

Study Details

PMID:39056520
Participants:352
Impact:no significant difference (9.5% povidone-iodine vs 7.1% control; P=0.430)
Trust score:4/5

Compared ciNPWT versus standard sterile gauze with an iodine disinfectant after ventral hernia repair; ciNPWT reduced infections numerically but increased hospital stay.

Trust comment: Randomized clinical study with clear outcomes but limited by relatively small size and some design ambiguities (described as retrospective/observational yet randomized).

Study Details

PMID:39336589
Participants:100
Impact:Sterile gauze + iodine: 12% vs ciNPWT: 4% (difference not statistically significant, p=0.27)
Trust score:3/5

No difference in surgical-site infection rate between chlorhexidine gluconate and povidone-iodine for clean-contaminated abdominal surgery.

Trust comment: Large randomized clinical trial with registered protocol and clear endpoint.

Study Details

PMID:27879993
Participants:534
Impact:no difference (5.6% vs 6.0%, p=0.853)
Trust score:4/5

Microbial sealant was equivalent to standard povidone-iodine cleaning plus plain adhesive drape for skin preparation in cardiac surgery; no postoperative wound infections occurred.

Trust comment: Prospective randomized study but relatively small and with no SSI events, limiting comparative conclusions.

Study Details

PMID:25022299
Participants:96
Impact:no infections in either group
Trust score:3/5

prosthetic joint infection

1 evidences

Using iodine-alcohol skin antisepsis before elective hip/knee replacement led to fewer surgical site infections than chlorhexidine-alcohol; no difference in superficial wound complications.

Trust comment: Large cluster RCT with assessor-blinded outcome adjudication; primary outcome null but secondary infection endpoints favor iodine, single-center study.

Study Details

PMID:31238121
Participants:780
Impact:lower with iodine-alcohol (0.5% vs 1.8%; p=0.022)
Trust score:4/5

24-h urinary iodine excretion — sodium restriction

1 evidences

In patients with diabetic kidney disease, moderate sodium restriction or hydrochlorothiazide alone did not change 24-h iodine excretion, but the combination produced a modest statistically significant reduction that remained above deficiency thresholds.

Trust comment: Randomized crossover design with 24‑h urine iodine measurement but small sample and post-hoc analysis limit generalizability.

Study Details

PMID:31547438
Participants:43
Impact:no significant change (mean diff −8 µg/day; p=0.6)
Trust score:4/5

24-h urinary iodine excretion — hydrochlorothiazide (HCT)

1 evidences

In patients with diabetic kidney disease, moderate sodium restriction or hydrochlorothiazide alone did not change 24-h iodine excretion, but the combination produced a modest statistically significant reduction that remained above deficiency thresholds.

Trust comment: Randomized crossover design with 24‑h urine iodine measurement but small sample and post-hoc analysis limit generalizability.

Study Details

PMID:31547438
Participants:43
Impact:no significant change (mean diff +14 µg/day; p=0.5)
Trust score:4/5

24-h urinary iodine excretion — sodium restriction + HCT

1 evidences

In patients with diabetic kidney disease, moderate sodium restriction or hydrochlorothiazide alone did not change 24-h iodine excretion, but the combination produced a modest statistically significant reduction that remained above deficiency thresholds.

Trust comment: Randomized crossover design with 24‑h urine iodine measurement but small sample and post-hoc analysis limit generalizability.

Study Details

PMID:31547438
Participants:43
Impact:decreased (mean diff −37 µg/day; 95% CI −67 to −7; p=0.02) but remained ≥RDA
Trust score:4/5

urinary iodine deficiency

1 evidences

A fortified seasoning powder served with school lunch reduced the prevalence of urinary iodine deficiency and improved zinc status in children; no clear effect on anemia prevalence.

Trust comment: Large randomized efficacy trial with objective biochemical endpoints; cluster/school delivery may influence adherence but results are robust for iodine.

Study Details

PMID:16702330
Participants:569
Impact:reduced odds (OR 0.52; 95% CI 0.38–0.71)
Trust score:4/5

serum zinc deficiency

1 evidences

A fortified seasoning powder served with school lunch reduced the prevalence of urinary iodine deficiency and improved zinc status in children; no clear effect on anemia prevalence.

Trust comment: Large randomized efficacy trial with objective biochemical endpoints; cluster/school delivery may influence adherence but results are robust for iodine.

Study Details

PMID:16702330
Participants:569
Impact:reduced odds (OR 0.63; 95% CI 0.42–0.94)
Trust score:4/5

FT4 AUC 0–3 (LT4 challenge)

1 evidences

In thyroidectomized patients, radioactive iodine administration reduced the rise in serum FT4 after an LT4 challenge (most notably at 1 month); LT4 formulation (liquid vs tablet) did not change this effect.

Trust comment: Randomized crossover and repeated measures but small single‑center sample limits precision and generalizability.

Study Details

PMID:35751777
Participants:29
Impact:decreased after RAI (significant drop at 1 month; interaction β=−0.44, p≈0.004)
Trust score:3/5

LT4 formulation effect (liquid vs solid)

1 evidences

In thyroidectomized patients, radioactive iodine administration reduced the rise in serum FT4 after an LT4 challenge (most notably at 1 month); LT4 formulation (liquid vs tablet) did not change this effect.

Trust comment: Randomized crossover and repeated measures but small single‑center sample limits precision and generalizability.

Study Details

PMID:35751777
Participants:29
Impact:no significant difference between formulations on FT4 AUC
Trust score:3/5

postimplant epididymitis incidence

1 evidences

Among patients receiving prostate brachytherapy with iodine-125 or palladium-103 seeds, clinically diagnosed epididymitis occurred in 5 of 517 patients (≈1%).

Trust comment: Large cohort from randomized treatment protocols reporting a low event rate; association with iodine seeds is indirect and events are few.

Study Details

PMID:14972474
Participants:517
Impact:1% (5/517 patients)
Trust score:3/5

radiation dose

5 evidences

A double-low CT protocol reduced radiation and iodine dose while maintaining similar image quality for aortic CTA.

Trust comment: Prospective randomized trial (n=72) with clear quantitative endpoints and significant dose reductions reported.

Study Details

PMID:27671868
Participants:72
Impact:-56% (vs control)
Trust score:4/5

Randomized volunteer study showing 70-kVp CT angiography improves vascular enhancement and image quality and allows reduced iodine contrast volume and lower radiation dose.

Trust comment: Randomized study with objective imaging metrics and reasonable sample size; applicable to clinical imaging practice.

Study Details

PMID:25510446
Participants:69
Impact:effective dose ~10% lower (70 kVp vs 120 kVp)
Trust score:4/5

Using 80 kVp low-iodine contrast protocol with IMR in CABG patients reduced radiation and iodine load and improved image quality for aorta, left ventricle and venous grafts.

Trust comment: Prospective randomized study in 71 CABG patients with objective imaging metrics and clear outcome measures.

Study Details

PMID:30606383
Participants:71
Impact:-49% (2.3±0.4 mSv vs 4.5±0.5 mSv)
Trust score:4/5

In 179 patients, a low-voltage/low-iodine CT protocol produced diagnostic coronary images while significantly lowering iodine intake and radiation dose.

Trust comment: Randomized clinical imaging study with large sample (n=179) and significant objective dose reductions and preserved image quality.

Study Details

PMID:25468636
Participants:179
Impact:significantly lower in 'double low' group vs conventional (p<0.001)
Trust score:4/5

Gadolinium-based contrast with dual-energy reconstructions can yield good pulmonary CT angiography; iodine-based iohexol gave highest attenuation but more SVC artifacts.

Trust comment: Randomized feasibility study comparing iodine and gadolinium techniques; clinically relevant but technical and comparatively small.

Study Details

PMID:36190598
Participants:66
Impact:lowest radiation dose observed in the turbo flash Gd group (Group B)
Trust score:3/5

thyroid hormone levels

3 evidences

In very low birth weight preterm infants, oral iodine supplementation corrected iodine status and affected thyroid hormones but did not change Bayley-III composite neurodevelopmental scores at 24 months.

Trust comment: Randomized assessor-blinded pilot trial with objective biochemical and developmental outcomes, but modest sample size.

Study Details

PMID:34651206
Participants:94
Impact:Plasma thyroid hormones were affected during the first 12 weeks in relation to iodine balance
Trust score:4/5

Randomized trial giving higher versus standard iodine in preterm formula; no change in thyroid hormone levels up to 41 weeks.

Trust comment: Randomized controlled trial in human preterm infants with clear reporting; objective hormonal outcomes though no effect found.

Study Details

PMID:10952698
Participants:121
Impact:no change
Trust score:4/5

A PVP-iodine liposomal hydrogel accelerated wound epithelialization, improved healing quality and reduced graft loss compared with chlorhexidine gauze.

Trust comment: Randomized phase II pilot (n=36) with positive clinical signals but small open-label design limits generalizability.

Study Details

PMID:11350649
Participants:36
Impact:no clinically relevant change
Trust score:3/5

parotid maximum accumulation ratio

1 evidences

Randomized trial testing aromatherapy versus placebo in patients receiving radioactive iodine; aromatherapy groups showed improved salivary gland function on scintigraphy.

Trust comment: Randomized, blinded outcome assessment with objective scintigraphic measures in humans; moderate sample size.

Study Details

PMID:28042578
Participants:71
Impact:increase (P < 0.05)
Trust score:4/5

submandibular maximum accumulation ratio

1 evidences

Randomized trial testing aromatherapy versus placebo in patients receiving radioactive iodine; aromatherapy groups showed improved salivary gland function on scintigraphy.

Trust comment: Randomized, blinded outcome assessment with objective scintigraphic measures in humans; moderate sample size.

Study Details

PMID:28042578
Participants:71
Impact:increase (P < 0.05, trend)
Trust score:4/5

parotid washout ratio (salivary excretion)

1 evidences

Randomized trial testing aromatherapy versus placebo in patients receiving radioactive iodine; aromatherapy groups showed improved salivary gland function on scintigraphy.

Trust comment: Randomized, blinded outcome assessment with objective scintigraphic measures in humans; moderate sample size.

Study Details

PMID:28042578
Participants:71
Impact:increase (P < 0.05)
Trust score:4/5

urinary iodine excretion

8 evidences

In patients with thyroid autonomy undergoing iodine exposure, short-term prophylactic antithyroid treatment blunted hormone changes compared with controls.

Trust comment: Prospective randomized human study with defined interventions and biochemical endpoints, but small sample size.

Study Details

PMID:8616532
Participants:51
Impact:about twofold increase in control group after iodine exposure; unchanged in treated groups
Trust score:4/5

Randomized dietary trial where children ate liver meat balls for 90 days; urinary iodine, haemoglobin, and cognitive scores improved in the supplemented group.

Trust comment: Randomized controlled dietary intervention with objective biochemical and standardized cognitive measures; modest sample size.

Study Details

PMID:35451359
Participants:60
Impact:increase (+20% in <72 months; +28% in ≥72 months; P < 0.05)
Trust score:4/5

Adding 150 µg iodine to individualized L-thyroxine increased urinary iodine and produced greater (though modest) reductions in thyroid volume and stronger TSH suppression versus L-thyroxine alone.

Trust comment: Controlled clinical comparison (n=94) showing biochemical and modest clinical benefit of iodine supplementation; limited methodological detail reported here.

Study Details

PMID:8965746
Participants:94
Impact:markedly increased (p<0.005)
Trust score:3/5

In 52 New Zealand women, urinary iodine excretion was low and showed no consistent trends during pregnancy or postpartum due to large variability.

Trust comment: Well-described longitudinal sampling but small sample size and large variability limit conclusions about iodine trends.

Study Details

PMID:11396779
Participants:52
Impact:much lower than previously reported in NZ; no consistent trend observed (high intra- and inter-subject variability)
Trust score:3/5

Inhabitants with high cold exposure (hunters, settlement dwellers) showed signs of increased thyroid activity (higher thyroglobulin) and lower fT3 despite higher urinary iodine excretion.

Trust comment: Population-based cross-sectional study with reasonable sample size (n=535), but observational design limits causal inference.

Study Details

PMID:22170797
Participants:535
Impact:↑ urinary iodine excretion in hunters and settlement dwellers (P<0.001)
Trust score:3/5

Four weeks of kelp supplementation increased urinary iodine dose-dependently and raised TSH (both low- and high-dose) with high-dose kelp lowering total T3 and augmenting TRH-stimulated TSH response.

Trust comment: Double-blind randomized trial but small sample and short duration (4 weeks); objective labs but limited power and follow-up.

Study Details

PMID:14583417
Participants:36
Impact:dose-dependent increase in 24-hour urinary iodine excretion in kelp groups
Trust score:3/5

Low-dose iodine intake in endemic-goitre patients markedly increased urinary iodine and induced autoimmune thyroid changes in a subset (antibody rise, lymphocytic infiltration) with some developing hypo- or hyperthyroidism that mostly remitted after withdrawal.

Trust comment: Randomized double-blind trial with objective hormone/antibody measures but modest sample size and specific population (endemic goitre).

Study Details

PMID:9758438
Participants:62
Impact:increase from ~36 µg/24 h baseline to ~415 µg/24 h at 6 months in iodine group
Trust score:4/5

Vegetarians and especially vegans had lower urinary iodine and higher prevalence of iodine deficiency compared with mixed-diet adults.

Trust comment: Cross-sectional study with small subgroups but objective urinary iodine measures support the conclusion of higher deficiency in vegans.

Study Details

PMID:12748410
Participants:81
Impact:vegans 78 μg/L, vegetarians 172 μg/L, mixed diet 216 μg/L
Trust score:3/5

blood haemoglobin

1 evidences

Randomized dietary trial where children ate liver meat balls for 90 days; urinary iodine, haemoglobin, and cognitive scores improved in the supplemented group.

Trust comment: Randomized controlled dietary intervention with objective biochemical and standardized cognitive measures; modest sample size.

Study Details

PMID:35451359
Participants:60
Impact:increase (+1.30 g/dl in <72 months; +1.15 g/dl in ≥72 months)
Trust score:4/5

IQ / cognitive test scores

1 evidences

Randomized dietary trial where children ate liver meat balls for 90 days; urinary iodine, haemoglobin, and cognitive scores improved in the supplemented group.

Trust comment: Randomized controlled dietary intervention with objective biochemical and standardized cognitive measures; modest sample size.

Study Details

PMID:35451359
Participants:60
Impact:increase (+6.9 IQ points in <72 months; +8.5 IQ points in ≥72 months)
Trust score:4/5

tympanogram improvement (type C)

1 evidences

Randomized single-blind pilot trial comparing salso‑bromo‑iodine thermal water versus saline nasal douche in children with middle-ear effusion; iodine solution led to better tympanogram and hearing outcomes.

Trust comment: Randomized pilot study with clear clinical outcomes but limited as a pilot and single-blind.

Study Details

PMID:29446785
Participants:80
Impact:greater improvement (p = 0.031)
Trust score:3/5

tympanogram healing (type A)

1 evidences

Randomized single-blind pilot trial comparing salso‑bromo‑iodine thermal water versus saline nasal douche in children with middle-ear effusion; iodine solution led to better tympanogram and hearing outcomes.

Trust comment: Randomized pilot study with clear clinical outcomes but limited as a pilot and single-blind.

Study Details

PMID:29446785
Participants:80
Impact:greater healing (p < 0.001)
Trust score:3/5

audiometric normal hearing prevalence

1 evidences

Randomized single-blind pilot trial comparing salso‑bromo‑iodine thermal water versus saline nasal douche in children with middle-ear effusion; iodine solution led to better tympanogram and hearing outcomes.

Trust comment: Randomized pilot study with clear clinical outcomes but limited as a pilot and single-blind.

Study Details

PMID:29446785
Participants:80
Impact:increase (p = 0.029)
Trust score:3/5

thyroid antibody formation (TPO/thyroglobulin)

1 evidences

Prospective study of iodine replacement in endemic goitre and healthy controls over 1 year; small proportion developed low-level thyroid antibodies without clinical thyroid dysfunction.

Trust comment: Prospective human study with sizable cohort and serial antibody and hormone testing, but heterogeneous dosing groups.

Study Details

PMID:10603730
Participants:262
Impact:new positive antibodies in 7.5% overall (higher with 500 μg/d: 14.8%)
Trust score:3/5

clinical thyroid dysfunction

1 evidences

Prospective study of iodine replacement in endemic goitre and healthy controls over 1 year; small proportion developed low-level thyroid antibodies without clinical thyroid dysfunction.

Trust comment: Prospective human study with sizable cohort and serial antibody and hormone testing, but heterogeneous dosing groups.

Study Details

PMID:10603730
Participants:262
Impact:no clinical hypothyroidism detected
Trust score:3/5

diagnostic image quality

1 evidences

Prospective randomized imaging study showed that virtual monochromatic low-energy images with ~50% reduced iodine contrast provided diagnostic aortoiliac CTA with higher intravascular attenuation and lower radiation dose-length product.

Trust comment: Prospective randomized study with objective quantitative imaging endpoints and moderate sample size, suitable for technical conclusions.

Study Details

PMID:30476460
Participants:52
Impact:all reduced-iodine DECTA exams rated diagnostic; image quality comparable to SECTA (scores ~4.2–4.8)
Trust score:4/5

effective radiation dose (ED)

2 evidences

Adjusting tube voltage and iodine delivery rate by weight in CCTA reduced contrast agent dose and radiation exposure while preserving or improving image quality.

Trust comment: Prospective randomized controlled imaging study with substantial sample size and objective dose metrics.

Study Details

PMID:38462355
Participants:297
Impact:median 2.07 vs 3.30 mSv (test vs control) — significantly lower in test group
Trust score:4/5

A prospective randomized study comparing low iodine dose/injection rate and low radiation (with AI denoising) versus standard protocol showed higher vascular CT attenuation, lower iodine intake, and substantially lower radiation dose with maintained diagnostic image quality.

Trust comment: Prospective randomized cohort (n=90) with objective quantitative imaging endpoints and statistically significant differences, though single-center and BMI-limited population.

Study Details

PMID:39739102
Participants:90
Impact:Experimental -5.86 mSv (5.09 vs 10.95 mSv; -53.5%)
Trust score:4/5

TSH

4 evidences

Screened elderly Chinese for thyroid problems; found thyroid dysfunction mainly in women, with possible contributions from autoimmunity and borderline iodine intake.

Trust comment: Large ambulatory human screening study with objective hormone assays but observational design limits causal inference.

Study Details

PMID:8733881
Participants:1880
Impact:Decreased with age in women; elevated TSH (>5.0 mIU/L) in 1.0% and suppressed TSH (<0.1 mIU/L) in 1.5% of subjects
Trust score:4/5

Short clinical study in HCV patients: excess iodine (with or without rIFN-alpha) caused small changes in thyroid function over 2 months.

Trust comment: Small clinical study with short (2-month) follow-up and non-randomized groups, but direct thyroid function measurements were reported.

Study Details

PMID:10341861
Participants:56
Impact: + small significant increase with iodine alone and rIFN-alpha + iodine (2 months)
Trust score:3/5

6-month randomized, double-blind 2x2 trial in children: vitamin A supplementation decreased TSH stimulation, thyroglobulin, and thyroid volume and thus reduced goiter risk in the context of mild-to-moderate iodine deficiency.

Trust comment: Large double-blind randomized factorial trial with clear biochemical and ultrasonographic outcomes and statistically significant effects.

Study Details

PMID:17921382
Participants:404
Impact:Decreased significantly with vitamin A supplementation (P<0.05)
Trust score:5/5

Short-term high-dose iodine and iodide both raised TSH in healthy men; anticipated differential effects versus animal data were not observed.

Trust comment: Controlled repeated-dose human dosing study with clear hormonal measurements but small sample and short duration.

Study Details

PMID:9761130
Participants:33
Impact:significantly increased by high dose I2 and I- versus control
Trust score:4/5

Aortic/portal/liver attenuation

1 evidences

In abdominal CT, two iodine concentrations produced similar vascular and liver enhancement; higher-concentration contrast had higher peak injection pressure.

Trust comment: Randomized trial with objective quantitative CT endpoints and clear reporting; moderate sample size supports internal validity.

Study Details

PMID:25174776
Participants:144
Impact:no significant difference between 370 vs 300 mgI/mL (e.g. aortic late arterial 300.32±59.76 vs 298.2±59.14 HU; p=0.8)
Trust score:4/5

Peak injection pressure

1 evidences

In abdominal CT, two iodine concentrations produced similar vascular and liver enhancement; higher-concentration contrast had higher peak injection pressure.

Trust comment: Randomized trial with objective quantitative CT endpoints and clear reporting; moderate sample size supports internal validity.

Study Details

PMID:25174776
Participants:144
Impact:higher with higher iodine concentration (115 psi vs 93 psi; significant)
Trust score:4/5

Urinary iodine concentration

14 evidences

After iodized oil administration, children's urinary iodine rose, goiter rates fell, and linear growth and puberty timing improved.

Trust comment: Large population intervention with long-term follow-up in a selected sample showing large, biologically plausible changes; observational selection of subsample limits full generalizability.

Study Details

PMID:18399768
Participants:295
Impact:median increase from 36 μg/L to 188 μg/L (4-year) and 175 μg/L (5-year); p<0.001)
Trust score:4/5

Pregnant women randomized to iodised salt or iodine supplements showed no difference in child neurodevelopment; prior long-term iodised salt use raised maternal urinary iodine and reduced thyroid volume.

Trust comment: Randomized trial with objective biochemical and clinical outcomes and moderate sample size; results appear reliable though subgroup baseline iodine status was mild-moderate deficiency.

Study Details

PMID:23375074
Participants:131
Impact:+~60 μg/L (1st trimester) and +~46 μg/L (3rd trimester) with iodised salt use ≥1 year before pregnancy
Trust score:4/5

Double-blind randomized trial in moderately iodine-deficient schoolchildren: Lipiodol increased urinary iodine but remained below normal and produced no short-term improvement in T4, TSH, weight, cognitive or motor tests at 4 months.

Trust comment: Randomized, double-blind trial with objective measures but relatively short follow-up and residual iodine deficiency limit inference on cognitive outcomes.

Study Details

PMID:11208941
Participants:305
Impact:Significant increase after Lipiodol (median urinary iodine from ~3.1 to 7.9 μmol/L; p<0.0001) but still below normal
Trust score:3/5

Daily 150 µg iodine for 28 weeks raised iodine status and produced small improvements in some cognitive tests in mildly iodine-deficient children.

Trust comment: Randomized, double-blind, placebo-controlled trial with objective biochemical and cognitive endpoints.

Study Details

PMID:19726593
Participants:184
Impact:+64 µg/L (145 vs 81 µg/L) at 28 wk
Trust score:5/5

Cluster randomized trial in 1602 children (4–6 years): market introduction of iodized salt increased children's urinary iodine but produced no overall improvement in cognitive/language test scores; some subgroup benefits observed.

Trust comment: Large cluster randomized effectiveness trial with biomarker and cognitive outcomes, but potential effect modification and context dependence limit broad conclusions.

Study Details

PMID:27145299
Participants:1602
Impact:endline urinary iodine significantly higher in intervention group (both medians > threshold)
Trust score:4/5

Single oral dose of iodized oil corrected iodine deficiency and reduced goiter prevalence in schoolchildren for over a year.

Trust comment: Prospective study with objective measures (urinary iodine, ultrasound), adequate sample and follow-up.

Study Details

PMID:12207166
Participants:214
Impact:Sharply increased after 200 mg oral iodized oil and remained within normal range for >1 year
Trust score:4/5

A single oral iodised-oil dose increased urinary iodine and markedly reduced goitre prevalence at 40 weeks; efficacy was lower in children with poorer weight-for-height.

Trust comment: Controlled field trial in a severely deficient population with objective biochemical and clinical endpoints; moderate sample size.

Study Details

PMID:10967613
Participants:197
Impact:+0.17 μmol/L (median increase from 0.15 to 0.32 μmol/L at 40 weeks)
Trust score:4/5

Eating farmed Atlantic salmon three times weekly for 16 weeks increased EPA/DHA biomarkers and modestly improved two raw cognitive subtest scores but did not change global IQ scores in preschool children.

Trust comment: Randomized trial in 205 children with objective cognitive tests and biomarkers; results reported and statistically analyzed.

Study Details

PMID:30598384
Participants:205
Impact:no significant change (biomarker not increased)
Trust score:4/5

In this cross-sectional pediatric survey iodine status was adequate and thyroid autoimmunity was present in a minority, more in females and older children.

Trust comment: Large, population-representative cross-sectional study with standard biochemical measures; cross-sectional design limits causal inference.

Study Details

PMID:22728345
Participants:1387
Impact:median 199.5 μg/L (indicating adequate iodine supply)
Trust score:3/5

Two weeks of a low‑iodine diet reduced urinary iodine similarly to three weeks and increased thyroid 131I uptake (numerically greater in 2-week group but not significantly different).

Trust comment: Randomized comparison with clear biochemical endpoints but small sample size limits precision.

Study Details

PMID:21162685
Participants:46
Impact:decrease ~63.2% (2-week) and ~60.9% (3-week); both significant, no difference between groups
Trust score:4/5

Patients with hyperthyroidism randomized to iodated vs non-iodated salt; antithyroid drug needs were tracked over 6 months.

Trust comment: Randomized human trial with clear participant numbers and measurable endpoints; some minor reporting inconsistencies in hormone values but primary drug-dose outcome is robust.

Study Details

PMID:14720423
Participants:101
Impact:decreased in pure-salt group from 213.4 to 148.4 μg/L at 2–3 months (-64.9 μg/L)
Trust score:4/5

Biscuits fortified with encapsulated ferrous sulfate plus potassium iodate raised women's iron stores and increased urinary iodine concentrations over 22 weeks.

Trust comment: Randomized double-blind controlled trial with biochemical outcomes and adequate sample size for target population.

Study Details

PMID:19653920
Participants:279
Impact:median 140 → 213 µg/L (+73 µg/L; significant increase)
Trust score:5/5

Lower urinary iodine was observed in people with periodontitis; a cutoff <76.93 μg/L was associated with high probability of periodontitis in this small sample.

Trust comment: Small sample and unclear design details despite being labeled randomized; findings are associative and need larger confirmatory studies.

Study Details

PMID:39503277
Participants:73
Impact:lower in periodontitis patients; urine <76.93 μg/L associated with 72.5% probability of periodontitis
Trust score:3/5

Dual-fortified salt improved iron status and reduced anemia; iodized salt and one dual-fortified formula increased urinary iodine, while the other iron formulation reduced iodine stability in salt.

Trust comment: Large, double-blind randomized household trial with robust biochemical endpoints, though local salt characteristics influenced iodine stability.

Study Details

PMID:18996875
Participants:458
Impact:median urinary iodine increased significantly in iodized salt (IS) and EFF dual-fortified groups at 10 months (P<0.001); not increased in MGFePP group
Trust score:4/5

Goiter prevalence

5 evidences

Iodine deficiency was present in the population; goiter prevalence rose with age and urinary iodine fell, with higher neonatal TSH observed.

Trust comment: Cross‑sectional nutritional survey with measured biomarkers and reasonable sample size, but observational design limits causal inference.

Study Details

PMID:9611400
Participants:294
Impact:Increases with age: 0% (young children), 12.1% (children), 23.3% (teenagers), 38.4% (women)
Trust score:3/5

Removing iodized salt for about 1.5 years led to a large drop in children's goiter prevalence.

Trust comment: Large community before–after study with objective ultrasound measures and significant results, but non-randomized observational design.

Study Details

PMID:26137616
Participants:459
Impact:-18.68 percentage points (from 24.56% to 5.88%)
Trust score:4/5

After iodized oil administration, children's urinary iodine rose, goiter rates fell, and linear growth and puberty timing improved.

Trust comment: Large population intervention with long-term follow-up in a selected sample showing large, biologically plausible changes; observational selection of subsample limits full generalizability.

Study Details

PMID:18399768
Participants:295
Impact:decrease from 99% to 2% (in treated group at 4 years)
Trust score:4/5

In iron-deficient goitrous children, adding iron improved iron status and made iodized salt more effective, reducing thyroid size and goiter rates.

Trust comment: Randomized, double-blind, placebo-controlled trial with clear outcome measures and adequate sample size.

Study Details

PMID:11916762
Participants:166
Impact:43% (iron) vs 62% (placebo) at 20 wk (-19 percentage points)
Trust score:5/5

Single oral dose of iodized oil corrected iodine deficiency and reduced goiter prevalence in schoolchildren for over a year.

Trust comment: Prospective study with objective measures (urinary iodine, ultrasound), adequate sample and follow-up.

Study Details

PMID:12207166
Participants:214
Impact:Decreased from 29% before therapy to 9% at 1 year (−20 percentage points)
Trust score:4/5

Height standard deviation score (SDS)

1 evidences

After iodized oil administration, children's urinary iodine rose, goiter rates fell, and linear growth and puberty timing improved.

Trust comment: Large population intervention with long-term follow-up in a selected sample showing large, biologically plausible changes; observational selection of subsample limits full generalizability.

Study Details

PMID:18399768
Participants:295
Impact:improved (from −0.5019 to −0.1364; p<0.001)
Trust score:4/5

Knowledge score

2 evidences

A 6-month community cluster education program for women markedly raised knowledge, attitudes and practices related to iodized salt use.

Trust comment: Cluster randomized controlled trial with high follow-up (99%); outcomes are validated KAP scores though no biochemical iodine status was measured.

Study Details

PMID:33198715
Participants:647
Impact:mean increase +8.82 points (adjusted effect ~8.81)
Trust score:4/5

Daily educational text messages improved women's knowledge and attitudes about iodine/iodized salt but did not change reported practice or urinary iodine.

Trust comment: Randomized behavioral trial with clear outcomes but limited to adult female participants and short follow-up for biological outcomes.

Study Details

PMID:22874004
Participants:205
Impact:increase (significant at follow-up; P=0.004)
Trust score:3/5

Attitude score

2 evidences

A 6-month community cluster education program for women markedly raised knowledge, attitudes and practices related to iodized salt use.

Trust comment: Cluster randomized controlled trial with high follow-up (99%); outcomes are validated KAP scores though no biochemical iodine status was measured.

Study Details

PMID:33198715
Participants:647
Impact:mean increase +3.00 points (adjusted effect ~3.35)
Trust score:4/5

Daily educational text messages improved women's knowledge and attitudes about iodine/iodized salt but did not change reported practice or urinary iodine.

Trust comment: Randomized behavioral trial with clear outcomes but limited to adult female participants and short follow-up for biological outcomes.

Study Details

PMID:22874004
Participants:205
Impact:increase (significant at follow-up; P=0.02)
Trust score:3/5

Practice score / urinary iodine concentration

1 evidences

Daily educational text messages improved women's knowledge and attitudes about iodine/iodized salt but did not change reported practice or urinary iodine.

Trust comment: Randomized behavioral trial with clear outcomes but limited to adult female participants and short follow-up for biological outcomes.

Study Details

PMID:22874004
Participants:205
Impact:no significant change
Trust score:3/5

Thyroid autoimmunity prevalence (TA)

1 evidences

In this cross-sectional pediatric survey iodine status was adequate and thyroid autoimmunity was present in a minority, more in females and older children.

Trust comment: Large, population-representative cross-sectional study with standard biochemical measures; cross-sectional design limits causal inference.

Study Details

PMID:22728345
Participants:1387
Impact:3.7% (95% CI 2.4–5.0)
Trust score:3/5

Autoimmune thyroiditis prevalence (AT)

1 evidences

In this cross-sectional pediatric survey iodine status was adequate and thyroid autoimmunity was present in a minority, more in females and older children.

Trust comment: Large, population-representative cross-sectional study with standard biochemical measures; cross-sectional design limits causal inference.

Study Details

PMID:22728345
Participants:1387
Impact:1.4% (95% CI 0.4–2.4)
Trust score:3/5

Evaluable CT scan rate (image quality)

1 evidences

In coronary CTA, iobitridol 350 mgI/mL was non-inferior to higher-concentration agents for image evaluability; higher iodine concentration gave higher absolute attenuation but similar SNR/CNR and slightly different AE rates.

Trust comment: Large multicentre randomized double-blind trial with predefined endpoints and appropriate analysis demonstrating non-inferiority.

Study Details

PMID:27271922
Participants:452
Impact:iobitridol 92.1% vs iopromide 95.4% vs iomeprol 94.6% (non-inferiority demonstrated)
Trust score:4/5

Post-contrast arterial attenuation

1 evidences

In coronary CTA, iobitridol 350 mgI/mL was non-inferior to higher-concentration agents for image evaluability; higher iodine concentration gave higher absolute attenuation but similar SNR/CNR and slightly different AE rates.

Trust comment: Large multicentre randomized double-blind trial with predefined endpoints and appropriate analysis demonstrating non-inferiority.

Study Details

PMID:27271922
Participants:452
Impact:higher with higher iodine concentration (average post-contrast 426.3±92.9 HU, 449.8±88.1 HU, 466.4±104.6 HU respectively; p=0.001)
Trust score:4/5

adverse event rate

2 evidences

Double-blind randomized trial of two iodine-containing contrast agents in cerebral angiography found similar diagnostic efficacy and no significant difference in adverse event rates.

Trust comment: Randomized double-blind phase III trial but small sample size limits precision of adverse event comparisons.

Study Details

PMID:8883527
Participants:49
Impact:48% (iodixanol) vs 25% (iohexol); no significant difference
Trust score:3/5

In coronary CTA, iobitridol 350 mgI/mL was non-inferior to higher-concentration agents for image evaluability; higher iodine concentration gave higher absolute attenuation but similar SNR/CNR and slightly different AE rates.

Trust comment: Large multicentre randomized double-blind trial with predefined endpoints and appropriate analysis demonstrating non-inferiority.

Study Details

PMID:27271922
Participants:452
Impact:15.1% (iobitridol) vs 19.5% (iopromide) vs 15.1% (iomeprol); mostly mild
Trust score:4/5

Radiation dose (CTDIvol / DLP / effective dose)

1 evidences

Using higher iodine delivery rate with current modulation reduced radiation dose by ~19% while preserving image quality in head and neck CTA.

Trust comment: Randomized small-sample imaging study showing consistent dose reductions with maintained quality; limited size and single-modality focus.

Study Details

PMID:35040416
Participants:64
Impact:reduction ~18–20% (CTDIvol 18.12%, DLP 19.91%, effective dose 19.84%; P<0.001)
Trust score:3/5

Image quality / vascular attenuation

1 evidences

Using higher iodine delivery rate with current modulation reduced radiation dose by ~19% while preserving image quality in head and neck CTA.

Trust comment: Randomized small-sample imaging study showing consistent dose reductions with maintained quality; limited size and single-modality focus.

Study Details

PMID:35040416
Participants:64
Impact:overall similar image quality; higher mean vascular CT values in ultra-low-dose group
Trust score:3/5

Perineal pain intensity

1 evidences

In first- and second-degree perineal tears, surgical glue reduced postpartum perineal pain and shortened repair time, with overall similar healing but a higher short-term re-repair rate in the glue group.

Trust comment: Well-powered randomized controlled trial with long follow-up but unblinded assessments and some follow-up/missing data.

Study Details

PMID:37046212
Participants:140
Impact:Lower with glue (statistically significant, p≤0.001)
Trust score:4/5

Perineal repair time

1 evidences

In first- and second-degree perineal tears, surgical glue reduced postpartum perineal pain and shortened repair time, with overall similar healing but a higher short-term re-repair rate in the glue group.

Trust comment: Well-powered randomized controlled trial with long follow-up but unblinded assessments and some follow-up/missing data.

Study Details

PMID:37046212
Participants:140
Impact:Shorter with glue: 12.1 min vs 18.2 min (difference −6.1 min)
Trust score:4/5

Perineal healing (REEDA)

1 evidences

In first- and second-degree perineal tears, surgical glue reduced postpartum perineal pain and shortened repair time, with overall similar healing but a higher short-term re-repair rate in the glue group.

Trust comment: Well-powered randomized controlled trial with long follow-up but unblinded assessments and some follow-up/missing data.

Study Details

PMID:37046212
Participants:140
Impact:Overall similar between groups; edge approximation favored suture early
Trust score:4/5

full-scale IQ

1 evidences

At age 6–9 years, children conceived within 6 months after HSG with oil-based versus water-based iodinated contrast showed no differences in intelligence, behaviour, academic performance or most neurocognitive domains; a small advantage in visuomotor integration for oil-based contrast was observed but may be due to chance.

Trust comment: Follow-up of an RCT with detailed neurocognitive testing but small sample (n=69) and limited statistical power.

Study Details

PMID:39198011
Participants:69
Impact:No significant difference (adjusted mean difference 4.09; 95% CI −1.53 to 9.71)
Trust score:3/5

visuomotor integration

1 evidences

At age 6–9 years, children conceived within 6 months after HSG with oil-based versus water-based iodinated contrast showed no differences in intelligence, behaviour, academic performance or most neurocognitive domains; a small advantage in visuomotor integration for oil-based contrast was observed but may be due to chance.

Trust comment: Follow-up of an RCT with detailed neurocognitive testing but small sample (n=69) and limited statistical power.

Study Details

PMID:39198011
Participants:69
Impact:Higher in oil-based group: adjusted mean difference 0.46 (95% CI 0.04 to 0.89) — exploratory and non-significant after multiple-test correction
Trust score:3/5

Behavioural functioning / academic performance

1 evidences

At age 6–9 years, children conceived within 6 months after HSG with oil-based versus water-based iodinated contrast showed no differences in intelligence, behaviour, academic performance or most neurocognitive domains; a small advantage in visuomotor integration for oil-based contrast was observed but may be due to chance.

Trust comment: Follow-up of an RCT with detailed neurocognitive testing but small sample (n=69) and limited statistical power.

Study Details

PMID:39198011
Participants:69
Impact:No significant differences between groups
Trust score:3/5

Normalized mean hepatic enhancement (MHE/I)

1 evidences

Dosing iodinated contrast by total body weight versus lean body weight produced similar magnitude and interpatient variability in normalized mean hepatic enhancement at routine abdominal CT, though TBW-based dosing used larger contrast volumes.

Trust comment: Stratified randomized controlled imaging trial with objective endpoints and adequate sample though some exclusions reduced initial allocation.

Study Details

PMID:31439467
Participants:229
Impact:No significant difference in magnitude or variability between TBW- and LBW-based dosing
Trust score:4/5

Contrast volume administered

2 evidences

Dosing iodinated contrast by total body weight versus lean body weight produced similar magnitude and interpatient variability in normalized mean hepatic enhancement at routine abdominal CT, though TBW-based dosing used larger contrast volumes.

Trust comment: Stratified randomized controlled imaging trial with objective endpoints and adequate sample though some exclusions reduced initial allocation.

Study Details

PMID:31439467
Participants:229
Impact:TBW dosing used more CM: men 106.5 ±20 vs 98.4 ±11 mL; women 93.7 ±20 vs 77.5 ±11 mL (p values reported)
Trust score:4/5

In high-risk PCI patients given iodinated contrast, IV prostaglandin E1 reduced the incidence of contrast-induced nephropathy versus control hydration alone.

Trust comment: Randomized trial with clinically relevant endpoint but moderate sample size and limited detail on blinding and follow-up.

Study Details

PMID:24570327
Participants:163
Impact:no difference (156 ± 63 vs 161 ± 68 mL)
Trust score:3/5

Ablation success rate (with THW subgroup)

1 evidences

In Chinese patients with differentiated thyroid cancer, low-dose (1.1 GBq) radioiodine ablation achieved similar ablation success rates to high-dose (3.7 GBq) at 6–8 months.

Trust comment: Large randomized clinical trial with robust clinical endpoints; single-center design but high sample size supports reliability.

Study Details

PMID:33470031
Participants:474
Impact:1.1 GBq 84% vs 3.7 GBq 80% (THW subgroup)
Trust score:4/5

Ablation success rate (without THW subgroup)

1 evidences

In Chinese patients with differentiated thyroid cancer, low-dose (1.1 GBq) radioiodine ablation achieved similar ablation success rates to high-dose (3.7 GBq) at 6–8 months.

Trust comment: Large randomized clinical trial with robust clinical endpoints; single-center design but high sample size supports reliability.

Study Details

PMID:33470031
Participants:474
Impact:1.1 GBq 89% vs 3.7 GBq 90% (no THW subgroup)
Trust score:4/5

Overall ablation success

1 evidences

In Chinese patients with differentiated thyroid cancer, low-dose (1.1 GBq) radioiodine ablation achieved similar ablation success rates to high-dose (3.7 GBq) at 6–8 months.

Trust comment: Large randomized clinical trial with robust clinical endpoints; single-center design but high sample size supports reliability.

Study Details

PMID:33470031
Participants:474
Impact:412/474 (87%) overall; no significant difference between doses
Trust score:4/5

Symptomatic urinary tract infection at 2 weeks

1 evidences

Chlorhexidine was not inferior to povidone-iodine for preventing symptomatic urinary tract infection within 2 weeks after urogynecologic surgery; secondary infection and irritation outcomes were similar.

Trust comment: Randomized noninferiority trial with pre-specified margin and completed primary outcome data but modest sample size.

Study Details

PMID:34973179
Participants:119
Impact:Chlorhexidine 10% vs iodine 17%; relative risk 0.6 (noninferior within predefined margin)
Trust score:4/5

Culture-proven UTI and other infection outcomes

1 evidences

Chlorhexidine was not inferior to povidone-iodine for preventing symptomatic urinary tract infection within 2 weeks after urogynecologic surgery; secondary infection and irritation outcomes were similar.

Trust comment: Randomized noninferiority trial with pre-specified margin and completed primary outcome data but modest sample size.

Study Details

PMID:34973179
Participants:119
Impact:No difference between groups for secondary UTI outcomes
Trust score:4/5

Vaginal irritation / surgical site infection

1 evidences

Chlorhexidine was not inferior to povidone-iodine for preventing symptomatic urinary tract infection within 2 weeks after urogynecologic surgery; secondary infection and irritation outcomes were similar.

Trust comment: Randomized noninferiority trial with pre-specified margin and completed primary outcome data but modest sample size.

Study Details

PMID:34973179
Participants:119
Impact:Similar rates between groups (low overall rates)
Trust score:4/5

breast milk/thyroid iodine handling (speculative)

1 evidences

Daily lipid-based supplement with 250 μg iodine did not raise urinary iodine concentrations in pregnant and postpartum women compared with iron–folic acid.

Trust comment: Large cluster-randomized trial with a large enrolled sample and repeated biomarker sampling in a prespecified subsample, though UIC is a spot measure and was a secondary outcome.

Study Details

PMID:28615379
Participants:4011
Impact:Authors suggest iodine may have been retained in thyroid or secreted in breast milk rather than excreted (not directly measured)
Trust score:4/5

image quality

7 evidences

Lower tube voltage plus iterative reconstruction allowed a ~26% lower iodine load and ~35% lower radiation dose while keeping image quality similar.

Trust comment: Prospective multicenter randomized trial with 231 patients and objective imaging/radiation measurements supports good reliability.

Study Details

PMID:25843243
Participants:231
Impact:no significant difference (scores ~4.0–4.1)
Trust score:4/5

In 179 patients, a low-voltage/low-iodine CT protocol produced diagnostic coronary images while significantly lowering iodine intake and radiation dose.

Trust comment: Randomized clinical imaging study with large sample (n=179) and significant objective dose reductions and preserved image quality.

Study Details

PMID:25468636
Participants:179
Impact:SNR, CNR, and image-quality scores comparable between groups despite lower iodine
Trust score:4/5

Randomized pediatric CT study showing lower-concentration iodinated contrast plus lower tube settings reduces iodine load and radiation while keeping image quality.

Trust comment: Prospective randomized pediatric study with clear quantitative iodine and radiation outcomes and reasonable sample size; moderate-high trust.

Study Details

PMID:27925466
Participants:110
Impact:no significant difference (diagnostic accuracy 92–96% intracardiac/extracardiac)
Trust score:4/5

Lower-strength iodine contrast produced diagnostically excellent neck CTs with fewer immediate minor side effects than higher-strength contrast.

Trust comment: Randomized study with blinded image assessment and objective measures but modest sample size.

Study Details

PMID:7834482
Participants:50
Impact:no significant difference (both concentrations yielded excellent images)
Trust score:4/5

Pilot randomized CTA study showing dual-energy CT allows up to ~60% iodinated contrast volume reduction without loss of image quality.

Trust comment: Prospective randomized pilot with clear randomized groups and objective image quality metrics; small sample but reliable within scope.

Study Details

PMID:25053514
Participants:80
Impact:no significant decrease up to 60% iodine reduction
Trust score:4/5

A double-low CT protocol reduced radiation and iodine dose while maintaining similar image quality for aortic CTA.

Trust comment: Prospective randomized trial (n=72) with clear quantitative endpoints and significant dose reductions reported.

Study Details

PMID:27671868
Participants:72
Impact:no significant change
Trust score:4/5

Randomized trial showing that halving contrast volume and using low tube voltage (80 kV) yields higher arterial attenuation and substantially lower radiation dose with good image quality.

Trust comment: Randomized clinical study (n=101) with clear quantitative endpoints showing dose and contrast reductions with preserved image quality.

Study Details

PMID:27421672
Participants:101
Impact:Good diagnostic image quality achieved with low contrast volume and low tube voltage
Trust score:4/5

serum TSH

2 evidences

In postmenopausal women, 7 weeks of seaweed (high iodine) raised urinary iodine and produced a small increase in TSH; soy had no effect.

Trust comment: Double-blind crossover design is strong but sample size is small, limiting generalizability.

Study Details

PMID:17472472
Participants:25
Impact:Increased from 1.69 ± 0.22 to 2.19 ± 0.22 µU/mL (P < 0.0001)
Trust score:3/5

In patients with Hashimoto's hypothyroidism, restricting iodine intake for 3 months led many to recover normal thyroid function.

Trust comment: Randomized human trial with objective thyroid hormone and urinary iodine measurements but small sample and short follow-up (3 months).

Study Details

PMID:12728462
Participants:45
Impact:decreased from 37.95 to 25.66 microIU/mL in restriction group (mean change −12.29 microIU/mL)
Trust score:4/5

biochemical progression (Phoenix definition)

1 evidences

In men receiving iodine-125 brachytherapy plus EBRT, extending androgen-deprivation therapy to 30 months did not improve 7-year biochemical progression compared with 6 months.

Trust comment: Multicenter randomized phase 3 trial with adequate sample size and long follow-up, providing reliable comparative effectiveness data for this iodine-125–based therapy regimen.

Study Details

PMID:37802225
Participants:332
Impact:7-year cumulative incidence 9.0% (short ADT) vs 8.0% (long ADT); no significant difference (P=0.65)
Trust score:4/5

grade 3+ endocrine- and radiation-related adverse events

1 evidences

In men receiving iodine-125 brachytherapy plus EBRT, extending androgen-deprivation therapy to 30 months did not improve 7-year biochemical progression compared with 6 months.

Trust comment: Multicenter randomized phase 3 trial with adequate sample size and long follow-up, providing reliable comparative effectiveness data for this iodine-125–based therapy regimen.

Study Details

PMID:37802225
Participants:332
Impact:Similar low rates between arms (endocrine 0.6% vs 1.8%; radiation 1.2% vs 0.6%)
Trust score:4/5

clinical/metastatic progression and survival

1 evidences

In men receiving iodine-125 brachytherapy plus EBRT, extending androgen-deprivation therapy to 30 months did not improve 7-year biochemical progression compared with 6 months.

Trust comment: Multicenter randomized phase 3 trial with adequate sample size and long follow-up, providing reliable comparative effectiveness data for this iodine-125–based therapy regimen.

Study Details

PMID:37802225
Participants:332
Impact:No significant differences between arms in reported secondary endpoints
Trust score:4/5

dry mouth complaints (xerostomia)

1 evidences

Bethanechol given after radioactive iodine therapy reduced acute dry mouth and salivary gland symptoms and improved some short-term quality-of-life measures versus placebo.

Trust comment: Double-blind randomized placebo-controlled trial but modest sample size (n=50); outcomes include patient-reported symptoms and objective saliva measures.

Study Details

PMID:34954424
Participants:50
Impact:Lower frequency in bethanechol group at 10 days (p=0.047) and 30 days (p=0.003)
Trust score:3/5

salivary gland pain/swelling

1 evidences

Bethanechol given after radioactive iodine therapy reduced acute dry mouth and salivary gland symptoms and improved some short-term quality-of-life measures versus placebo.

Trust comment: Double-blind randomized placebo-controlled trial but modest sample size (n=50); outcomes include patient-reported symptoms and objective saliva measures.

Study Details

PMID:34954424
Participants:50
Impact:More frequent in placebo at 10 days (p=0.047)
Trust score:3/5

unstimulated whole saliva (UWS)

1 evidences

Bethanechol given after radioactive iodine therapy reduced acute dry mouth and salivary gland symptoms and improved some short-term quality-of-life measures versus placebo.

Trust comment: Double-blind randomized placebo-controlled trial but modest sample size (n=50); outcomes include patient-reported symptoms and objective saliva measures.

Study Details

PMID:34954424
Participants:50
Impact:No significant difference between groups
Trust score:3/5

TSH and free T4

1 evidences

Daily 150 μg iodine supplementation for 24 weeks raised urinary iodine and reduced thyroglobulin levels in mildly iodine-deficient adults without changing TSH or free T4.

Trust comment: Randomized double-blind placebo-controlled trial with reasonable sample size (n=112) and appropriate biomarker measurements, supporting internal validity.

Study Details

PMID:26891118
Participants:112
Impact:No significant changes
Trust score:4/5

iodine intake

10 evidences

Partially replacing animal proteins with plant proteins for 12 weeks lowered iodine intake and urinary iodine excretion in healthy adults.

Trust comment: Well-conducted 12-week randomized dietary trial (n=136) with objective biomarkers but limited to short duration and female-dominant sample.

Study Details

PMID:34837522
Participants:136
Impact:PLANT vs ANIMAL: -83.0 µg/d (180.9 vs 263.9 µg/d, p<0.001)
Trust score:4/5

A prospective randomized study comparing low iodine dose/injection rate and low radiation (with AI denoising) versus standard protocol showed higher vascular CT attenuation, lower iodine intake, and substantially lower radiation dose with maintained diagnostic image quality.

Trust comment: Prospective randomized cohort (n=90) with objective quantitative imaging endpoints and statistically significant differences, though single-center and BMI-limited population.

Study Details

PMID:39739102
Participants:90
Impact:Experimental -3.85 g (15.04 vs 18.89 g; -20.4%)
Trust score:4/5

A 12‑week dietary intervention to increase protein meals in older adults raised overall protein and several micronutrient intakes, including iodine, driven by more animal‑derived protein foods.

Trust comment: Randomized intervention with 56 older adults and clear nutrient intake changes; moderate quality but dietary self‑reporting limits certainty.

Study Details

PMID:34725773
Participants:56
Impact:Increased in NUTR and NUTR+EX groups (P<0.05)
Trust score:3/5

Individualized dietary counseling in older caregivers increased protein intake, raised calcium intake modestly, and greatly increased use of vitamin D supplementation over 6 months.

Trust comment: Randomized, population-based trial with validated dietary assessment and appropriate statistical analysis; some COVID-19–related visit changes noted.

Study Details

PMID:35622137
Participants:113
Impact:+18 µg/day (231→249 µg/day, p=0.016)
Trust score:4/5

In a small randomized subsample, an 8-week whole-food plant-based diet reduced weight, HbA1c and several cardiometabolic risk factors but decreased intake of some micronutrients including vitamin D and calcium.

Trust comment: Randomized trial with weighed food records but small analyzed subsample (n=37) and potential reporting/selection bias for dietary records.

Study Details

PMID:36364858
Participants:37
Impact:Significant decrease in PBD vs control (p < 0.001); intake classified as insufficient in both groups
Trust score:3/5

Four-week randomized diet trial in women showing the Paleolithic diet led to greater short-term weight and fat loss and reduced dietary calcium intake compared to guidelines-based diet.

Trust comment: Small, short-duration randomized trial with objective biochemical measures but limited power and short follow-up.

Study Details

PMID:27223304
Participants:39
Impact:significant decrease in Paleolithic group (p<0.01)
Trust score:3/5

6-week RCT in healthy men replacing most red/processed meat with legumes; studied nutrient intakes and biomarkers including iodine intake and urinary iodine excretion.

Trust comment: Well-conducted randomized controlled trial with validated biochemical iodine measures, but short duration and limited to healthy men affecting generalizability.

Study Details

PMID:40828321
Participants:102
Impact:No difference at endpoint (MEAT 245 ± 71 µg/d vs LEGUME 246 ± 76 µg/d)
Trust score:4/5

A reduced-voltage CT protocol with lower-iodine concentration cut iodine dose and radiation while preserving image quality in patients with BMI 18.5–27.9.

Trust comment: Prospective randomized study with 128 patients, objective quantitative endpoints and appropriate statistical analysis; limited to BMI 18.5–27.9 kg/m2.

Study Details

PMID:27368012
Participants:128
Impact:-26.5% (group A vs group C)
Trust score:4/5

An 8-week intensive lifestyle program in children with abdominal obesity increased diet quality and improved some micronutrient intakes including calcium and vitamin D, and reduced BMI-SDS.

Trust comment: Randomized, multidisciplinary intervention with objective measures and validated dietary assessment; moderate sample and short term.

Study Details

PMID:30322156
Participants:107
Impact:increased in intensive care group (significant)
Trust score:4/5

In 179 patients, a low-voltage/low-iodine CT protocol produced diagnostic coronary images while significantly lowering iodine intake and radiation dose.

Trust comment: Randomized clinical imaging study with large sample (n=179) and significant objective dose reductions and preserved image quality.

Study Details

PMID:25468636
Participants:179
Impact:significantly lower in 'double low' group vs conventional (p<0.001)
Trust score:4/5

euthyroid maintenance (methimazole)

1 evidences

Randomized trial comparing long-term methimazole versus radioiodine in toxic multinodular goiter; most methimazole patients remained euthyroid while radioiodine commonly produced hypothyroidism.

Trust comment: Randomized, long-term (60–100 months) clinical trial with substantial follow-up and clear clinical outcomes, though some exclusions occurred.

Study Details

PMID:30803411
Participants:107
Impact:51/53 patients remained euthyroid (96.2%) over 60–100 months
Trust score:4/5

hypothyroidism (radioiodine)

1 evidences

Randomized trial comparing long-term methimazole versus radioiodine in toxic multinodular goiter; most methimazole patients remained euthyroid while radioiodine commonly produced hypothyroidism.

Trust comment: Randomized, long-term (60–100 months) clinical trial with substantial follow-up and clear clinical outcomes, though some exclusions occurred.

Study Details

PMID:30803411
Participants:107
Impact:22/54 patients became hypothyroid (41%)
Trust score:4/5

persistent/recurrence hyperthyroidism (radioiodine)

1 evidences

Randomized trial comparing long-term methimazole versus radioiodine in toxic multinodular goiter; most methimazole patients remained euthyroid while radioiodine commonly produced hypothyroidism.

Trust comment: Randomized, long-term (60–100 months) clinical trial with substantial follow-up and clear clinical outcomes, though some exclusions occurred.

Study Details

PMID:30803411
Participants:107
Impact:12/54 patients (22%); 20/54 became euthyroid (37%)
Trust score:4/5

effective half-time in remnant tissue

1 evidences

Prospective randomized study of radioiodine ablation after rhTSH versus thyroid hormone withdrawal in 63 patients, assessing iodine biokinetics and dosimetry.

Trust comment: Prospective, randomized, multicenter dosimetry study with objective measurements and statistically significant findings for key parameters.

Study Details

PMID:16595499
Participants:63
Impact:rhTSH: 67.6 ± 48.8 h vs THW: 48.0 ± 52.6 h (P = 0.01) — longer with rhTSH
Trust score:4/5

specific absorbed blood dose

1 evidences

Prospective randomized study of radioiodine ablation after rhTSH versus thyroid hormone withdrawal in 63 patients, assessing iodine biokinetics and dosimetry.

Trust comment: Prospective, randomized, multicenter dosimetry study with objective measurements and statistically significant findings for key parameters.

Study Details

PMID:16595499
Participants:63
Impact:rhTSH mean 0.109 ± 0.028 mGy/MBq vs THW mean 0.167 ± 0.061 mGy/MBq (P < 0.0001) — lower with rhTSH
Trust score:4/5

48-h remnant uptake / residence time

1 evidences

Prospective randomized study of radioiodine ablation after rhTSH versus thyroid hormone withdrawal in 63 patients, assessing iodine biokinetics and dosimetry.

Trust comment: Prospective, randomized, multicenter dosimetry study with objective measurements and statistically significant findings for key parameters.

Study Details

PMID:16595499
Participants:63
Impact:No statistically significant difference in 48-h uptake (0.5% ± 0.7% vs 0.9% ± 1.0%; P = 0.1) or residence times (P = 0.1)
Trust score:4/5

urinary iodine concentration (UI)

2 evidences

Double-blind, placebo-controlled trial in 133 infants comparing daily/weekly multiple-micronutrient tablets and iron/placebo on urinary iodine at 23 weeks; no significant differences between groups.

Trust comment: Double-blind, placebo-controlled randomized trial with adequate sample size but baseline UI within normal range and no significant group differences.

Study Details

PMID:17209189
Participants:133
Impact:Baseline mean UI 1.37 μmol/L; DMM group had largest increment but adjusted changes not significantly different between groups at 23 weeks (P = 0.39)
Trust score:4/5

In moderately iodine‑deficient children, a single oral iodized oil dose improved iodine and thyroid status and produced significant gains on several cognitive and motor tests at 24 weeks.

Trust comment: Large double-blind randomized trial with objective biochemical and psychometric outcomes supports reliability.

Study Details

PMID:16400058
Participants:310
Impact:median UI increased from 43 µg/L at baseline to 172 µg/L at 24 weeks in treated group
Trust score:4/5

iodine deficiency prevalence

2 evidences

Vegetarians and especially vegans had lower urinary iodine and higher prevalence of iodine deficiency compared with mixed-diet adults.

Trust comment: Cross-sectional study with small subgroups but objective urinary iodine measures support the conclusion of higher deficiency in vegans.

Study Details

PMID:12748410
Participants:81
Impact:vegans 80% deficient, vegetarians 25% deficient, mixed diet 9% deficient (threshold <100 μg/L)
Trust score:3/5

Double-blind, placebo-controlled trial in 133 infants comparing daily/weekly multiple-micronutrient tablets and iron/placebo on urinary iodine at 23 weeks; no significant differences between groups.

Trust comment: Double-blind, placebo-controlled randomized trial with adequate sample size but baseline UI within normal range and no significant group differences.

Study Details

PMID:17209189
Participants:133
Impact:Baseline iodine deficiency in 30.8% (UI < 0.79 μmol/L); no significant between-group differences in reduction of deficiency (P = 0.13)
Trust score:4/5

Milk iodine concentration

1 evidences

Giving mothers MMS raised iodine in breast milk but did not change infant growth at 3 months.

Trust comment: Cluster-randomized substudy with blinded outcome assessment and validated assays but did not reach target sample size and may be underpowered for some micronutrients.

Study Details

PMID:40409469
Participants:186
Impact:+45 μg/L (geometric mean 122 vs 77 μg/L; P < 0.0001)
Trust score:4/5

Proportion of milk below iodine MAE

1 evidences

Giving mothers MMS raised iodine in breast milk but did not change infant growth at 3 months.

Trust comment: Cluster-randomized substudy with blinded outcome assessment and validated assays but did not reach target sample size and may be underpowered for some micronutrients.

Study Details

PMID:40409469
Participants:186
Impact:-21 percentage points (60% vs 81% below IOM MAE; P = 0.004)
Trust score:4/5

Infant growth (LAZ, WAZ, WLZ, HCZ)

1 evidences

Giving mothers MMS raised iodine in breast milk but did not change infant growth at 3 months.

Trust comment: Cluster-randomized substudy with blinded outcome assessment and validated assays but did not reach target sample size and may be underpowered for some micronutrients.

Study Details

PMID:40409469
Participants:186
Impact:No difference at 3 months
Trust score:4/5

Proportion at risk for iodine deficiency

1 evidences

Pregnant women offered daily iodine had higher urinary iodine and fewer were at risk of deficiency, though >20% of supplemented women remained at risk.

Trust comment: Large cross-sectional comparison with clear biochemical endpoints but non-randomized design and possible selection/confounding bias.

Study Details

PMID:24117002
Participants:365
Impact:-16.1 percentage points (22.8% vs 38.9% at risk)
Trust score:3/5

5-year disease-free survival

1 evidences

A single dose of intra-arterial I-131 lipiodol after resection improved 5-year disease-free and overall survival versus observation; long-term (10-year) differences were not statistically significant.

Trust comment: Randomized prospective trial with long follow-up but small sample (n=43) limiting precision and long-term significance.

Study Details

PMID:18156922
Participants:43
Impact:61.9% vs 31.8% (absolute +30.1 percentage points; P = 0.0397)
Trust score:3/5

5-year overall survival

1 evidences

A single dose of intra-arterial I-131 lipiodol after resection improved 5-year disease-free and overall survival versus observation; long-term (10-year) differences were not statistically significant.

Trust comment: Randomized prospective trial with long follow-up but small sample (n=43) limiting precision and long-term significance.

Study Details

PMID:18156922
Participants:43
Impact:66.7% vs 36.4% (absolute +30.3 percentage points; P = 0.0433)
Trust score:3/5

10-year survival difference

1 evidences

A single dose of intra-arterial I-131 lipiodol after resection improved 5-year disease-free and overall survival versus observation; long-term (10-year) differences were not statistically significant.

Trust comment: Randomized prospective trial with long follow-up but small sample (n=43) limiting precision and long-term significance.

Study Details

PMID:18156922
Participants:43
Impact:No statistically significant difference (P > 0.05)
Trust score:3/5

Cure rate after first 131I dose

1 evidences

Short course iopanoic acid rapidly restored euthyroidism and did not impair the efficacy or long-term outcomes of subsequent radioiodine therapy.

Trust comment: Well-conducted randomized trial with long-term follow-up and clear clinical endpoints.

Study Details

PMID:16189259
Participants:200
Impact:No significant difference (80% control vs 76.2% iopanoic acid; P = 0.54)
Trust score:4/5

Long-term hypothyroidism incidence

1 evidences

Short course iopanoic acid rapidly restored euthyroidism and did not impair the efficacy or long-term outcomes of subsequent radioiodine therapy.

Trust comment: Well-conducted randomized trial with long-term follow-up and clear clinical endpoints.

Study Details

PMID:16189259
Participants:200
Impact:Similar over ~11 years (58% control vs 51% IA group)
Trust score:4/5

Time to readiness for 131I

1 evidences

Short course iopanoic acid rapidly restored euthyroidism and did not impair the efficacy or long-term outcomes of subsequent radioiodine therapy.

Trust comment: Well-conducted randomized trial with long-term follow-up and clear clinical endpoints.

Study Details

PMID:16189259
Participants:200
Impact:Majority ready within 1–2 weeks after IA withdrawal (86% and 94%)
Trust score:4/5

Maternal urinary iodine

1 evidences

Cluster-randomized introduction of iodized salt improved maternal/child iodine status and produced a small but significant gain in child cognitive scores.

Trust comment: Large cluster-randomized trial with biochemical and developmental outcomes, though some contamination and cluster-level differences noted.

Study Details

PMID:31912649
Participants:1024
Impact:Median difference +43 μg/L (intervention higher; Δ 43.3 [26.9,59.7]; P < .05)
Trust score:4/5

Child cognitive score (Bayley)

1 evidences

Cluster-randomized introduction of iodized salt improved maternal/child iodine status and produced a small but significant gain in child cognitive scores.

Trust comment: Large cluster-randomized trial with biochemical and developmental outcomes, though some contamination and cluster-level differences noted.

Study Details

PMID:31912649
Participants:1024
Impact:Mean +0.6 raw points (intervention 33.0 vs control 32.0; effect size d = 0.17; P < .05) (~≈4 IQ points)
Trust score:4/5

Child urinary iodine

1 evidences

Cluster-randomized introduction of iodized salt improved maternal/child iodine status and produced a small but significant gain in child cognitive scores.

Trust comment: Large cluster-randomized trial with biochemical and developmental outcomes, though some contamination and cluster-level differences noted.

Study Details

PMID:31912649
Participants:1024
Impact:Higher in intervention (median difference ~21 μg/L; 161.4 vs 141.0 μg/L)
Trust score:4/5

Positive cultures after skin preparation

1 evidences

Both chlorhexidine-alcohol and iodine-alcohol skin preps effectively eliminated skin bacteria before lumbar spine surgery with no clear difference in post-closure cultures.

Trust comment: Prospective randomized study with blinded culture processing and clear microbiologic endpoints, though sample size modest.

Study Details

PMID:22437997
Participants:100
Impact:ChloraPrep 0% vs DuraPrep 6% (post-prep; difference not statistically significant, P = 0.24)
Trust score:4/5

Positive cultures after wound closure

1 evidences

Both chlorhexidine-alcohol and iodine-alcohol skin preps effectively eliminated skin bacteria before lumbar spine surgery with no clear difference in post-closure cultures.

Trust comment: Prospective randomized study with blinded culture processing and clear microbiologic endpoints, though sample size modest.

Study Details

PMID:22437997
Participants:100
Impact:No difference (ChloraPrep 34% vs DuraPrep 32%)
Trust score:4/5

Thyroglobulin concentration

2 evidences

Double-blind RCT in older adults testing selenium, iodine, their combination, or placebo for 3 months; thyroid function, thyroglobulin, selenium status and urinary iodine measured.

Trust comment: Double-blind, placebo-controlled RCT with clear biochemical outcomes and adequate sample for population studied; results consistent and plausible.

Study Details

PMID:19692495
Participants:100
Impact:decreased by 24% in iodine group (−24% vs baseline) and by 13% in selenium+iodine group (−13%; iodine group significant, combo not significant)
Trust score:4/5

Daily 150 µg iodine for 28 weeks raised iodine status and produced small improvements in some cognitive tests in mildly iodine-deficient children.

Trust comment: Randomized, double-blind, placebo-controlled trial with objective biochemical and cognitive endpoints.

Study Details

PMID:19726593
Participants:184
Impact:Lower in supplement group (8.5 vs 11.6 µg/L at 28 wk)
Trust score:5/5

Overall cognitive score

1 evidences

Daily 150 µg iodine for 28 weeks raised iodine status and produced small improvements in some cognitive tests in mildly iodine-deficient children.

Trust comment: Randomized, double-blind, placebo-controlled trial with objective biochemical and cognitive endpoints.

Study Details

PMID:19726593
Participants:184
Impact:+0.19 SDs (supplement vs placebo); improvements in picture concepts and matrix reasoning (P<0.05)
Trust score:5/5

hemoglobin/iron status

2 evidences

Adding microencapsulated iron to iodized salt improved iron status and amplified the beneficial effects of iodine on thyroid size and function in goitrous, iron-deficient children.

Trust comment: Large randomized double-blind controlled trial with objective ultrasound and biochemical outcomes.

Study Details

PMID:12457449
Participants:377
Impact:Increased (P<0.05) in dual-fortified vs iodized salt
Trust score:4/5

In iron-deficient goitrous children, adding iron improved iron status and made iodized salt more effective, reducing thyroid size and goiter rates.

Trust comment: Randomized, double-blind, placebo-controlled trial with clear outcome measures and adequate sample size.

Study Details

PMID:11916762
Participants:166
Impact:significant increase in hemoglobin and iron indices (P < 0.05)
Trust score:5/5

Serum thyroxine / hypothyroidism prevalence

1 evidences

Adding microencapsulated iron to iodized salt improved iron status and amplified the beneficial effects of iodine on thyroid size and function in goitrous, iron-deficient children.

Trust comment: Large randomized double-blind controlled trial with objective ultrasound and biochemical outcomes.

Study Details

PMID:12457449
Participants:377
Impact:Serum T4 increased and prevalence of hypothyroidism/goiter decreased (P<0.05 to P<0.01)
Trust score:4/5

urinary iodine

12 evidences

Cross-sectional study showing long-term environmental cadmium exposure alters urinary mineral balance, including increased urinary calcium.

Trust comment: Observational cross-sectional study with reasonable sample size showing associations but limited by potential confounding and environmental exposure assessment constraints.

Study Details

PMID:27029362
Participants:298
Impact:Exposed group median urinary I: 246.94 vs control 213.85 μg/g creatinine (P<0.001)
Trust score:3/5

In iodine-deficient children, salt fortified with iodine plus micronized iron increased hemoglobin and iron stores and improved urinary iodine and thyroid volume over 10 months.

Trust comment: Randomized double-blind controlled trial in 158 children with clear biochemical outcomes; well-conducted though limited to one region.

Study Details

PMID:15447905
Participants:158
Impact:improved (P<0.001)
Trust score:4/5

Intraoperative diluted povidone-iodine irrigation caused a marked, transient rise in urinary iodine but did not change thyroid hormone levels through postoperative day 14.

Trust comment: Prospective matched case-control study with objective lab measures but non-randomized design and short follow-up.

Study Details

PMID:39380015
Participants:96
Impact:Marked rise postoperatively (e.g., day1 421.6 vs 176.8 µg/L; ≈+245 µg/L); remained elevated vs control through day14
Trust score:3/5

Women consuming salt fortified with iron and iodine showed improved iron markers versus iodized-salt controls after ~8–9 months.

Trust comment: Well-conducted double-blind randomized controlled trial with appropriate biomarkers and adequate sample (n=212).

Study Details

PMID:24744318
Participants:212
Impact:median increased overall but no difference between DFS and control groups
Trust score:5/5

In preterm infants, iodine-containing contrast increased urinary iodine and improved PICC tip visualization but did not alter subsequent thyroid function (TSH).

Trust comment: Randomized controlled trial in preterm infants with objective endpoints but small sample size limits precision.

Study Details

PMID:29807945
Participants:41
Impact:Significantly increased in contrast-exposed group
Trust score:4/5

Using multiple micronutrient-fortified salt in school meals improved markers of iron status but did not change urinary iodine or serum ferritin over one year.

Trust comment: Pre-post field study with an intervention and reference group gives useful real-world data but lacks randomized individual allocation and has potential confounders.

Study Details

PMID:32990618
Participants:228
Impact:no change (no differences within or between groups)
Trust score:3/5

Single oral doses of iodized oil (200–800 mg iodine) normalized urinary iodine and thyroid hormones for about one year and reduced goiter in about two-thirds of adults.

Trust comment: Randomized allocation with 1-year follow-up and objective biochemical and clinical outcomes; clear results though some dose-related adverse events noted.

Study Details

PMID:7883848
Participants:117
Impact:median urinary iodine restored to reference limits and maintained for ~1 year
Trust score:4/5

Children eating salt fortified with multiple micronutrients including iodine for one year showed better micronutrient status and improvements on several memory and attention tests.

Trust comment: Moderate quality; one-year intervention with objective labs and cognitive tests but nonrandomized group assignment and potential selection differences.

Study Details

PMID:17704033
Participants:129
Impact:significant increase in experimental group vs significant decline in control (p<0.05)
Trust score:3/5

Small RCT showing povidone-iodine oral irrigation causes rapid increase in serum and urinary iodine but did not change thyroxine levels in the short term.

Trust comment: Randomized controlled study with small sample (n=24); clear biomarker changes documented but limited sample and short follow-up.

Study Details

PMID:34196852
Participants:24
Impact:Increased ~5-fold on first day after operation; decreased by day 3 but remained above baseline
Trust score:3/5

A fortified biscuit increased urinary iodine and improved vitamin A and iron markers during school terms, but many gains (except urinary iodine) fell back after long school holidays.

Trust comment: Longitudinal cohort (n=108) with serial biochemical measures showing short‑term benefits and seasonal loss of effect; limited by school‑term/holiday confounding.

Study Details

PMID:11796083
Participants:108
Impact:increased during first 12 months and remained higher after summer holidays (sustained vs other markers)
Trust score:3/5

Fortified salt containing iodine and other micronutrients given to children and women for 8 months improved iron and zinc status and reduced anemia; urinary iodine was maintained in the fortified group.

Trust comment: Randomized controlled community trial with clearly reported biomarker outcomes and reasonable sample size, though potential implementation/contextual confounders exist.

Study Details

PMID:33952731
Participants:212
Impact:No change in experimental group; decreased in control group
Trust score:4/5

Fortified biscuits (including iodine) increased iodine and other micronutrient status and reduced anemia in primary schoolchildren and improved deworming effectiveness.

Trust comment: Large randomized, double-blind, placebo-controlled trial with clear biochemical endpoints and adequate sample size.

Study Details

PMID:19321576
Participants:510
Impact:+22.49 µmol/L
Trust score:5/5

Thyroid function (TSH, fT3, fT4)

1 evidences

Intraoperative diluted povidone-iodine irrigation caused a marked, transient rise in urinary iodine but did not change thyroid hormone levels through postoperative day 14.

Trust comment: Prospective matched case-control study with objective lab measures but non-randomized design and short follow-up.

Study Details

PMID:39380015
Participants:96
Impact:No significant change through postoperative day 14
Trust score:3/5

Time to euthyroidism (TSH normalization)

1 evidences

Randomized trial (12-year follow-up) comparing long-term methimazole versus radioactive iodine for toxic multinodular goiter found faster and more sustained euthyroidism with methimazole.

Trust comment: Randomized long-term clinical trial with extensive follow-up and objective thyroid endpoints though not double-blinded and with some crossover/loss to follow-up.

Study Details

PMID:36415961
Participants:130
Impact:MMI 4.3±1.3 months vs RAI 11.4±6.1 months
Trust score:4/5

Time spent in euthyroidism

1 evidences

Randomized trial (12-year follow-up) comparing long-term methimazole versus radioactive iodine for toxic multinodular goiter found faster and more sustained euthyroidism with methimazole.

Trust comment: Randomized long-term clinical trial with extensive follow-up and objective thyroid endpoints though not double-blinded and with some crossover/loss to follow-up.

Study Details

PMID:36415961
Participants:130
Impact:MMI 95.8%±5.7% vs RAI 72.4%±14.8% of 12 years
Trust score:4/5

body weight change

1 evidences

Randomized trial (12-year follow-up) comparing long-term methimazole versus radioactive iodine for toxic multinodular goiter found faster and more sustained euthyroidism with methimazole.

Trust comment: Randomized long-term clinical trial with extensive follow-up and objective thyroid endpoints though not double-blinded and with some crossover/loss to follow-up.

Study Details

PMID:36415961
Participants:130
Impact:Mean weight gain MMI +1.1±3.1 kg vs RAI +2.7±4.0 kg
Trust score:4/5

median survival time

2 evidences

Randomized trial in advanced pancreatic cancer reported longer median survival with I-125 seed implantation plus arterial infusion chemotherapy versus systemic chemotherapy.

Trust comment: Randomized clinical trial showing survival benefit but modest sample size and some inconsistencies in reported symptom outcomes.

Study Details

PMID:38687687
Participants:101
Impact:Experimental 15 months vs control 9 months (median; p<0.001)
Trust score:3/5

Adding an iodine-125 seed strand to TACE improved survival compared with TACE alone in patients with hepatocellular carcinoma and portal vein tumor thrombosis.

Trust comment: Randomized two-arm clinical trial showing statistically significant survival benefit with addition of I-125 seeds in a moderate sample.

Study Details

PMID:24374800
Participants:85
Impact:210±17.5 days vs 154±11.2 days (group A vs B)
Trust score:4/5

Tumor control rate

1 evidences

Randomized trial in advanced pancreatic cancer reported longer median survival with I-125 seed implantation plus arterial infusion chemotherapy versus systemic chemotherapy.

Trust comment: Randomized clinical trial showing survival benefit but modest sample size and some inconsistencies in reported symptom outcomes.

Study Details

PMID:38687687
Participants:101
Impact:Improved tumor control in experimental group (reported significant; exact % unclear)
Trust score:3/5

Abdominal pain (patient-reported)

1 evidences

Randomized trial in advanced pancreatic cancer reported longer median survival with I-125 seed implantation plus arterial infusion chemotherapy versus systemic chemotherapy.

Trust comment: Randomized clinical trial showing survival benefit but modest sample size and some inconsistencies in reported symptom outcomes.

Study Details

PMID:38687687
Participants:101
Impact:Reported differences in 1- and 3-month pain scores between groups (significant; direction inconsistently reported)
Trust score:3/5

complete resolution of subretinal fluid

1 evidences

In diabetic patients with central serous retinopathy, lecithin-bound iodine produced numerically greater improvement than spironolactone over 6 months but differences were not statistically significant.

Trust comment: Randomized trial with 200 completers; results were consistently non-significant limiting claims of superiority.

Study Details

PMID:37548195
Participants:200
Impact:87% vs 81% (lecithin-bound iodine vs spironolactone; ns)
Trust score:4/5

subretinal fluid (SRF) height

1 evidences

In diabetic patients with central serous retinopathy, lecithin-bound iodine produced numerically greater improvement than spironolactone over 6 months but differences were not statistically significant.

Trust comment: Randomized trial with 200 completers; results were consistently non-significant limiting claims of superiority.

Study Details

PMID:37548195
Participants:200
Impact:median 91.2 vs 142.5 (lecithin-bound iodine vs spironolactone; ns)
Trust score:4/5

central macular thickness / lesion size / visual acuity

1 evidences

In diabetic patients with central serous retinopathy, lecithin-bound iodine produced numerically greater improvement than spironolactone over 6 months but differences were not statistically significant.

Trust comment: Randomized trial with 200 completers; results were consistently non-significant limiting claims of superiority.

Study Details

PMID:37548195
Participants:200
Impact:greater numerical improvement with lecithin-bound iodine (ns)
Trust score:4/5

total cholesterol

1 evidences

In overweight iodine-deficient women, daily 200 μg iodine for 6 months increased urinary iodine and reduced total cholesterol and the prevalence of hypercholesterolemia.

Trust comment: Randomized controlled trial with clear biochemical outcomes in a defined iodine-deficient population; moderate sample size.

Study Details

PMID:26203098
Participants:163
Impact:reduced by 11% after intervention (P=0.034)
Trust score:4/5

prevalence of hypercholesterolemia (total cholesterol >5 mmol/L)

1 evidences

In overweight iodine-deficient women, daily 200 μg iodine for 6 months increased urinary iodine and reduced total cholesterol and the prevalence of hypercholesterolemia.

Trust comment: Randomized controlled trial with clear biochemical outcomes in a defined iodine-deficient population; moderate sample size.

Study Details

PMID:26203098
Participants:163
Impact:21.5% treated vs 34.8% controls at 6 mo (baseline treated 44.2%) (P=0.015)
Trust score:4/5

hypothyroidism incidence

4 evidences

In nontoxic nodular goiter, 131I therapy reduced goiter size substantially more than suppressive levothyroxine but caused more hypothyroidism; levothyroxine caused bone loss.

Trust comment: Randomized trial with 2-year follow-up and objective measures; moderate sample and good design, though modest size.

Study Details

PMID:11238476
Participants:57
Impact:45% developed hypothyroidism in the 131I group by 2 years
Trust score:4/5

Randomized comparison of two fixed radioactive‑iodine doses in drug‑resistant Graves' disease showing the higher 370 MBq dose produced substantially greater overall treatment response but higher rates of hypothyroidism.

Trust comment: Randomized study with 2-year follow-up but modest sample size and limited multicenter validation; results show clear dose-related differences.

Study Details

PMID:16390021
Participants:59
Impact:185 MBq: 18.2% hypothyroid; 370 MBq: 50% hypothyroid
Trust score:3/5

In elderly patients with subclinical hyperthyroidism, radioiodine led to more hypothyroidism while long-term low‑dose methimazole maintained euthyroidism in most patients over 60 months.

Trust comment: Long (60‑month) comparative study with good follow-up; clinical outcomes clearly reported though not a large randomized sample.

Study Details

PMID:32811342
Participants:71
Impact:RAI: 23/35 (66%) became hypothyroid vs MMI: 2/36 (≈6%)
Trust score:4/5

Radioiodine reduced thyroid volume substantially; adjunct lithium prevented early radioiodine-induced hyperthyroidism.

Trust comment: Randomized clinical trial with 24-month follow-up and clear objective endpoints.

Study Details

PMID:15871016
Participants:80
Impact:19% at 24 months
Trust score:4/5

euthyroid status at 60 months

1 evidences

In elderly patients with subclinical hyperthyroidism, radioiodine led to more hypothyroidism while long-term low‑dose methimazole maintained euthyroidism in most patients over 60 months.

Trust comment: Long (60‑month) comparative study with good follow-up; clinical outcomes clearly reported though not a large randomized sample.

Study Details

PMID:32811342
Participants:71
Impact:RAI: 12/35 (34%) euthyroid vs MMI: 34/36 (94%) euthyroid
Trust score:4/5

adverse events

10 evidences

Patients reported fewer unpleasant experiences and adverse events with povidone-iodine nasal decolonization compared with mupirocin.

Trust comment: Large randomized trial with high interview completion and significant patient-reported differences.

Study Details

PMID:24972440
Participants:1679
Impact:fewer with povidone-iodine (P<0.01)
Trust score:4/5

Using 2% chlorhexidine in alcohol for skin disinfection was associated with a lower risk of catheter-related infection compared with alcoholic povidone-iodine in ICU patients.

Trust comment: Large multicenter cohort with propensity adjustment and quasi-experimental component, though not a fully randomized comparison for all antiseptics.

Study Details

PMID:27311311
Participants:3362
Impact:no significant difference between antiseptics
Trust score:4/5

In elderly patients with subclinical hyperthyroidism, radioiodine led to more hypothyroidism while long-term low‑dose methimazole maintained euthyroidism in most patients over 60 months.

Trust comment: Long (60‑month) comparative study with good follow-up; clinical outcomes clearly reported though not a large randomized sample.

Study Details

PMID:32811342
Participants:71
Impact:minor adverse events in both groups; no serious side effects or deaths over 60 months
Trust score:4/5

Using a lower-iodine concentration contrast agent produced image quality similar to a higher-iodine agent and had slightly fewer adverse events.

Trust comment: Randomized, double-blind multicentre trial with clear endpoints and 98 patients supports moderate-to-high trust.

Study Details

PMID:20821930
Participants:98
Impact:-6.1 percentage points (14.3% vs 20.4%)
Trust score:4/5

Giving recombinant human TSH before radioiodine therapy led to greater thyroid size reduction but much higher rates of permanent hypothyroidism.

Trust comment: Double-blind randomized trial with clear endpoints and significant differences, though sample size modest.

Study Details

PMID:16864757
Participants:57
Impact:more events with rhTSH (34 vs 12; P<0.001)
Trust score:4/5

In 504 low-risk thyroid cancer patients, omission of postoperative radioiodine ablation was non-inferior to ablation for 5-year recurrence-free survival; adverse events were similar.

Trust comment: Large multicentre randomized non-inferiority phase 3 trial with long follow-up and rigorous endpoints.

Study Details

PMID:40543520
Participants:504
Impact:Similar between groups (most common: fatigue, lethargy, dry mouth)
Trust score:5/5

Iomeprol-400 produced greater arterial and portal venous enhancement on MDCT than iodixanol-320 with similar safety profiles.

Trust comment: Large comparative study with blinded independent readers and objective HU measures; clinically relevant for iodinated contrast selection.

Study Details

PMID:19064592
Participants:183
Impact:1/91 (1.1%) with iomeprol vs 4/92 (4.3%) with iodixanol
Trust score:4/5

Iodopovidone pleurodesis in malignant pleural effusion caused frequent adverse events and raised CRP; efficacy and quality of life were similar for 1% and 2% doses.

Trust comment: Double-blind randomized clinical trial (60 patients) with systematic adverse-event and biomarker measurement, though sample size moderate.

Study Details

PMID:26439936
Participants:60
Impact:227 events total; 47 serious events in 34/60 patients
Trust score:4/5

Randomized double-blind multicenter trial found povidone iodine and dequalinium chloride equivalently improved vaginal infection symptoms with good tolerability.

Trust comment: Multicenter, randomized double-blind design with 180 patients supports reliability of equivalence conclusion, though detailed subgroup effect sizes not provided in excerpt.

Study Details

PMID:12404887
Participants:180
Impact:Low in test group (≈5.8%)
Trust score:4/5

In this small pilot RCT povidone‑iodine showed similar wound healing time to honey and paraffin gauze with no statistically significant differences.

Trust comment: Single‑blind pilot RCT with very small sample (n=35), limiting statistical power and precision.

Study Details

PMID:39137253
Participants:35
Impact:fewer adverse events reported in povidone‑iodine and honey groups (no counts reported)
Trust score:3/5

thyroid 131I uptake

1 evidences

Two weeks of a low‑iodine diet reduced urinary iodine similarly to three weeks and increased thyroid 131I uptake (numerically greater in 2-week group but not significantly different).

Trust comment: Randomized comparison with clear biochemical endpoints but small sample size limits precision.

Study Details

PMID:21162685
Participants:46
Impact:increase 43% (2-week) vs 26.7% (3-week) (p=0.105, ns)
Trust score:4/5

contrast agent dosage

1 evidences

Adjusting tube voltage and iodine delivery rate by weight in CCTA reduced contrast agent dose and radiation exposure while preserving or improving image quality.

Trust comment: Prospective randomized controlled imaging study with substantial sample size and objective dose metrics.

Study Details

PMID:38462355
Participants:297
Impact:mean 38.28 ml vs 45.31 ml (test vs control) — significantly lower in test group
Trust score:4/5

subjective image quality / CT values

1 evidences

Adjusting tube voltage and iodine delivery rate by weight in CCTA reduced contrast agent dose and radiation exposure while preserving or improving image quality.

Trust comment: Prospective randomized controlled imaging study with substantial sample size and objective dose metrics.

Study Details

PMID:38462355
Participants:297
Impact:test group had higher CT values and superior subjective image scores (significant)
Trust score:4/5

lesion progression to severe dysplasia / carcinoma / ESCC

1 evidences

Absence of iodine staining at baseline endoscopy identified lesions at higher risk of progression to severe dysplasia or esophageal cancer; a prediction model combining staining and clinical features performed well.

Trust comment: Large prospective trial with development and external validation cohorts and strong predictive performance.

Study Details

PMID:31518715
Participants:1468
Impact:non-staining lesions accounted for ~39.3% (development) and 50.0% (validation) of progressed lesions
Trust score:5/5

predictive model performance (AUC)

1 evidences

Absence of iodine staining at baseline endoscopy identified lesions at higher risk of progression to severe dysplasia or esophageal cancer; a prediction model combining staining and clinical features performed well.

Trust comment: Large prospective trial with development and external validation cohorts and strong predictive performance.

Study Details

PMID:31518715
Participants:1468
Impact:AUC 0.868 (development) and 0.850 (validation)
Trust score:5/5

patient discomfort / pain (heartburn and retrosternal pain)

1 evidences

In a double-blind RCT, 1% iodine caused less patient-reported heartburn/retrosternal pain than 2% iodine during chromoendoscopy, with equivalent staining quality.

Trust comment: Prospective double-blind RCT (n=77) with clear patient-centered endpoints and appropriate analysis.

Study Details

PMID:31669091
Participants:77
Impact:11 patients reported pain: 2 in 1% group vs 9 in 2% group (p = 0.02); 2% produced significantly more pain
Trust score:4/5

staining quality / detection yield

1 evidences

In a double-blind RCT, 1% iodine caused less patient-reported heartburn/retrosternal pain than 2% iodine during chromoendoscopy, with equivalent staining quality.

Trust comment: Prospective double-blind RCT (n=77) with clear patient-centered endpoints and appropriate analysis.

Study Details

PMID:31669091
Participants:77
Impact:no significant difference between 1% and 2% iodine
Trust score:4/5

recurrence rate

5 evidences

Povidone-iodine pleurodesis reduced drainage time and hospital stay versus surveillance with acceptable complications.

Trust comment: Randomized prospective trial with registry design but small sample size (n=40) supports moderate confidence.

Study Details

PMID:34904450
Participants:40
Impact:-4.76 percentage points (0% vs 4.76% recurrence; Group A vs B)
Trust score:4/5

In 460 untreated hyperthyroid patients followed ~9 years, radioiodine (131I) produced higher cure rates and lower recurrence but more hypothyroidism versus antithyroid drugs.

Trust comment: Large randomized prospective trial with blinded endpoint assessment and long follow-up; open-label treatment is a limitation.

Study Details

PMID:19194213
Participants:460
Impact:-24.3 percentage points (6.2% vs 30.5%)
Trust score:4/5

Adding iodine-131 to levothyroxine after thyroid cancer surgery improved response rate and reduced one-year recurrence without increasing side effects.

Trust comment: Large prospective randomized controlled trial with 1-year follow-up; well-powered but limited detail on blinding.

Study Details

PMID:39307136
Participants:374
Impact:-5.89 percentage points (2.67% vs 8.56%)
Trust score:4/5

In 228 low-risk DTC patients randomized to low- (1850 MBq) or high-dose (3700 MBq) radioiodine, long-term recurrence, survival, and biochemical outcomes were similar between doses.

Trust comment: Prospective randomized clinical trial with adequate sample size and long-term follow-up showing equivalent clinical outcomes.

Study Details

PMID:39233456
Participants:228
Impact:low-dose 9/117 (8.7%) vs high-dose 8/111 (8.2%); no significant difference
Trust score:5/5

Sentinel lymph node biopsy detected occult lateral metastases but did not change stimulated thyroglobulin after ablation or recurrence rates at median 39-month follow-up.

Trust comment: Randomized controlled trial with adequate sample size and median 39-month follow-up, though some sTg data were missing for subsets.

Study Details

PMID:25633731
Participants:283
Impact:1 case (LSLNB) vs 3 cases (control) over median 39 months
Trust score:4/5

Survival

1 evidences

In 228 low-risk DTC patients randomized to low- (1850 MBq) or high-dose (3700 MBq) radioiodine, long-term recurrence, survival, and biochemical outcomes were similar between doses.

Trust comment: Prospective randomized clinical trial with adequate sample size and long-term follow-up showing equivalent clinical outcomes.

Study Details

PMID:39233456
Participants:228
Impact:100% (low-dose) vs 98.2% (high-dose); no significant difference
Trust score:5/5

biochemical abnormalities

1 evidences

In 228 low-risk DTC patients randomized to low- (1850 MBq) or high-dose (3700 MBq) radioiodine, long-term recurrence, survival, and biochemical outcomes were similar between doses.

Trust comment: Prospective randomized clinical trial with adequate sample size and long-term follow-up showing equivalent clinical outcomes.

Study Details

PMID:39233456
Participants:228
Impact:no significant differences between groups at 6–10 years
Trust score:5/5

prevalence of anaemia in women

1 evidences

In rural Ghana, double-fortified salt (iron+iodine) prevented an increase in women's anemia and reduced anemia in children versus iodised salt alone, while iodine status improved similarly across groups.

Trust comment: Double-blind randomized controlled trial with reasonably sized cohorts showing clinically relevant effects on anemia; iodine outcomes consistent across groups.

Study Details

PMID:18232268
Participants:266
Impact:unchanged in DFS and IS+weekly iron groups; increased by 19.5% in control (IS+placebo) (P = 0.039)
Trust score:4/5

prevalence of anaemia in children

1 evidences

In rural Ghana, double-fortified salt (iron+iodine) prevented an increase in women's anemia and reduced anemia in children versus iodised salt alone, while iodine status improved similarly across groups.

Trust comment: Double-blind randomized controlled trial with reasonably sized cohorts showing clinically relevant effects on anemia; iodine outcomes consistent across groups.

Study Details

PMID:18232268
Participants:266
Impact:DFS group decreased by 21.7% (P = 0.025); no change in control
Trust score:4/5

iodine deficiency (ID) prevalence

1 evidences

In rural Ghana, double-fortified salt (iron+iodine) prevented an increase in women's anemia and reduced anemia in children versus iodised salt alone, while iodine status improved similarly across groups.

Trust comment: Double-blind randomized controlled trial with reasonably sized cohorts showing clinically relevant effects on anemia; iodine outcomes consistent across groups.

Study Details

PMID:18232268
Participants:266
Impact:ID decreased significantly in all groups of women and children with no differences between groups
Trust score:4/5

patient-reported stress

1 evidences

In a randomized trial of women undergoing breast-conserving surgery, use of iodine-125 seed localisation (ROLLIS) produced significantly less patient-reported stress and discomfort than hookwire localisation.

Trust comment: Multi-centre randomized trial (n=218) with high response rates for patient-reported outcomes and adjusted multivariate analysis.

Study Details

PMID:29102440
Participants:218
Impact:HWL associated with higher odds of greater stress vs ROLLIS (OR 2.07, p = 0.01)
Trust score:4/5

patient-reported discomfort

1 evidences

In a randomized trial of women undergoing breast-conserving surgery, use of iodine-125 seed localisation (ROLLIS) produced significantly less patient-reported stress and discomfort than hookwire localisation.

Trust comment: Multi-centre randomized trial (n=218) with high response rates for patient-reported outcomes and adjusted multivariate analysis.

Study Details

PMID:29102440
Participants:218
Impact:HWL associated with higher odds of greater discomfort vs ROLLIS (OR 1.94, p = 0.01)
Trust score:4/5

serum amylase increase after I therapy

1 evidences

Parotid gland massage during high-dose radioactive iodine therapy reduced serum amylase rise and lowered the rate of parotid salivary gland dysfunction on 8-month scintigraphy.

Trust comment: Randomized clinical trial in humans (100 enrolled, ~95 with follow-up) with objective biochemical and imaging endpoints showing a protective effect of massage.

Study Details

PMID:31274608
Participants:95
Impact:smaller increase in massage group vs non-massage (P = 0.0052)
Trust score:4/5

parotid gland dysfunction on follow-up scintigraphy

1 evidences

Parotid gland massage during high-dose radioactive iodine therapy reduced serum amylase rise and lowered the rate of parotid salivary gland dysfunction on 8-month scintigraphy.

Trust comment: Randomized clinical trial in humans (100 enrolled, ~95 with follow-up) with objective biochemical and imaging endpoints showing a protective effect of massage.

Study Details

PMID:31274608
Participants:95
Impact:incidence lower in massage group (OR 0.3704; P = 0.0195); massage significantly associated with fewer abnormalities at 8 months
Trust score:4/5

hemoglobin

6 evidences

One-year multicenter community trial: double-fortified salt (iron + iodine) was stable in storage and improved hemoglobin and corrected iodine deficiency similarly to iodized salt; DFS increased hemoglobin more than iodized salt.

Trust comment: Large multicenter community trial with real-world implementation and objective hemoglobin and urinary iodine outcomes, though some sampling limitations and single-blind design.

Study Details

PMID:17718017
Participants:829
Impact:+1.98 g/dL in DFS (experimental) vs +0.77 g/dL in control over 1 year (significant, P<0.05)
Trust score:4/5

Fortified salt containing iodine and other micronutrients given to children and women for 8 months improved iron and zinc status and reduced anemia; urinary iodine was maintained in the fortified group.

Trust comment: Randomized controlled community trial with clearly reported biomarker outcomes and reasonable sample size, though potential implementation/contextual confounders exist.

Study Details

PMID:33952731
Participants:212
Impact:+>1.05 g/dL (experimental vs control)
Trust score:4/5

10-month double-blind randomized trial in schoolchildren showed triple-fortified salt improved hemoglobin, iron stores, and vitamin A status vs iodized salt.

Trust comment: Randomized double-blind trial in children with clear biomarker and prevalence improvements; moderate sample size.

Study Details

PMID:15531677
Participants:157
Impact:mean increase in TFS group +15 g/L at 10 months (P < 0.01)
Trust score:4/5

Women consuming salt fortified with iron and iodine showed improved iron markers versus iodized-salt controls after ~8–9 months.

Trust comment: Well-conducted double-blind randomized controlled trial with appropriate biomarkers and adequate sample (n=212).

Study Details

PMID:24744318
Participants:212
Impact:increase attributable to DFS ~+2.4 g/L (GLM adjusted effect)
Trust score:5/5

In iodine-deficient children, salt fortified with iodine plus micronized iron increased hemoglobin and iron stores and improved urinary iodine and thyroid volume over 10 months.

Trust comment: Randomized double-blind controlled trial in 158 children with clear biochemical outcomes; well-conducted though limited to one region.

Study Details

PMID:15447905
Participants:158
Impact:+16 g/L
Trust score:4/5

Children given multiple-micronutrient fortified salt (includes iodine) had better blood nutrient markers and improved memory compared with iodized-salt controls.

Trust comment: Randomized controlled trial with large sample and biochemical outcomes supports credibility, though multiple nutrients were co-administered so iodine-specific effects cannot be isolated.

Study Details

PMID:20533221
Participants:402
Impact:+0.67 g/dL (post-intervention vs control, p<0.05)
Trust score:4/5

body iron stores

1 evidences

In iodine-deficient children, salt fortified with iodine plus micronized iron increased hemoglobin and iron stores and improved urinary iodine and thyroid volume over 10 months.

Trust comment: Randomized double-blind controlled trial in 158 children with clear biochemical outcomes; well-conducted though limited to one region.

Study Details

PMID:15447905
Participants:158
Impact:increased (P<0.01)
Trust score:4/5

practice score

1 evidences

A 6-month community cluster education program for women markedly raised knowledge, attitudes and practices related to iodized salt use.

Trust comment: Cluster randomized controlled trial with high follow-up (99%); outcomes are validated KAP scores though no biochemical iodine status was measured.

Study Details

PMID:33198715
Participants:647
Impact:mean increase +3.11 points (adjusted effect ~2.90)
Trust score:4/5

thyroidal iodide uptake

1 evidences

Short-course lithium before radioiodine increased thyroid iodide uptake, lowered circulating T3/T4 levels, and improved early radioiodine therapy outcomes in hyperthyroid patients.

Trust comment: Clinical treatment study with 3-year follow-up showing consistent physiological effects but appears non-randomized/heterogeneous so moderate confidence.

Study Details

PMID:21751165
Participants:128
Impact:increased (observed in 106/128 patients)
Trust score:3/5

serum T3/T4 levels

1 evidences

Short-course lithium before radioiodine increased thyroid iodide uptake, lowered circulating T3/T4 levels, and improved early radioiodine therapy outcomes in hyperthyroid patients.

Trust comment: Clinical treatment study with 3-year follow-up showing consistent physiological effects but appears non-randomized/heterogeneous so moderate confidence.

Study Details

PMID:21751165
Participants:128
Impact:decreased (T3, FT3, T4, FT4 decreased; TSH unchanged)
Trust score:3/5

radioiodine therapy efficacy (first year)

1 evidences

Short-course lithium before radioiodine increased thyroid iodide uptake, lowered circulating T3/T4 levels, and improved early radioiodine therapy outcomes in hyperthyroid patients.

Trust comment: Clinical treatment study with 3-year follow-up showing consistent physiological effects but appears non-randomized/heterogeneous so moderate confidence.

Study Details

PMID:21751165
Participants:128
Impact:improved (better results in year 1 vs control)
Trust score:3/5

Th1 immune pathway activation

1 evidences

In a pilot randomized trial, molecular iodine (5 mg/day) given perioperatively (and with chemotherapy in advanced cases) activated antitumor immune pathways and induced epigenetic changes in breast tumors.

Trust comment: Randomized pilot with transcriptomic, IHC and methylation data but small sample sizes and pooled analyses limit generalizability.

Study Details

PMID:34680134
Participants:60
Impact:increased (≥2-fold gene expression in treated tumors)
Trust score:3/5

IFNγ expression

1 evidences

In a pilot randomized trial, molecular iodine (5 mg/day) given perioperatively (and with chemotherapy in advanced cases) activated antitumor immune pathways and induced epigenetic changes in breast tumors.

Trust comment: Randomized pilot with transcriptomic, IHC and methylation data but small sample sizes and pooled analyses limit generalizability.

Study Details

PMID:34680134
Participants:60
Impact:increased (mRNA and protein)
Trust score:3/5

T-BET expression

1 evidences

In a pilot randomized trial, molecular iodine (5 mg/day) given perioperatively (and with chemotherapy in advanced cases) activated antitumor immune pathways and induced epigenetic changes in breast tumors.

Trust comment: Randomized pilot with transcriptomic, IHC and methylation data but small sample sizes and pooled analyses limit generalizability.

Study Details

PMID:34680134
Participants:60
Impact:increased (protein level)
Trust score:3/5

TGF-β expression

1 evidences

In a pilot randomized trial, molecular iodine (5 mg/day) given perioperatively (and with chemotherapy in advanced cases) activated antitumor immune pathways and induced epigenetic changes in breast tumors.

Trust comment: Randomized pilot with transcriptomic, IHC and methylation data but small sample sizes and pooled analyses limit generalizability.

Study Details

PMID:34680134
Participants:60
Impact:decreased/suppressed (including loss of unmethylated active form in Cht+I2)
Trust score:3/5

intratumoral immune infiltration (CD8+/NK/B cells, APC)

1 evidences

In a pilot randomized trial, molecular iodine (5 mg/day) given perioperatively (and with chemotherapy in advanced cases) activated antitumor immune pathways and induced epigenetic changes in breast tumors.

Trust comment: Randomized pilot with transcriptomic, IHC and methylation data but small sample sizes and pooled analyses limit generalizability.

Study Details

PMID:34680134
Participants:60
Impact:increased (greater cytotoxic and APC signatures)
Trust score:3/5

effective radiation dose

11 evidences

Forty patients underwent CT angiography with a low-iodine contrast protocol; image quality remained diagnostic while iodine dose and radiation dose were reduced.

Trust comment: Prospective randomized imaging study with objective dose metrics and blinded image assessment but modest sample size (n=40).

Study Details

PMID:27577517
Participants:40
Impact:reduced by ~11.01% vs conventional protocol
Trust score:4/5

Randomized whole-body CTA trial showing that low tube voltage with low-concentration contrast reduces iodine load and radiation while preserving vascular enhancement and image quality.

Trust comment: Randomized study of 109 patients with quantitative imaging and dose metrics; methods appropriate though subgroup comparisons moderate in size.

Study Details

PMID:24370154
Participants:109
Impact:370-120 group higher (2.8–5.4 mSv) vs other groups (2.3–4.3 mSv)
Trust score:4/5

In 255 patients, deep learning image reconstruction plus high-concentration iodinated contrast enabled a double-low protocol (lower radiation and lower contrast volume) while maintaining or improving image quality.

Trust comment: Prospective single-center randomized assignment with clear quantitative imaging endpoints and 255 patients; vendor-specific DLIR limits generalizability.

Study Details

PMID:39299952
Participants:255
Impact:Groups B/C ED 2.36–2.39 mSv vs Group A 4.07 mSv (≈ −42% ED reduction for B/C vs A)
Trust score:4/5

In 120 patients, low-iodine-concentration contrast (iodixanol 270 mgI/ml) with low tube voltage and iterative reconstruction achieved comparable image quality to higher-concentration contrast while substantially reducing radiation dose.

Trust comment: Randomized assignment, objective imaging endpoints, and clear radiation dose measurements support good internal validity.

Study Details

PMID:25391867
Participants:120
Impact:reduced by ~50% (dose savings 53.2% and 50.6% in low and high weight subgroups; p<0.01)
Trust score:4/5

Using lower-concentration iodine contrast with lower tube voltage reduced radiation and kept acceptable image quality.

Trust comment: Prospective randomized study with objective image metrics and clear endpoints, but modest sample size (n=63).

Study Details

PMID:26388465
Participants:63
Impact:-2.26 mSv (3.44 vs 5.70 mSv; −39.7%)
Trust score:4/5

Lower tube voltage plus iterative reconstruction allowed a ~26% lower iodine load and ~35% lower radiation dose while keeping image quality similar.

Trust comment: Prospective multicenter randomized trial with 231 patients and objective imaging/radiation measurements supports good reliability.

Study Details

PMID:25843243
Participants:231
Impact:-34.9% (2.3 mSv vs 3.5 mSv)
Trust score:4/5

Low tube voltage + low-concentration contrast and iterative reconstruction produced similar image quality with lower radiation and iodine dose.

Trust comment: Randomized imaging study with objective measures but moderate sample size and single-technology setting limits generalizability.

Study Details

PMID:27577515
Participants:154
Impact:-63% (Group B vs Group A)
Trust score:3/5

Prospective comparison of 80 kVp with moderate-concentration iodinated contrast vs 120 kVp with high-concentration contrast for renal CTA in 50 patients.

Trust comment: Prospective human study with balanced groups and objective imaging metrics; sample size moderate but appropriate for imaging endpoints.

Study Details

PMID:22733899
Participants:50
Impact:-8.2% (4.5 mSv vs 4.9 mSv) with 80 kVp protocol
Trust score:4/5

Using 80 kVp plus iterative reconstruction allowed reduction of iodine contrast dose while maintaining or improving some image metrics and lowering radiation dose.

Trust comment: Randomized 3-arm human study with objective image and dose metrics and adequate sample size.

Study Details

PMID:25677790
Participants:90
Impact:significantly lower using 80-kVp protocol
Trust score:4/5

A personalized diluted contrast protocol with a test bolus produced diagnostic craniocervical CTA while significantly reducing radiation dose and iodine uptake.

Trust comment: Prospective randomized design with objective dose and attenuation measures and diagnostic-quality imaging.

Study Details

PMID:39198109
Participants:86
Impact:significantly lower with the personalized low-concentration protocol (group B)
Trust score:4/5

Compared low- vs high-iodine contrast protocols in 100 patients undergoing aortic CT to assess image quality, radiation dose, and adverse effects.

Trust comment: Randomized allocation, clear methodology and objective measures in 100 patients, but single-center and modest sample size per group.

Study Details

PMID:25643353
Participants:100
Impact:-34% (4.40 vs 6.73 mSv; low-iodine vs high-iodine)
Trust score:4/5

serum ferritin

2 evidences

Women consuming salt fortified with iron and iodine showed improved iron markers versus iodized-salt controls after ~8–9 months.

Trust comment: Well-conducted double-blind randomized controlled trial with appropriate biomarkers and adequate sample (n=212).

Study Details

PMID:24744318
Participants:212
Impact:increase in DFS vs control +11.6 µg/L (difference-in-difference)
Trust score:5/5

Biscuits fortified with encapsulated ferrous sulfate plus potassium iodate raised women's iron stores and increased urinary iodine concentrations over 22 weeks.

Trust comment: Randomized double-blind controlled trial with biochemical outcomes and adequate sample size for target population.

Study Details

PMID:19653920
Participants:279
Impact:+88% (encapsulated FeSO4 group vs control; P<0.001)
Trust score:5/5

Serum retinol

1 evidences

A fortified biscuit increased urinary iodine and improved vitamin A and iron markers during school terms, but many gains (except urinary iodine) fell back after long school holidays.

Trust comment: Longitudinal cohort (n=108) with serial biochemical measures showing short‑term benefits and seasonal loss of effect; limited by school‑term/holiday confounding.

Study Details

PMID:11796083
Participants:108
Impact:improved during first 12 months but declined after long holidays (partial rebound during school terms)
Trust score:3/5

anemia prevalence

1 evidences

Fortified biscuits (including iodine) increased iodine and other micronutrient status and reduced anemia in primary schoolchildren and improved deworming effectiveness.

Trust comment: Large randomized, double-blind, placebo-controlled trial with clear biochemical endpoints and adequate sample size.

Study Details

PMID:19321576
Participants:510
Impact:- >40% (risk reduction)
Trust score:5/5

euthyroid without medication

1 evidences

88 patients with Graves' were randomized to different I-131 dosing methods; no dosing method proved superior.

Trust comment: Randomized trial in humans with long follow-up (mean 63 months); clear design though no advantage shown.

Study Details

PMID:12629071
Participants:88
Impact:no significant difference between fixed and adjusted dose methods
Trust score:4/5

hypothyroidism requiring L-T4

1 evidences

88 patients with Graves' were randomized to different I-131 dosing methods; no dosing method proved superior.

Trust comment: Randomized trial in humans with long follow-up (mean 63 months); clear design though no advantage shown.

Study Details

PMID:12629071
Participants:88
Impact:no significant difference between fixed and adjusted dose methods
Trust score:4/5

time to clinical outcome

1 evidences

88 patients with Graves' were randomized to different I-131 dosing methods; no dosing method proved superior.

Trust comment: Randomized trial in humans with long follow-up (mean 63 months); clear design though no advantage shown.

Study Details

PMID:12629071
Participants:88
Impact:no significant difference between dose methods
Trust score:4/5

cough-specific quality of life (PC-QOL)

1 evidences

Children with URTI and postnasal drip received salso-bromo-iodine thermal water or saline; the iodine-containing solution improved cough-related outcomes.

Trust comment: Randomized single-blind pilot RCT in children with statistically significant differences but limited by pilot scope.

Study Details

PMID:29450988
Participants:140
Impact:improved with SBI-H-GSE vs saline (p=0.011)
Trust score:3/5

nasal mucociliary transport time (NMTT)

1 evidences

Children with URTI and postnasal drip received salso-bromo-iodine thermal water or saline; the iodine-containing solution improved cough-related outcomes.

Trust comment: Randomized single-blind pilot RCT in children with statistically significant differences but limited by pilot scope.

Study Details

PMID:29450988
Participants:140
Impact:reduced with SBI-H-GSE vs saline (p=0.047)
Trust score:3/5

PND-related symptoms and signs

1 evidences

Children with URTI and postnasal drip received salso-bromo-iodine thermal water or saline; the iodine-containing solution improved cough-related outcomes.

Trust comment: Randomized single-blind pilot RCT in children with statistically significant differences but limited by pilot scope.

Study Details

PMID:29450988
Participants:140
Impact:reduced prevalence with SBI-H-GSE (all p<0.005 except cobblestone mucosa)
Trust score:3/5

duration of URTI symptoms

1 evidences

Children with URTI and postnasal drip received salso-bromo-iodine thermal water or saline; the iodine-containing solution improved cough-related outcomes.

Trust comment: Randomized single-blind pilot RCT in children with statistically significant differences but limited by pilot scope.

Study Details

PMID:29450988
Participants:140
Impact:shorter with SBI-H-GSE (p=0.023)
Trust score:3/5

antibiotic usage

1 evidences

Children with URTI and postnasal drip received salso-bromo-iodine thermal water or saline; the iodine-containing solution improved cough-related outcomes.

Trust comment: Randomized single-blind pilot RCT in children with statistically significant differences but limited by pilot scope.

Study Details

PMID:29450988
Participants:140
Impact:reduced with SBI-H-GSE (p=0.011)
Trust score:3/5

Soluble transferrin receptor (sTfR)

2 evidences

Using multiple micronutrient-fortified salt in school meals improved markers of iron status but did not change urinary iodine or serum ferritin over one year.

Trust comment: Pre-post field study with an intervention and reference group gives useful real-world data but lacks randomized individual allocation and has potential confounders.

Study Details

PMID:32990618
Participants:228
Impact:decreased in intervention (-0.80 mg/L) vs increased in reference (+0.47 mg/L)
Trust score:3/5

Women consuming salt fortified with iron and iodine showed improved iron markers versus iodized-salt controls after ~8–9 months.

Trust comment: Well-conducted double-blind randomized controlled trial with appropriate biomarkers and adequate sample (n=212).

Study Details

PMID:24744318
Participants:212
Impact:decrease in DFS vs control −0.90 mg/L (difference-in-difference)
Trust score:5/5

body iron

1 evidences

Women consuming salt fortified with iron and iodine showed improved iron markers versus iodized-salt controls after ~8–9 months.

Trust comment: Well-conducted double-blind randomized controlled trial with appropriate biomarkers and adequate sample (n=212).

Study Details

PMID:24744318
Participants:212
Impact:increase in DFS vs control +1.74 mg/kg (difference-in-difference)
Trust score:5/5

aorta contrast enhancement

1 evidences

Seventy patients randomized to contrast media with 300 vs 370 mg/ml iodine; overall enhancement was similar between concentrations.

Trust comment: Randomized human imaging study with modest sample size and surrogate imaging endpoints; findings limited to enhancement measures.

Study Details

PMID:15309493
Participants:70
Impact:no significant difference between 300 and 370 mg/ml iodine concentrations
Trust score:3/5

portal vein contrast enhancement

1 evidences

Seventy patients randomized to contrast media with 300 vs 370 mg/ml iodine; overall enhancement was similar between concentrations.

Trust comment: Randomized human imaging study with modest sample size and surrogate imaging endpoints; findings limited to enhancement measures.

Study Details

PMID:15309493
Participants:70
Impact:no significant difference except at late arterial phase (significant difference)
Trust score:3/5

liver parenchyma enhancement

1 evidences

Seventy patients randomized to contrast media with 300 vs 370 mg/ml iodine; overall enhancement was similar between concentrations.

Trust comment: Randomized human imaging study with modest sample size and surrogate imaging endpoints; findings limited to enhancement measures.

Study Details

PMID:15309493
Participants:70
Impact:no significant difference between concentrations
Trust score:3/5

iron status / body iron

1 evidences

10-month double-blind randomized trial in schoolchildren showed triple-fortified salt improved hemoglobin, iron stores, and vitamin A status vs iodized salt.

Trust comment: Randomized double-blind trial in children with clear biomarker and prevalence improvements; moderate sample size.

Study Details

PMID:15531677
Participants:157
Impact:significant improvement with TFS (P < 0.05)
Trust score:4/5

serum retinol and retinol-binding protein

1 evidences

10-month double-blind randomized trial in schoolchildren showed triple-fortified salt improved hemoglobin, iron stores, and vitamin A status vs iodized salt.

Trust comment: Randomized double-blind trial in children with clear biomarker and prevalence improvements; moderate sample size.

Study Details

PMID:15531677
Participants:157
Impact:increased with TFS (P < 0.01)
Trust score:4/5

prevalence of vitamin A deficiency and iron deficiency anemia

1 evidences

10-month double-blind randomized trial in schoolchildren showed triple-fortified salt improved hemoglobin, iron stores, and vitamin A status vs iodized salt.

Trust comment: Randomized double-blind trial in children with clear biomarker and prevalence improvements; moderate sample size.

Study Details

PMID:15531677
Participants:157
Impact:significantly lower in TFS group at 10 months (P < 0.001)
Trust score:4/5

post-preparation culture positivity

1 evidences

240 patients randomized to ChloraPrep, DuraPrep, or Betadine (povidone-iodine); DuraPrep and Betadine produced fewer positive post-prep cultures than ChloraPrep.

Trust comment: Large randomized prospective trial with clear microbiologic endpoints and adequate follow-up for culture results.

Study Details

PMID:28453340
Participants:240
Impact:ChloraPrep 26.3% vs DuraPrep 3.8% vs Betadine 1.2% (P < .001); DuraPrep and Betadine superior to ChloraPrep
Trust score:4/5

DuraPrep vs Betadine

1 evidences

240 patients randomized to ChloraPrep, DuraPrep, or Betadine (povidone-iodine); DuraPrep and Betadine produced fewer positive post-prep cultures than ChloraPrep.

Trust comment: Large randomized prospective trial with clear microbiologic endpoints and adequate follow-up for culture results.

Study Details

PMID:28453340
Participants:240
Impact:no significant difference in postprep culture rate (P = 1.000)
Trust score:4/5

Tumor uptake of 131I-Metuximab

1 evidences

I-131–labeled Metuximab preferentially accumulates in hepatocellular carcinoma lesions with best tumor:nontumor contrast at ~192 hours.

Trust comment: Small (n=24) clinical imaging study with clear biodistribution data but limited sample size and early-phase scope.

Study Details

PMID:16481737
Participants:24
Impact:Accumulated more in hepatoma; %ID uptake in tumor > comparable normal organs; T/NT >1 at 12–192 h
Trust score:3/5

Optimal imaging time

1 evidences

I-131–labeled Metuximab preferentially accumulates in hepatocellular carcinoma lesions with best tumor:nontumor contrast at ~192 hours.

Trust comment: Small (n=24) clinical imaging study with clear biodistribution data but limited sample size and early-phase scope.

Study Details

PMID:16481737
Participants:24
Impact:Highest tumor:nontumor (T/NT) ratio at 192 h after injection
Trust score:3/5

Selective radiation delivery

1 evidences

I-131–labeled Metuximab preferentially accumulates in hepatocellular carcinoma lesions with best tumor:nontumor contrast at ~192 hours.

Trust comment: Small (n=24) clinical imaging study with clear biodistribution data but limited sample size and early-phase scope.

Study Details

PMID:16481737
Participants:24
Impact:Delivered relatively selective radiation to tumor tissues versus non-target tissues
Trust score:3/5

Apical seed loss

1 evidences

Coated iodine-125 prostate seeds reduced apical seed loss and overall seed loss versus regular loose seeds at 30 days postimplant.

Trust comment: Randomized trial (n=40) with objective imaging endpoints and statistically significant reductions in seed loss.

Study Details

PMID:23477886
Participants:40
Impact:Reduced from 8 seeds (regular) to 1 seed (coated) (p=0.015)
Trust score:4/5

Total seed loss

1 evidences

Coated iodine-125 prostate seeds reduced apical seed loss and overall seed loss versus regular loose seeds at 30 days postimplant.

Trust comment: Randomized trial (n=40) with objective imaging endpoints and statistically significant reductions in seed loss.

Study Details

PMID:23477886
Participants:40
Impact:Reduced from 1.0% (regular) to 0.3% (coated) (trend)
Trust score:4/5

Apical seed displacement

1 evidences

Coated iodine-125 prostate seeds reduced apical seed loss and overall seed loss versus regular loose seeds at 30 days postimplant.

Trust comment: Randomized trial (n=40) with objective imaging endpoints and statistically significant reductions in seed loss.

Study Details

PMID:23477886
Participants:40
Impact:Apical displacement: 0.43 cm (coated) vs 0.31 cm (regular) toward COM (p=0.003)
Trust score:4/5

No evidence of disease at 5 years

1 evidences

In low-risk thyroid cancer, low-activity (1.1 GBq) radioactive iodine ablation was equivalent to high-activity (3.7 GBq); 98% had no evidence of disease at ~5 years.

Trust comment: Large multicentre randomized phase 3 trial with long follow-up and high retention (97%), high-quality evidence for RAI strategies.

Study Details

PMID:29807824
Participants:726
Impact:715/726 patients (98%) had no evidence of disease at median 5.4 years follow-up
Trust score:5/5

Equivalence of RAI activities

1 evidences

In low-risk thyroid cancer, low-activity (1.1 GBq) radioactive iodine ablation was equivalent to high-activity (3.7 GBq); 98% had no evidence of disease at ~5 years.

Trust comment: Large multicentre randomized phase 3 trial with long follow-up and high retention (97%), high-quality evidence for RAI strategies.

Study Details

PMID:29807824
Participants:726
Impact:1.1 GBq radioiodine shown equivalent to 3.7 GBq for ablation outcomes
Trust score:5/5

Local tumor control rate

1 evidences

I-125 seed brachytherapy for lung cancer produced better local tumor control and fewer complications than EBRT; I-125 environmental radiation decreased quickly with time/distance and was blocked by lead aprons.

Trust comment: Small randomized study (n=40) with clinical and environmental measurements but limited sample size and short follow-up detail.

Study Details

PMID:37347183
Participants:40
Impact:Higher in I-125 seed implantation group than EBRT group (reported as superior; numerical values not specified)
Trust score:3/5

Tumor marker response

1 evidences

I-125 seed brachytherapy for lung cancer produced better local tumor control and fewer complications than EBRT; I-125 environmental radiation decreased quickly with time/distance and was blocked by lead aprons.

Trust comment: Small randomized study (n=40) with clinical and environmental measurements but limited sample size and short follow-up detail.

Study Details

PMID:37347183
Participants:40
Impact:CEA, NSE, CYFRA21-1 decreased significantly from baseline in both groups (p<0.05)
Trust score:3/5

Environmental radiation from I-125

1 evidences

I-125 seed brachytherapy for lung cancer produced better local tumor control and fewer complications than EBRT; I-125 environmental radiation decreased quickly with time/distance and was blocked by lead aprons.

Trust comment: Small randomized study (n=40) with clinical and environmental measurements but limited sample size and short follow-up detail.

Study Details

PMID:37347183
Participants:40
Impact:Radiation dose decreased rapidly with time and distance after implantation; lead apron significantly reduces exposure
Trust score:3/5

Contrast agent dose

2 evidences

Combining GSI and ASIR in abdominal CT reduced iodine contrast dose (~14%) and radiation dose (~41%) in higher-BMI patients while maintaining diagnostic image quality.

Trust comment: Prospective IRB-approved feasibility study (n=47) with quantitative dose and image-quality metrics; limited by modest sample size.

Study Details

PMID:26079259
Participants:47
Impact:Reduced by 14.40% (mean 76.92 ml vs 89.86 ml)
Trust score:4/5

Reducing injection rate and contrast dose (iodine-containing agent) in 3D DSA was feasible and produced satisfactory images.

Trust comment: Randomized groups, objective quantitative imaging metrics, moderate sample size and clear outcomes.

Study Details

PMID:26916657
Participants:51
Impact:significantly reduced across groups (low-dose protocols feasible)
Trust score:4/5

Radiation dose (CTDIvol/DLP)

1 evidences

Combining GSI and ASIR in abdominal CT reduced iodine contrast dose (~14%) and radiation dose (~41%) in higher-BMI patients while maintaining diagnostic image quality.

Trust comment: Prospective IRB-approved feasibility study (n=47) with quantitative dose and image-quality metrics; limited by modest sample size.

Study Details

PMID:26079259
Participants:47
Impact:Reduced by ~40–49% across phases; average DLP reduction ~40.68%
Trust score:4/5

Image quality (SNR/CNR)

2 evidences

Low tube voltage + low-concentration contrast and iterative reconstruction produced similar image quality with lower radiation and iodine dose.

Trust comment: Randomized imaging study with objective measures but moderate sample size and single-technology setting limits generalizability.

Study Details

PMID:27577515
Participants:154
Impact:no significant difference / diagnostic quality preserved (~98% vs 97.6% segments)
Trust score:3/5

Combining GSI and ASIR in abdominal CT reduced iodine contrast dose (~14%) and radiation dose (~41%) in higher-BMI patients while maintaining diagnostic image quality.

Trust comment: Prospective IRB-approved feasibility study (n=47) with quantitative dose and image-quality metrics; limited by modest sample size.

Study Details

PMID:26079259
Participants:47
Impact:SNR/CNR improved or similar; all images diagnostic (image quality scores ≥4)
Trust score:4/5

IL-6 response to RAI

1 evidences

Radioactive iodine (RAI) ablation increased inflammatory cytokines (notably IL-6); therapeutic omega-3 given after RAI produced greater anti-inflammatory effects than prophylactic use before RAI.

Trust comment: Randomized subgroup allocation (n=85) with cytokine endpoints; informative about RAI-associated inflammatory changes but moderate sample size and complex design.

Study Details

PMID:35293348
Participants:85
Impact:IL-6 showed an increasing trend after RAI ablation regardless of RAI dose
Trust score:3/5

Persistent elevated cytokines after RAI

1 evidences

Radioactive iodine (RAI) ablation increased inflammatory cytokines (notably IL-6); therapeutic omega-3 given after RAI produced greater anti-inflammatory effects than prophylactic use before RAI.

Trust comment: Randomized subgroup allocation (n=85) with cytokine endpoints; informative about RAI-associated inflammatory changes but moderate sample size and complex design.

Study Details

PMID:35293348
Participants:85
Impact:IL-4, IL-22, and IL-17A remained higher than healthy controls after RAI
Trust score:3/5

Therapeutic omega-3 effects

1 evidences

Radioactive iodine (RAI) ablation increased inflammatory cytokines (notably IL-6); therapeutic omega-3 given after RAI produced greater anti-inflammatory effects than prophylactic use before RAI.

Trust comment: Randomized subgroup allocation (n=85) with cytokine endpoints; informative about RAI-associated inflammatory changes but moderate sample size and complex design.

Study Details

PMID:35293348
Participants:85
Impact:Omega-3 given after RAI reduced Th1+Th17/Th2+Th22 ratios and increased IL-10 versus prophylactic use
Trust score:3/5

pancreas attenuation (HU)

1 evidences

In 57 patients with pancreatic cancer, CT imaging at 80kVp showed that 0.3 gI/kg was the minimum iodine load needed to detect tumors.

Trust comment: Randomized assignment and objective CT measurements in a well-described cohort of 57 patients, moderate sample size and clear outcome measures.

Study Details

PMID:27130049
Participants:57
Impact:158.8 HU (0.5 gI/kg) vs 121.7 HU (0.4 gI/kg) vs 106.6 HU (0.3 gI/kg)
Trust score:4/5

tumor conspicuity/detection threshold

1 evidences

In 57 patients with pancreatic cancer, CT imaging at 80kVp showed that 0.3 gI/kg was the minimum iodine load needed to detect tumors.

Trust comment: Randomized assignment and objective CT measurements in a well-described cohort of 57 patients, moderate sample size and clear outcome measures.

Study Details

PMID:27130049
Participants:57
Impact:minimum iodine load for detection = 0.3 gI/kg
Trust score:4/5

implant dose coverage (V100)

1 evidences

In 40 men randomized to high- or low-activity 125I seeds, higher-activity seeds improved dose coverage, reduced cost, and shortened operating time.

Trust comment: Randomized trial with objective dosimetric endpoints but small sample (n=40); results are clear for short-term procedural outcomes.

Study Details

PMID:15629592
Participants:40
Impact:96.3% ± 3.5% (high-strength) vs 90.4% ± 5.3% (low-strength); p < 0.002
Trust score:4/5

seed cost

1 evidences

In 40 men randomized to high- or low-activity 125I seeds, higher-activity seeds improved dose coverage, reduced cost, and shortened operating time.

Trust comment: Randomized trial with objective dosimetric endpoints but small sample (n=40); results are clear for short-term procedural outcomes.

Study Details

PMID:15629592
Participants:40
Impact:~$2400 per case (high-strength) vs ~$3840 per case (low-strength)
Trust score:4/5

operating room time

1 evidences

In 40 men randomized to high- or low-activity 125I seeds, higher-activity seeds improved dose coverage, reduced cost, and shortened operating time.

Trust comment: Randomized trial with objective dosimetric endpoints but small sample (n=40); results are clear for short-term procedural outcomes.

Study Details

PMID:15629592
Participants:40
Impact:67 ± 16 min (high-strength) vs 85 ± 20 min (low-strength); p < 0.004
Trust score:4/5

plasma/urinary selenium

1 evidences

In 52 New Zealand women, urinary iodine excretion was low and showed no consistent trends during pregnancy or postpartum due to large variability.

Trust comment: Well-described longitudinal sampling but small sample size and large variability limit conclusions about iodine trends.

Study Details

PMID:11396779
Participants:52
Impact:plasma selenium and urinary selenium excretion fell during pregnancy, total selenium excretion greater during pregnancy than postpartum
Trust score:3/5

iodine insufficiency (proportion)

1 evidences

In 208 Thai pregnant women, universal and targeted iodine supplementation were similarly effective at preventing deficiency, but universal supplementation produced more women with iodine above requirement.

Trust comment: Randomized controlled trial with adequate sample size and objective urinary measures; statistically significant difference for above-requirement levels.

Study Details

PMID:32160632
Participants:208
Impact:27.9% (universal) vs 33.3% (targeted); p = 0.508 (no significant difference)
Trust score:4/5

iodine above requirement (proportion)

1 evidences

In 208 Thai pregnant women, universal and targeted iodine supplementation were similarly effective at preventing deficiency, but universal supplementation produced more women with iodine above requirement.

Trust comment: Randomized controlled trial with adequate sample size and objective urinary measures; statistically significant difference for above-requirement levels.

Study Details

PMID:32160632
Participants:208
Impact:47.1% (universal) vs 30.0% (targeted); p = 0.048 (universal higher)
Trust score:4/5

surgical site infection incidence

2 evidences

In 2013 women undergoing unscheduled cesarean, the type of skin preparation (including iodine-alcohol) was not associated with differences in postoperative surgical site infection rates.

Trust comment: Large secondary analysis of a multicenter RCT with adjusted analyses; robust sample though secondary nature limits primary randomization for this comparison.

Study Details

PMID:32727231
Participants:2013
Impact:unadjusted rates ranged 2.9%–5.7%; adjusted ORs vs iodine-alcohol: chlorhexidine 0.71 (95% CI 0.30–1.66), chlorhexidine-alcohol 0.97 (0.41–2.28), combination 0.88 (0.36–2.20) — no significant differences
Trust score:4/5

Randomized study in clean and potentially contaminated operations found similar surgical site infection incidence between povidone-iodine and chlorhexidine preparations.

Trust comment: Randomized longitudinal design with a moderate sample and direct clinical outcome measurement supports moderate confidence.

Study Details

PMID:24573620
Participants:205
Impact:no significant difference between povidone-iodine and chlorhexidine (overall similar rates)
Trust score:4/5

postoperative complication rate

2 evidences

In a review of 170 surgeries, complication rates were similar between iodine-125 seed localization and hook-wire localization for breast-conserving surgery.

Trust comment: Randomized trial overall, but this analysis is based on a subset (170/690) by medical record review, which may introduce selection bias and reduces certainty.

Study Details

PMID:36797222
Participants:170
Impact:ROLLIS 19.5% vs HWL 22.7% (no statistically significant difference)
Trust score:3/5

Compared a sequential thyroid defunctionalization preoperative method to conventional antithyroid drugs plus iodine; the test method reduced bleeding and complications.

Trust comment: Large clinical series with randomized grouping reported benefit in bleeding and complications, but reporting language and methodological detail limit full certainty.

Study Details

PMID:17953380
Participants:476
Impact:Test group 8.61% (21/244) vs control 17.24% (40/232); significant difference (P<0.005)
Trust score:3/5

CTCAE grade II complications

1 evidences

In a review of 170 surgeries, complication rates were similar between iodine-125 seed localization and hook-wire localization for breast-conserving surgery.

Trust comment: Randomized trial overall, but this analysis is based on a subset (170/690) by medical record review, which may introduce selection bias and reduces certainty.

Study Details

PMID:36797222
Participants:170
Impact:ROLLIS 15.9% vs HWL 20.5%
Trust score:3/5

CTCAE grade III complications

1 evidences

In a review of 170 surgeries, complication rates were similar between iodine-125 seed localization and hook-wire localization for breast-conserving surgery.

Trust comment: Randomized trial overall, but this analysis is based on a subset (170/690) by medical record review, which may introduce selection bias and reduces certainty.

Study Details

PMID:36797222
Participants:170
Impact:ROLLIS 3.66% vs HWL 2.27%
Trust score:3/5

Parotid salivary gland absorbed dose

1 evidences

In thyroid cancer patients given therapeutic 131I, sucking vitamin C at various times had only a limited effect on salivary radioiodine dose.

Trust comment: Prospective randomized single-blind controlled trial with 72 analyzable patients and objective dosimetry measures; reasonably reliable though single-center.

Study Details

PMID:20237029
Participants:72
Impact:0.18±0.11, 0.16±0.07, 0.16±0.09, 0.16±0.12 mGy/MBq across groups A–D (P=0.37; no significant difference)
Trust score:4/5

Submandibular salivary gland absorbed dose

1 evidences

In thyroid cancer patients given therapeutic 131I, sucking vitamin C at various times had only a limited effect on salivary radioiodine dose.

Trust comment: Prospective randomized single-blind controlled trial with 72 analyzable patients and objective dosimetry measures; reasonably reliable though single-center.

Study Details

PMID:20237029
Participants:72
Impact:0.19±0.05, 0.17±0.05, 0.18±0.07, 0.17±0.06 mGy/MBq across groups A–D (P=0.28; no significant difference)
Trust score:4/5

Salivary cumulated activity (first 24 h)

1 evidences

In thyroid cancer patients given therapeutic 131I, sucking vitamin C at various times had only a limited effect on salivary radioiodine dose.

Trust comment: Prospective randomized single-blind controlled trial with 72 analyzable patients and objective dosimetry measures; reasonably reliable though single-center.

Study Details

PMID:20237029
Participants:72
Impact:86.08%±7.89% of total cumulated activity (range 75%–98%); no significant intergroup differences
Trust score:4/5

Neutralizing antibody response to OPV serotype 1

1 evidences

In infants given oral iodized oil at first OPV dose, iodized oil did not reduce neutralizing antibody responses to poliovirus serotypes 1–3.

Trust comment: Large randomized double-blind placebo-controlled trial with paired pre/post sera in 478 infants, high-quality design and direct measurements.

Study Details

PMID:10427933
Participants:478
Impact:No reduction in antibody titres after OIO compared with placebo; post-immunization non-detectable antibodies overall 2 (0.4%)
Trust score:5/5

Neutralizing antibody response to OPV serotype 2

1 evidences

In infants given oral iodized oil at first OPV dose, iodized oil did not reduce neutralizing antibody responses to poliovirus serotypes 1–3.

Trust comment: Large randomized double-blind placebo-controlled trial with paired pre/post sera in 478 infants, high-quality design and direct measurements.

Study Details

PMID:10427933
Participants:478
Impact:No reduction in antibody titres after OIO compared with placebo; post-immunization non-detectable antibodies overall 1 (0.2%)
Trust score:5/5

Neutralizing antibody response to OPV serotype 3

1 evidences

In infants given oral iodized oil at first OPV dose, iodized oil did not reduce neutralizing antibody responses to poliovirus serotypes 1–3.

Trust comment: Large randomized double-blind placebo-controlled trial with paired pre/post sera in 478 infants, high-quality design and direct measurements.

Study Details

PMID:10427933
Participants:478
Impact:No reduction in antibody titres after OIO compared with placebo; post-immunization non-detectable antibodies overall 16 (3.3%)
Trust score:5/5

Urinary iodine (UI) at 18 months

1 evidences

Providing lipid-based nutrient supplements containing iodine to young children in a region with iodised salt did not change urinary iodine, TSH, or T4 at 18 months compared with controls.

Trust comment: Cluster-randomized trial with measured biochemical outcomes in 179 children; credible but context-specific to an area with iodised-salt program.

Study Details

PMID:26411504
Participants:179
Impact:No difference between cohorts; combined geometric mean UI 339.2 µg/L (95% CI 298.6–385.2)
Trust score:4/5

thyroid-stimulating hormone (TSH)

1 evidences

Providing lipid-based nutrient supplements containing iodine to young children in a region with iodised salt did not change urinary iodine, TSH, or T4 at 18 months compared with controls.

Trust comment: Cluster-randomized trial with measured biochemical outcomes in 179 children; credible but context-specific to an area with iodised-salt program.

Study Details

PMID:26411504
Participants:179
Impact:No difference between cohorts at baseline or 18 months; combined median TSH 0.8 mU/L (95% CI 0.7–0.8)
Trust score:4/5

Total thyroxine (T4)

1 evidences

Providing lipid-based nutrient supplements containing iodine to young children in a region with iodised salt did not change urinary iodine, TSH, or T4 at 18 months compared with controls.

Trust comment: Cluster-randomized trial with measured biochemical outcomes in 179 children; credible but context-specific to an area with iodised-salt program.

Study Details

PMID:26411504
Participants:179
Impact:No difference between cohorts at baseline or 18 months; combined T4 118 nmol/L (95% CI 114–122)
Trust score:4/5

Urinary iodine/creatinine (UI/Creat)

1 evidences

Daily 225 µg iodine from first trimester increased maternal iodine status, lowered maternal thyroglobulin and altered TSH trends, without adverse thyroid hormone changes.

Trust comment: Randomized placebo-controlled trial with trimester measurements but modest sample size and notable dropouts; results plausible and measured objectively.

Study Details

PMID:31689890
Participants:69
Impact:Iodine vs placebo median UI/Creat at T1: 183.23 vs 65.54 µg/g (p<0.0001); at T2: 171.16 vs 84.19 µg/g (p<0.0001); at T3: 104.88 vs 58.24 µg/g (p=0.10)
Trust score:4/5

thyroglobulin (Tg)

1 evidences

Daily 225 µg iodine from first trimester increased maternal iodine status, lowered maternal thyroglobulin and altered TSH trends, without adverse thyroid hormone changes.

Trust comment: Randomized placebo-controlled trial with trimester measurements but modest sample size and notable dropouts; results plausible and measured objectively.

Study Details

PMID:31689890
Participants:69
Impact:Tg at T2: 6.07 ng/mL (iodine) vs 9.80 ng/mL (placebo), p=0.02 (reduced with supplementation)
Trust score:4/5

Maternal TSH (post-partum T3)

1 evidences

Daily 225 µg iodine from first trimester increased maternal iodine status, lowered maternal thyroglobulin and altered TSH trends, without adverse thyroid hormone changes.

Trust comment: Randomized placebo-controlled trial with trimester measurements but modest sample size and notable dropouts; results plausible and measured objectively.

Study Details

PMID:31689890
Participants:69
Impact:TSH at T3: 1.14 mIU/L (iodine) vs 1.8 mIU/L (placebo), p=0.001 (lower in supplemented group)
Trust score:4/5

Daily iodine intake

1 evidences

Patients with short gut and on parenteral nutrition had similar iodine intake and urinary iodine excretion to controls, indicating maintained iodine status.

Trust comment: Small observational study (n=27) with standard biochemical measures; limited sample size but direct measurements support conclusions.

Study Details

PMID:15979283
Participants:27
Impact:Group I 658±125 µg, Group II 573±204 µg, Group III 629±208 µg (no significant differences)
Trust score:3/5

Daily urinary iodine excretion

1 evidences

Patients with short gut and on parenteral nutrition had similar iodine intake and urinary iodine excretion to controls, indicating maintained iodine status.

Trust comment: Small observational study (n=27) with standard biochemical measures; limited sample size but direct measurements support conclusions.

Study Details

PMID:15979283
Participants:27
Impact:Group I 399±308 µg, Group II 439±192 µg, Group III 370±268 µg (no significant differences)
Trust score:3/5

Urinary iodine to creatinine ratio

1 evidences

Patients with short gut and on parenteral nutrition had similar iodine intake and urinary iodine excretion to controls, indicating maintained iodine status.

Trust comment: Small observational study (n=27) with standard biochemical measures; limited sample size but direct measurements support conclusions.

Study Details

PMID:15979283
Participants:27
Impact:Group I 614±349 µg/g, Group II 354±142 µg/g, Group III 483±292 µg/g (no significant differences)
Trust score:3/5

thyroid hormone concentrations

2 evidences

12-week RCT in women of childbearing age: increasing cow milk intake raised urinary iodine concentration but did not change thyroid hormone or selenium measures.

Trust comment: Well-conducted randomized controlled trial with objective biomarkers (UIC) but modest sample size, limiting power for clinical thyroid outcomes.

Study Details

PMID:29546298
Participants:78
Impact:no significant change
Trust score:4/5

Iodine administration normalized thyroid tests and improved growth; adding selenium did not alter established disease outcomes at 12 months.

Trust comment: Double-blind randomized trial in 324 children with biochemical and clinical outcomes assessed at 12 months.

Study Details

PMID:12816783
Participants:324
Impact:within reference ranges after iodine; not significantly affected by selenium
Trust score:4/5

iron status / body iron stores

1 evidences

Children given multiple-micronutrient fortified salt (includes iodine) had better blood nutrient markers and improved memory compared with iodized-salt controls.

Trust comment: Randomized controlled trial with large sample and biochemical outcomes supports credibility, though multiple nutrients were co-administered so iodine-specific effects cannot be isolated.

Study Details

PMID:20533221
Participants:402
Impact:increased (significant, p<0.05)
Trust score:4/5

memory (cognitive function)

1 evidences

Children given multiple-micronutrient fortified salt (includes iodine) had better blood nutrient markers and improved memory compared with iodized-salt controls.

Trust comment: Randomized controlled trial with large sample and biochemical outcomes supports credibility, though multiple nutrients were co-administered so iodine-specific effects cannot be isolated.

Study Details

PMID:20533221
Participants:402
Impact:improved (p<0.05)
Trust score:4/5

goiter volume reduction

2 evidences

In patients with very large multinodular goiters, giving 0.3 mg rhTSH before I-131 improved thyroid shrinkage but increased transient adverse effects.

Trust comment: Double-blind randomized trial directly testing radioiodine ± rhTSH with MRI follow-up but small sample (n=29).

Study Details

PMID:17566091
Participants:29
Impact:placebo: -34.1% vs rhTSH: -53.3% (between-group P<0.001)
Trust score:4/5

Giving recombinant human TSH before radioiodine therapy led to greater thyroid size reduction but much higher rates of permanent hypothyroidism.

Trust comment: Double-blind randomized trial with clear endpoints and significant differences, though sample size modest.

Study Details

PMID:16864757
Participants:57
Impact:placebo 46.1% vs rhTSH 62.1% (P=0.002)
Trust score:4/5

permanent hypothyroidism incidence

1 evidences

Giving recombinant human TSH before radioiodine therapy led to greater thyroid size reduction but much higher rates of permanent hypothyroidism.

Trust comment: Double-blind randomized trial with clear endpoints and significant differences, though sample size modest.

Study Details

PMID:16864757
Participants:57
Impact:placebo 11% (3/29) vs rhTSH 62% (16/26) (P<0.001)
Trust score:4/5

parotid gland radioiodine uptake/dose

1 evidences

In patients treated with radioiodine, chewing gum did not change parotid gland radioiodine counts in the first 48 hours nor salivary symptoms at 6 months.

Trust comment: Randomized small study with objective imaging endpoints but limited sample size reducing power to detect small effects.

Study Details

PMID:29696945
Participants:22
Impact:no significant difference between chewing-gum and control during first 48 h
Trust score:3/5

salivary gland dysfunction symptoms

1 evidences

In patients treated with radioiodine, chewing gum did not change parotid gland radioiodine counts in the first 48 hours nor salivary symptoms at 6 months.

Trust comment: Randomized small study with objective imaging endpoints but limited sample size reducing power to detect small effects.

Study Details

PMID:29696945
Participants:22
Impact:no significant difference at 6 months follow-up
Trust score:3/5

therapeutic success rate (one-year)

1 evidences

Higher radioiodine activity (1110 MBq) produced greater one-year treatment success than lower activity (555 MBq); dose and patient factors influenced outcome.

Trust comment: Prospective randomized trial with complete follow-up and dosimetric analysis supports findings, though applicability may vary by clinical context.

Study Details

PMID:26204202
Participants:91
Impact:1110 MBq 94.8% vs 555 MBq 77.4% (P=0.02)
Trust score:4/5

radiation absorbed dose effect

1 evidences

Higher radioiodine activity (1110 MBq) produced greater one-year treatment success than lower activity (555 MBq); dose and patient factors influenced outcome.

Trust comment: Prospective randomized trial with complete follow-up and dosimetric analysis supports findings, though applicability may vary by clinical context.

Study Details

PMID:26204202
Participants:91
Impact:>300 Gy success 89% vs <300 Gy 60% (P=0.01)
Trust score:4/5

thyroid nodule prevalence

1 evidences

In an iodine-deficient region, patients with metabolic syndrome had larger thyroid volumes and more nodules than matched controls.

Trust comment: Large case-control study with ultrasound outcomes; observational design limits causal inference and setting is iodine-deficient which affects generalizability.

Study Details

PMID:19633072
Participants:539
Impact:50.4% (MetS) vs 14.6% (controls), P<0.0001
Trust score:3/5

TSH association with MetS

1 evidences

In an iodine-deficient region, patients with metabolic syndrome had larger thyroid volumes and more nodules than matched controls.

Trust comment: Large case-control study with ultrasound outcomes; observational design limits causal inference and setting is iodine-deficient which affects generalizability.

Study Details

PMID:19633072
Participants:539
Impact:TSH positively correlated with presence of MetS (significant)
Trust score:3/5

maternal urinary iodine concentration (UIC)

3 evidences

Pilot study of 36 pregnant/lactating women given 150 µg/day iodine from 20 weeks gestation; urinary and breast milk iodine measured.

Trust comment: Well-measured biochemical endpoints but small pilot sample (n=36) limits generalizability.

Study Details

PMID:30019676
Participants:36
Impact:median UICs 102 → 144 → 112 µg/L at 20 GW, 36 GW, and 4 weeks postpartum; % below cut-off 83% → 56% → 40%
Trust score:3/5

Randomized trial in 80 mother–infant pairs: daily iodine‑fortified milk for 4 weeks increased maternal urinary iodine and breast‑milk iodine compared with control; infant iodine status showed no significant adjusted change.

Trust comment: Multicenter randomized controlled trial with objective biomarkers and good follow-up but short duration (1 month) and modest sample size.

Study Details

PMID:28241419
Participants:80
Impact:median increased from 70.2 to 104.1 µg/L at 1 month (intervention) and decreased to 41.1 µg/L in controls; mixed‑model p<0.001
Trust score:4/5

In moderately iodine-deficient Gambian women, prenatal MMN containing 300 μg iodine improved maternal iodine biomarkers during pregnancy and reduced maternal thyroglobulin, but had minimal impact on maternal thyroid hormones and limited postnatal benefit for breastmilk or infant iodine status.

Trust comment: Randomized trial with good sample size, high compliance, repeated biochemical measures and ICP-MS assays (high quality).

Study Details

PMID:32183608
Participants:397
Impact:MMN median UIC 56→90 μg/L at 30 wk (+34 μg/L) vs FeFol 48→41 μg/L (−7 μg/L); p<0.001
Trust score:5/5

breast milk iodine concentration (BMIC)

3 evidences

Supplementing lactating women with 75 or 150 μg I/day raised maternal urinary iodine and breast-milk iodine but did not fully correct iodine deficiency in mothers or infants.

Trust comment: Randomized, double-blind, placebo-controlled trial with repeated measures and clinically relevant endpoints.

Study Details

PMID:20702609
Participants:109
Impact:placebo: −40% over 24 wk; supplementation: 75 μg/day ≈+30% (1.3×) and 150 μg/day ≈+70% (1.7×) vs placebo
Trust score:5/5

Randomized trial in 80 mother–infant pairs: daily iodine‑fortified milk for 4 weeks increased maternal urinary iodine and breast‑milk iodine compared with control; infant iodine status showed no significant adjusted change.

Trust comment: Multicenter randomized controlled trial with objective biomarkers and good follow-up but short duration (1 month) and modest sample size.

Study Details

PMID:28241419
Participants:80
Impact:median increased from 176.0 to 210.0 µg/L in intervention (baseline‑adjusted increase significant, p<0.001)
Trust score:4/5

In moderately iodine-deficient Gambian women, prenatal MMN containing 300 μg iodine improved maternal iodine biomarkers during pregnancy and reduced maternal thyroglobulin, but had minimal impact on maternal thyroid hormones and limited postnatal benefit for breastmilk or infant iodine status.

Trust comment: Randomized trial with good sample size, high compliance, repeated biochemical measures and ICP-MS assays (high quality).

Study Details

PMID:32183608
Participants:397
Impact:BMIC higher with MMN than FeFol (e.g., 57 vs 51 μg/L at 8 wk); overall MMN > FeFol independent of time (p=0.006)
Trust score:5/5

infant urinary iodine concentration (UIC)

1 evidences

Randomized trial in 80 mother–infant pairs: daily iodine‑fortified milk for 4 weeks increased maternal urinary iodine and breast‑milk iodine compared with control; infant iodine status showed no significant adjusted change.

Trust comment: Multicenter randomized controlled trial with objective biomarkers and good follow-up but short duration (1 month) and modest sample size.

Study Details

PMID:28241419
Participants:80
Impact:no significant difference between groups after adjustment (intervention median ~231 µg/L to ~230 µg/L)
Trust score:4/5

cognitive/language test performance

1 evidences

Cluster randomized trial in 1602 children (4–6 years): market introduction of iodized salt increased children's urinary iodine but produced no overall improvement in cognitive/language test scores; some subgroup benefits observed.

Trust comment: Large cluster randomized effectiveness trial with biomarker and cognitive outcomes, but potential effect modification and context dependence limit broad conclusions.

Study Details

PMID:27145299
Participants:1602
Impact:no significant overall difference between groups on main cognitive tests; subgroup effects (e.g., benefits when mothers had schooling) observed
Trust score:4/5

vascular attenuation (HU)

1 evidences

Randomized study in 33 patients comparing 50 ml vs 100 ml iodinated contrast at different tube voltages: low‑volume (50 ml) at low kV provided non‑inferior vascular enhancement for pulmonary CTA.

Trust comment: Randomized clinical imaging trial with objective measurements but small sample size; results are specific to CT protocol and devices.

Study Details

PMID:27059387
Participants:33
Impact:no significant difference between 50 ml and 100 ml CM at 80 kV (537.9±146.7 vs 634.6±168.3 HU, p=0.088) and 120 kV (410.4±106.0 vs 482.8±127.7 HU, p=0.085)
Trust score:4/5

contrast-to-noise and signal-to-noise ratio (CNR/SNR)

1 evidences

Randomized study in 33 patients comparing 50 ml vs 100 ml iodinated contrast at different tube voltages: low‑volume (50 ml) at low kV provided non‑inferior vascular enhancement for pulmonary CTA.

Trust comment: Randomized clinical imaging trial with objective measurements but small sample size; results are specific to CT protocol and devices.

Study Details

PMID:27059387
Participants:33
Impact:CNR and SNR higher at 120 kV than 80 kV (p=0.000–0.019); no significant differences between 50 ml and 100 ml protocols (p=0.600–0.952)
Trust score:4/5

qualitative vascular enhancement

1 evidences

Randomized study in 33 patients comparing 50 ml vs 100 ml iodinated contrast at different tube voltages: low‑volume (50 ml) at low kV provided non‑inferior vascular enhancement for pulmonary CTA.

Trust comment: Randomized clinical imaging trial with objective measurements but small sample size; results are specific to CT protocol and devices.

Study Details

PMID:27059387
Participants:33
Impact:no significant subjective difference between protocols (p=0.524–1.000)
Trust score:4/5

proportion of contaminated positive cultures

1 evidences

Crossover randomized trial evaluating 10% povidone iodine, 2% iodine tincture, and 2% chlorhexidine for blood culture skin antisepsis across 12,904 culture sets; no significant differences in contamination rates among agents.

Trust comment: Large randomized crossover study with blinded adjudication of positives; robust design though outcome is rare and context-specific.

Study Details

PMID:23221187
Participants:12904
Impact:98 contaminated cultures of 12,904 sets (overall contamination rate 0.76%)
Trust score:4/5

elevated TSH incidence

1 evidences

Over ~14 years, continuous methimazole had better mood/cognition and fewer thyroid, lipid, and some cardiac abnormalities than radioiodine replacement.

Trust comment: Long follow-up and many measures with randomized and voluntary arms; moderate-to-high quality though some patients self-selected and only 132 completed follow-up.

Study Details

PMID:22827783
Participants:132
Impact:+23% (RR 1.23 for TSH >5 mU/L in RAI vs MMI)
Trust score:4/5

adverse lipid profile (↑ triglycerides, ↓ HDL)

1 evidences

Over ~14 years, continuous methimazole had better mood/cognition and fewer thyroid, lipid, and some cardiac abnormalities than radioiodine replacement.

Trust comment: Long follow-up and many measures with randomized and voluntary arms; moderate-to-high quality though some patients self-selected and only 132 completed follow-up.

Study Details

PMID:22827783
Participants:132
Impact:↑ triglycerides: +120% (RR 2.20); ↑ low HDL incidence: +246% (RR 3.46) in RAI vs MMI
Trust score:4/5

neuropsychological performance

1 evidences

Over ~14 years, continuous methimazole had better mood/cognition and fewer thyroid, lipid, and some cardiac abnormalities than radioiodine replacement.

Trust comment: Long follow-up and many measures with randomized and voluntary arms; moderate-to-high quality though some patients self-selected and only 132 completed follow-up.

Study Details

PMID:22827783
Participants:132
Impact:worse in RAI group; MMI scored better on mood, memory and IQ tests (no effect size reported)
Trust score:4/5

cure rate at 12 months

1 evidences

In Graves' patients with rapid I-131 turnover, the highest I-131 dose (7.4 MBq/g) gave the best 12-month cure rate with fewer side effects than lower-dose regimens with lithium.

Trust comment: Randomized, registered trial with ITT analysis but small sample (n=60) limiting power for some comparisons.

Study Details

PMID:31083231
Participants:60
Impact:80% cure in high-dose I-131 (7.4 MBq/g); absolute +35% vs standard 3.7 MBq/g + Li (95% CI 7–66.8%; P=0.02)
Trust score:4/5

odds of cure over follow-up

1 evidences

In Graves' patients with rapid I-131 turnover, the highest I-131 dose (7.4 MBq/g) gave the best 12-month cure rate with fewer side effects than lower-dose regimens with lithium.

Trust comment: Randomized, registered trial with ITT analysis but small sample (n=60) limiting power for some comparisons.

Study Details

PMID:31083231
Participants:60
Impact:adjusted odds ratio 3.09 (group C vs group A)
Trust score:4/5

treatment side effects

1 evidences

In Graves' patients with rapid I-131 turnover, the highest I-131 dose (7.4 MBq/g) gave the best 12-month cure rate with fewer side effects than lower-dose regimens with lithium.

Trust comment: Randomized, registered trial with ITT analysis but small sample (n=60) limiting power for some comparisons.

Study Details

PMID:31083231
Participants:60
Impact:7 patients reported side effects overall; more events in lithium groups than high-dose I-131 group
Trust score:4/5

periodontitis odds associated with low iodine

1 evidences

Lower urinary iodine was observed in people with periodontitis; a cutoff <76.93 μg/L was associated with high probability of periodontitis in this small sample.

Trust comment: Small sample and unclear design details despite being labeled randomized; findings are associative and need larger confirmatory studies.

Study Details

PMID:39503277
Participants:73
Impact:small increased odds: OR 1.04 (≈+4% odds) for low iodine vs high iodine
Trust score:3/5

vascular CT numbers

1 evidences

Dual-energy CT at 40 keV allowed a 50% reduction in iodine contrast while maintaining or increasing vascular contrast and SNR, but worsened intrapelvic arterial visualization and increased radiation dose slightly.

Trust comment: Controlled imaging study with clear technical outcomes but modest sample size and trade-offs (image quality vs radiation) limit generalizability.

Study Details

PMID:33617294
Participants:65
Impact:increased with DECTA at 40 keV using 50% reduced iodine vs standard SECTA (statistically significant)
Trust score:3/5

signal-to-noise ratio (SNR)

2 evidences

In 255 patients, deep learning image reconstruction plus high-concentration iodinated contrast enabled a double-low protocol (lower radiation and lower contrast volume) while maintaining or improving image quality.

Trust comment: Prospective single-center randomized assignment with clear quantitative imaging endpoints and 255 patients; vendor-specific DLIR limits generalizability.

Study Details

PMID:39299952
Participants:255
Impact:Group B 30.5 vs Group A 21.6 (≈ +41% B vs A); Group C intermediate
Trust score:4/5

Dual-energy CT at 40 keV allowed a 50% reduction in iodine contrast while maintaining or increasing vascular contrast and SNR, but worsened intrapelvic arterial visualization and increased radiation dose slightly.

Trust comment: Controlled imaging study with clear technical outcomes but modest sample size and trade-offs (image quality vs radiation) limit generalizability.

Study Details

PMID:33617294
Participants:65
Impact:increased with reduced-iodine DECTA vs SECTA
Trust score:3/5

intrapelvic arterial depiction

1 evidences

Dual-energy CT at 40 keV allowed a 50% reduction in iodine contrast while maintaining or increasing vascular contrast and SNR, but worsened intrapelvic arterial visualization and increased radiation dose slightly.

Trust comment: Controlled imaging study with clear technical outcomes but modest sample size and trade-offs (image quality vs radiation) limit generalizability.

Study Details

PMID:33617294
Participants:65
Impact:degraded (worse visualization) with reduced-iodine DECTA
Trust score:3/5

radioactive iodine uptake (RAIU)

1 evidences

A single very low dose (0.03 mg) rhTSH markedly increased thyroid radioactive iodine uptake and was well tolerated without lasting thyroid dysfunction at 8 weeks.

Trust comment: Double-blind randomized design with clear, large effect on RAIU in a small but well-conducted trial.

Study Details

PMID:26841373
Participants:40
Impact:increased from 30.44% ±7.4 to 77.22% ±8.7 (absolute +46.78 percentage points; P<0.001)
Trust score:4/5

serum TSH kinetics

1 evidences

A single very low dose (0.03 mg) rhTSH markedly increased thyroid radioactive iodine uptake and was well tolerated without lasting thyroid dysfunction at 8 weeks.

Trust comment: Double-blind randomized design with clear, large effect on RAIU in a small but well-conducted trial.

Study Details

PMID:26841373
Participants:40
Impact:TSH peaked at 24 hours (within normal for euthyroid; slightly above normal in subclinical group at 24h, normalized by 48h)
Trust score:4/5

tolerability and short-term thyroid function

1 evidences

A single very low dose (0.03 mg) rhTSH markedly increased thyroid radioactive iodine uptake and was well tolerated without lasting thyroid dysfunction at 8 weeks.

Trust comment: Double-blind randomized design with clear, large effect on RAIU in a small but well-conducted trial.

Study Details

PMID:26841373
Participants:40
Impact:well tolerated; TSH and fT4 within normal range at 8 weeks
Trust score:4/5

iron status and anemia prevalence

1 evidences

Dual-fortified salt improved iron status and reduced anemia; iodized salt and one dual-fortified formula increased urinary iodine, while the other iron formulation reduced iodine stability in salt.

Trust comment: Large, double-blind randomized household trial with robust biochemical endpoints, though local salt characteristics influenced iodine stability.

Study Details

PMID:18996875
Participants:458
Impact:median ferritin/body iron improved; anemia prevalence fell (MGFePP: 16.8%→7.7%; EFF: 15.1%→5.0%) after 10 months
Trust score:4/5

neonatal FT3 level

1 evidences

Late cord clamping (60 s) was associated with higher neonatal FT3/FT4 and fewer neonates with low vitamin B12 compared with early clamping (≤10 s); urinary iodine results were measured but not emphasized.

Trust comment: Randomized perinatal study with modest sample size; thyroid hormone differences reported but urinary iodine effects were not clearly reported.

Study Details

PMID:34263919
Participants:60
Impact:more newborns had FT3 below normal with early clamping (62.5% vs 28.5%)
Trust score:3/5

neonatal FT4 level

1 evidences

Late cord clamping (60 s) was associated with higher neonatal FT3/FT4 and fewer neonates with low vitamin B12 compared with early clamping (≤10 s); urinary iodine results were measured but not emphasized.

Trust comment: Randomized perinatal study with modest sample size; thyroid hormone differences reported but urinary iodine effects were not clearly reported.

Study Details

PMID:34263919
Participants:60
Impact:more newborns had FT4 below normal with early clamping (15.6% vs 0%)
Trust score:3/5

neonatal vitamin B12 status

1 evidences

Late cord clamping (60 s) was associated with higher neonatal FT3/FT4 and fewer neonates with low vitamin B12 compared with early clamping (≤10 s); urinary iodine results were measured but not emphasized.

Trust comment: Randomized perinatal study with modest sample size; thyroid hormone differences reported but urinary iodine effects were not clearly reported.

Study Details

PMID:34263919
Participants:60
Impact:vitamin B12 below normal more frequent with early clamping (significant)
Trust score:3/5

Post-radioiodine nausea

1 evidences

Randomized trial in DTC patients receiving I-131 comparing antiemetics; ondansetron reduced post-radioiodine nausea versus placebo, pantoprazole and metoclopramide did not.

Trust comment: Randomized single-blind RCT with moderate sample size (85); results plausible but limited by single-blind design and relatively small groups.

Study Details

PMID:24961816
Participants:85
Impact:Ondansetron showed therapeutic benefit vs placebo (p<0.05); pantoprazole and metoclopramide showed no significant benefit (p>0.05)
Trust score:3/5

vomiting

1 evidences

Randomized trial in DTC patients receiving I-131 comparing antiemetics; ondansetron reduced post-radioiodine nausea versus placebo, pantoprazole and metoclopramide did not.

Trust comment: Randomized single-blind RCT with moderate sample size (85); results plausible but limited by single-blind design and relatively small groups.

Study Details

PMID:24961816
Participants:85
Impact:No significant reduction with pantoprazole or metoclopramide (p>0.05); ondansetron beneficial for nausea (vomiting effect not specified)
Trust score:3/5

Local recurrence (5- and 8-year)

1 evidences

Small randomized trial comparing two 125I radiation dose regimens with episcleral hyperthermia in uveal melanoma; outcomes were similar between dose groups.

Trust comment: Prospective randomized trial but very small (n=35) limiting power and generalizability; outcomes reported clearly.

Study Details

PMID:15062131
Participants:35
Impact:Group1 5-/8-year local recurrence 33%; Group2 25% (p=0.73)
Trust score:3/5

Disease-free survival (5-year)

1 evidences

Small randomized trial comparing two 125I radiation dose regimens with episcleral hyperthermia in uveal melanoma; outcomes were similar between dose groups.

Trust comment: Prospective randomized trial but very small (n=35) limiting power and generalizability; outcomes reported clearly.

Study Details

PMID:15062131
Participants:35
Impact:5-year DFS Group1 54% vs Group2 67% (p=0.51)
Trust score:3/5

Overall survival (5-year)

1 evidences

Small randomized trial comparing two 125I radiation dose regimens with episcleral hyperthermia in uveal melanoma; outcomes were similar between dose groups.

Trust comment: Prospective randomized trial but very small (n=35) limiting power and generalizability; outcomes reported clearly.

Study Details

PMID:15062131
Participants:35
Impact:5-year overall survival Group1 68% vs Group2 83% (p=0.60)
Trust score:3/5

Serum iodine

2 evidences

Two long-term dietary patterns affected several serum minerals over 24 months; serum calcium showed no significant change while other minerals (selenium, manganese, magnesium) increased and serum zinc decreased.

Trust comment: Large randomized controlled trial with repeated measures and adequate sample, but mineral status was an incidental (not primary) outcome.

Study Details

PMID:38701651
Participants:368
Impact:no significant change
Trust score:4/5

Small RCT showing povidone-iodine oral irrigation causes rapid increase in serum and urinary iodine but did not change thyroxine levels in the short term.

Trust comment: Randomized controlled study with small sample (n=24); clear biomarker changes documented but limited sample and short follow-up.

Study Details

PMID:34196852
Participants:24
Impact:Increased ~2–3-fold within 15–30 minutes after intraoral povidone-iodine
Trust score:3/5

Free thyroxine (FT4)

1 evidences

Small RCT showing povidone-iodine oral irrigation causes rapid increase in serum and urinary iodine but did not change thyroxine levels in the short term.

Trust comment: Randomized controlled study with small sample (n=24); clear biomarker changes documented but limited sample and short follow-up.

Study Details

PMID:34196852
Participants:24
Impact:No significant change observed in blood FT4 levels
Trust score:3/5

Urinary iodine concentration (MUIC)

1 evidences

Randomized trial testing excess iodate supplementation (various doses with/without selenium) in older adults; excess iodate markedly increased urinary iodine and induced transient thyroid dysfunction in some participants.

Trust comment: Well-powered randomized controlled trial (n=143) with measured biochemical and endocrine outcomes; findings clearly reported though some effects were transient.

Study Details

PMID:21878580
Participants:143
Impact:MUIC increased ~9-fold (Se+highI) and ~6-fold (highI) at week 8, returning toward baseline by week 12
Trust score:4/5

TSH abnormalities

1 evidences

Randomized trial testing excess iodate supplementation (various doses with/without selenium) in older adults; excess iodate markedly increased urinary iodine and induced transient thyroid dysfunction in some participants.

Trust comment: Well-powered randomized controlled trial (n=143) with measured biochemical and endocrine outcomes; findings clearly reported though some effects were transient.

Study Details

PMID:21878580
Participants:143
Impact:10/43 participants in excess iodate group had elevated TSH at week 8 (mostly normalized by week 12); 3 developed TSH<0.10 mIU/L remaining low at week 12
Trust score:4/5

Whole blood glutathione peroxidase (WBGPx)

1 evidences

Randomized trial testing excess iodate supplementation (various doses with/without selenium) in older adults; excess iodate markedly increased urinary iodine and induced transient thyroid dysfunction in some participants.

Trust comment: Well-powered randomized controlled trial (n=143) with measured biochemical and endocrine outcomes; findings clearly reported though some effects were transient.

Study Details

PMID:21878580
Participants:143
Impact:Excess iodate reduced WBGPx activity and attenuated WBGPx increase after selenium supplementation
Trust score:4/5

hearing threshold (>=2000 Hz)

1 evidences

In mildly iodine-deficient Beninese children higher thyroglobulin was linked to worse high-frequency hearing and lower non-verbal test performance.

Trust comment: Randomized placebo-controlled trial in children but abstract reports associations rather than clear quantified effects of supplementation.

Study Details

PMID:11528490
Participants:197
Impact:elevated in children with higher serum thyroglobulin (association)
Trust score:3/5

non-verbal mental test performance

1 evidences

In mildly iodine-deficient Beninese children higher thyroglobulin was linked to worse high-frequency hearing and lower non-verbal test performance.

Trust comment: Randomized placebo-controlled trial in children but abstract reports associations rather than clear quantified effects of supplementation.

Study Details

PMID:11528490
Participants:197
Impact:lower performance associated with higher hearing thresholds
Trust score:3/5

serum thyroglobulin

3 evidences

Inhabitants with high cold exposure (hunters, settlement dwellers) showed signs of increased thyroid activity (higher thyroglobulin) and lower fT3 despite higher urinary iodine excretion.

Trust comment: Population-based cross-sectional study with reasonable sample size (n=535), but observational design limits causal inference.

Study Details

PMID:22170797
Participants:535
Impact:↑ thyroglobulin (highest in hunters and settlement dwellers; P≤0.009)
Trust score:3/5

In mildly iodine-deficient Beninese children higher thyroglobulin was linked to worse high-frequency hearing and lower non-verbal test performance.

Trust comment: Randomized placebo-controlled trial in children but abstract reports associations rather than clear quantified effects of supplementation.

Study Details

PMID:11528490
Participants:197
Impact:higher levels associated with elevated high-frequency hearing thresholds
Trust score:3/5

Randomized trial with >10-year follow-up (analyzed n=151) comparing total thyroidectomy alone vs with prophylactic central compartment lymph node dissection: no differences in oncologic outcomes or rates of permanent hypocalcemia or serum calcium at long-term follow-up.

Trust comment: Large randomized controlled trial with long (>10-year) follow-up and objective biochemical and surgical endpoints.

Study Details

PMID:39983243
Participants:151
Impact:mean 0.1±0.1 ng/mL (no-dissection) vs 0.3±1.3 ng/mL (dissection); no significant difference (P = .146)
Trust score:5/5

infant socio-emotional problems (ASQ:SE)

1 evidences

Giving pregnant women cod twice weekly did not change general infant development but improved infant socio-emotional scores in the first months.

Trust comment: Randomized controlled trial with clear developmental outcomes and mediation analysis; moderate sample size.

Study Details

PMID:33847344
Participants:133
Impact:improved; ~5–6 point lower ASQ:SE scores at 3 and 6 mo (P=0.020)
Trust score:4/5

general infant development (ASQ-2)

1 evidences

Giving pregnant women cod twice weekly did not change general infant development but improved infant socio-emotional scores in the first months.

Trust comment: Randomized controlled trial with clear developmental outcomes and mediation analysis; moderate sample size.

Study Details

PMID:33847344
Participants:133
Impact:no difference between groups (P=0.633)
Trust score:4/5

T4

1 evidences

Short-term high-dose iodine and iodide both raised TSH in healthy men; anticipated differential effects versus animal data were not observed.

Trust comment: Controlled repeated-dose human dosing study with clear hormonal measurements but small sample and short duration.

Study Details

PMID:9761130
Participants:33
Impact:decreases observed but not statistically significant
Trust score:4/5

>90% lesion reduction (TTO + iodine)

1 evidences

Topical combination of tea tree oil plus organically bound iodine cleared molluscum lesions in most children, whereas iodine alone had minimal effect.

Trust comment: Small randomized treatment groups with clear clinical outcome but limited sample size and short follow-up.

Study Details

PMID:22395586
Participants:48
Impact:achieved in 16/19 children (~84%)
Trust score:3/5

>90% lesion reduction (iodine alone)

1 evidences

Topical combination of tea tree oil plus organically bound iodine cleared molluscum lesions in most children, whereas iodine alone had minimal effect.

Trust comment: Small randomized treatment groups with clear clinical outcome but limited sample size and short follow-up.

Study Details

PMID:22395586
Participants:48
Impact:achieved in 1/16 children (~6%)
Trust score:3/5

>90% lesion reduction (TTO alone)

1 evidences

Topical combination of tea tree oil plus organically bound iodine cleared molluscum lesions in most children, whereas iodine alone had minimal effect.

Trust comment: Small randomized treatment groups with clear clinical outcome but limited sample size and short follow-up.

Study Details

PMID:22395586
Participants:48
Impact:achieved in 3/18 children (~17%)
Trust score:3/5

maternal TSH increase

1 evidences

Treating mild iodine deficiency in pregnancy with potassium iodide (with or without T4) reduced maternal thyroid stimulation and normalized neonatal thyroid measures.

Trust comment: Randomized double-blind trial with 180 participants and clinically relevant maternal and neonatal thyroid outcomes.

Study Details

PMID:7829623
Participants:180
Impact:suppressed/minimized in KI and KI+T4 groups versus placebo (less rise than placebo)
Trust score:4/5

maternal serum thyroglobulin (TG)

1 evidences

Treating mild iodine deficiency in pregnancy with potassium iodide (with or without T4) reduced maternal thyroid stimulation and normalized neonatal thyroid measures.

Trust comment: Randomized double-blind trial with 180 participants and clinically relevant maternal and neonatal thyroid outcomes.

Study Details

PMID:7829623
Participants:180
Impact:decreased significantly with active treatment versus placebo
Trust score:4/5

maternal and neonatal thyroid volume

1 evidences

Treating mild iodine deficiency in pregnancy with potassium iodide (with or without T4) reduced maternal thyroid stimulation and normalized neonatal thyroid measures.

Trust comment: Randomized double-blind trial with 180 participants and clinically relevant maternal and neonatal thyroid outcomes.

Study Details

PMID:7829623
Participants:180
Impact:maternal thyroid-volume increase minimized (KI) or suppressed (KI+T4); newborn thyroid volume normalized
Trust score:4/5

malondialdehyde (MDA)

1 evidences

Radioiodine therapy increased oxidative stress markers; vitamin C given before therapy reduced some oxidative enzyme responses versus control.

Trust comment: Clinical study on radioiodine patients with small groups and biochemical endpoints; shows RAIT effects and some vitamin C mitigation but small sample limits generalizability.

Study Details

PMID:29860661
Participants:58
Impact:increased after RAIT in all groups (oxidative stress marker)
Trust score:3/5

catalase (CAT) activity

1 evidences

Radioiodine therapy increased oxidative stress markers; vitamin C given before therapy reduced some oxidative enzyme responses versus control.

Trust comment: Clinical study on radioiodine patients with small groups and biochemical endpoints; shows RAIT effects and some vitamin C mitigation but small sample limits generalizability.

Study Details

PMID:29860661
Participants:58
Impact:increased after RAIT in all groups but increase was significantly lower in groups receiving vitamin C before RAIT versus control
Trust score:3/5

glutathione / SOD

1 evidences

Radioiodine therapy increased oxidative stress markers; vitamin C given before therapy reduced some oxidative enzyme responses versus control.

Trust comment: Clinical study on radioiodine patients with small groups and biochemical endpoints; shows RAIT effects and some vitamin C mitigation but small sample limits generalizability.

Study Details

PMID:29860661
Participants:58
Impact:no consistent significant mitigation reported in abstract
Trust score:3/5

T3 / T4 ratio

1 evidences

Short-term high-dose iodine and iodide both raised TSH in healthy men; anticipated differential effects versus animal data were not observed.

Trust comment: Controlled repeated-dose human dosing study with clear hormonal measurements but small sample and short duration.

Study Details

PMID:9761130
Participants:33
Impact:no consistent differential effect between I2 and I- in humans compared to prior rat data
Trust score:4/5

hemoglobin / red blood cell count

1 evidences

Children eating salt fortified with multiple micronutrients including iodine for one year showed better micronutrient status and improvements on several memory and attention tests.

Trust comment: Moderate quality; one-year intervention with objective labs and cognitive tests but nonrandomized group assignment and potential selection differences.

Study Details

PMID:17704033
Participants:129
Impact:significant increase in experimental group (p<0.05) vs decline in control (p<0.05)
Trust score:3/5

memory and attention (cognition)

1 evidences

Children eating salt fortified with multiple micronutrients including iodine for one year showed better micronutrient status and improvements on several memory and attention tests.

Trust comment: Moderate quality; one-year intervention with objective labs and cognitive tests but nonrandomized group assignment and potential selection differences.

Study Details

PMID:17704033
Participants:129
Impact:significant greater mean score increments in 4/7 memory tests and letter cancellation test in experimental vs control (p<0.05)
Trust score:3/5

health-related quality of life (SGRQ)

1 evidences

Two weeks of inhaled salt–bromide–iodine thermal water modestly improved quality of life and reduced airway neutrophil percentage in COPD patients.

Trust comment: Randomized single-blind trial with objective sputum measures but small sample and short duration.

Study Details

PMID:15878492
Participants:39
Impact:significant improvement in active (thermal water) vs control at end of trial
Trust score:3/5

sputum neutrophil percentage

1 evidences

Two weeks of inhaled salt–bromide–iodine thermal water modestly improved quality of life and reduced airway neutrophil percentage in COPD patients.

Trust comment: Randomized single-blind trial with objective sputum measures but small sample and short duration.

Study Details

PMID:15878492
Participants:39
Impact:small but significant decrease after thermal water inhalation (P<0.01)
Trust score:3/5

lung volumes (pre/post salbutamol)

1 evidences

Two weeks of inhaled salt–bromide–iodine thermal water modestly improved quality of life and reduced airway neutrophil percentage in COPD patients.

Trust comment: Randomized single-blind trial with objective sputum measures but small sample and short duration.

Study Details

PMID:15878492
Participants:39
Impact:no change after treatment in either group
Trust score:3/5

goiter reduction

1 evidences

Single oral doses of iodized oil (200–800 mg iodine) normalized urinary iodine and thyroid hormones for about one year and reduced goiter in about two-thirds of adults.

Trust comment: Randomized allocation with 1-year follow-up and objective biochemical and clinical outcomes; clear results though some dose-related adverse events noted.

Study Details

PMID:7883848
Participants:117
Impact:about two-thirds of subjects in each dose group showed reduction in goiter size
Trust score:4/5

thyroid hormones (T4, TSH)

1 evidences

Single oral doses of iodized oil (200–800 mg iodine) normalized urinary iodine and thyroid hormones for about one year and reduced goiter in about two-thirds of adults.

Trust comment: Randomized allocation with 1-year follow-up and objective biochemical and clinical outcomes; clear results though some dose-related adverse events noted.

Study Details

PMID:7883848
Participants:117
Impact:mean serum T4 and median TSH restored to reference limits; transient TSH rise in some and biochemical thyrotoxicosis more frequent with higher doses
Trust score:4/5

cure rate of hyperthyroidism

1 evidences

Adding lithium to radioiodine therapy increased cure rates and accelerated control of hyperthyroidism and enhanced goiter shrinkage.

Trust comment: Randomized controlled trial with stratification by goiter size and objective clinical endpoints; solid design and sample size for clinical outcomes.

Study Details

PMID:10022407
Participants:110
Impact:radioiodine 72% (33/46) vs radioiodine+ lithium 83% (45/54); higher and earlier cure with lithium (P=0.02)
Trust score:4/5

goiter shrinkage

1 evidences

Adding lithium to radioiodine therapy increased cure rates and accelerated control of hyperthyroidism and enhanced goiter shrinkage.

Trust comment: Randomized controlled trial with stratification by goiter size and objective clinical endpoints; solid design and sample size for clinical outcomes.

Study Details

PMID:10022407
Participants:110
Impact:goiters shrank in both groups but more effectively and promptly with radioiodine+ lithium (P<0.0005)
Trust score:4/5

early thyroid hormone rise (post-therapy)

1 evidences

Adding lithium to radioiodine therapy increased cure rates and accelerated control of hyperthyroidism and enhanced goiter shrinkage.

Trust comment: Randomized controlled trial with stratification by goiter size and objective clinical endpoints; solid design and sample size for clinical outcomes.

Study Details

PMID:10022407
Participants:110
Impact:serum free T4 and T3 increased shortly after therapy only in radioiodine alone group (P<0.01)
Trust score:4/5

birth weight (overall and boys)

1 evidences

Higher maternal urinary iodine in early pregnancy (below ~1 mg/L) was associated with modest increases in birth size measures in male newborns.

Trust comment: Large prospective cohort nested in a trial with early pregnancy biomarker measurement and quantitative effect estimates; robust sample though observational associations.

Study Details

PMID:25031330
Participants:1617
Impact:overall: +9.3 g per 0.1 mg/L maternal UIC (95% CI: 2.9,16); boys: +70 g per 0.5 mg/L (P=0.019)
Trust score:4/5

birth length (overall and boys)

1 evidences

Higher maternal urinary iodine in early pregnancy (below ~1 mg/L) was associated with modest increases in birth size measures in male newborns.

Trust comment: Large prospective cohort nested in a trial with early pregnancy biomarker measurement and quantitative effect estimates; robust sample though observational associations.

Study Details

PMID:25031330
Participants:1617
Impact:overall: +0.042 cm per 0.1 mg/L UIC (95% CI: 0.0066,0.076); boys: +0.41 cm per 0.5 mg/L (P=0.013)
Trust score:4/5

head circumference (boys)

1 evidences

Higher maternal urinary iodine in early pregnancy (below ~1 mg/L) was associated with modest increases in birth size measures in male newborns.

Trust comment: Large prospective cohort nested in a trial with early pregnancy biomarker measurement and quantitative effect estimates; robust sample though observational associations.

Study Details

PMID:25031330
Participants:1617
Impact:boys: +0.28 cm per 0.5 mg/L increase in maternal UIC (P=0.031); no association in girls
Trust score:4/5

TSH (basal and post-TRH)

1 evidences

Four weeks of kelp supplementation increased urinary iodine dose-dependently and raised TSH (both low- and high-dose) with high-dose kelp lowering total T3 and augmenting TRH-stimulated TSH response.

Trust comment: Double-blind randomized trial but small sample and short duration (4 weeks); objective labs but limited power and follow-up.

Study Details

PMID:14583417
Participants:36
Impact:basal TSH increased in low- and high-dose kelp (P=0.04 and P=0.002); post-TRH TSH response increased after high-dose kelp (P=0.0002)
Trust score:3/5

total triiodothyronine (T3)

1 evidences

Four weeks of kelp supplementation increased urinary iodine dose-dependently and raised TSH (both low- and high-dose) with high-dose kelp lowering total T3 and augmenting TRH-stimulated TSH response.

Trust comment: Double-blind randomized trial but small sample and short duration (4 weeks); objective labs but limited power and follow-up.

Study Details

PMID:14583417
Participants:36
Impact:significant decrease after high-dose kelp therapy (P=0.04)
Trust score:3/5

thyroid volume reduction

4 evidences

Radioiodine therapy produced large, dose-dependent reductions in thyroid volume, most of which occurred within six months and progressed by one year.

Trust comment: Prospective randomized multicenter study using ultrasound volumetry with clear dose–response data.

Study Details

PMID:8682157
Participants:92
Impact:Median ~57% reduction at 6 months; median ~71% reduction at 1 year
Trust score:4/5

In patients receiving (131)I therapy for multinodular goiter, pre-treatment with 0.03 mg MRrhTSH increased thyroid volume reduction compared with placebo or 0.01 mg.

Trust comment: Randomized, placebo-controlled multicenter trial with clear primary endpoint and adequate sample size for dose selection.

Study Details

PMID:21346067
Participants:95
Impact:placebo 23.1% ±8.8; MRrhTSH 0.01 mg 23.3% ±16.5; MRrhTSH 0.03 mg 32.9% ±20.7 (0.03 mg > placebo, P=0.03)
Trust score:4/5

Low-dose rhTSH before a fixed radioiodine dose increased thyroid volume reduction compared with placebo in patients with multinodular goitre.

Trust comment: Controlled clinical study with objective thyroid volume outcomes but small sample (n=28) limits precision and generalizability.

Study Details

PMID:18803554
Participants:28
Impact:~37.2±25.5% (0.1 mg rhTSH) and 39.3±27.9% (0.005 mg rhTSH) vs 15.3±28.3% (placebo) at 24 months
Trust score:4/5

In iron-deficient goitrous children, adding iron improved iron status and made iodized salt more effective, reducing thyroid size and goiter rates.

Trust comment: Randomized, double-blind, placebo-controlled trial with clear outcome measures and adequate sample size.

Study Details

PMID:11916762
Participants:166
Impact:-22.8% (iron) vs -12.7% (placebo) at 20 wk
Trust score:5/5

tracheal cross-sectional area

1 evidences

In patients receiving (131)I therapy for multinodular goiter, pre-treatment with 0.03 mg MRrhTSH increased thyroid volume reduction compared with placebo or 0.01 mg.

Trust comment: Randomized, placebo-controlled multicenter trial with clear primary endpoint and adequate sample size for dose selection.

Study Details

PMID:21346067
Participants:95
Impact:increased by 3.8% (A), 4.8% (B), and 10.2% (C) with no significant between-group differences
Trust score:4/5

Safety/tolerability

1 evidences

In patients receiving (131)I therapy for multinodular goiter, pre-treatment with 0.03 mg MRrhTSH increased thyroid volume reduction compared with placebo or 0.01 mg.

Trust comment: Randomized, placebo-controlled multicenter trial with clear primary endpoint and adequate sample size for dose selection.

Study Details

PMID:21346067
Participants:95
Impact:well tolerated with no major safety concerns reported
Trust score:4/5

Systolic blood pressure

2 evidences

Small randomized double-blind trial in Ecuador suggests 4–6 g/d seaweed (rich in iodine) may reduce systolic blood pressure and modestly reduce waist circumference in women.

Trust comment: Randomized double-blind design but small sample size limits generalizability and power.

Study Details

PMID:19713172
Participants:27
Impact:Group 2: −10.5 mmHg after 1 month of 6 g/d seaweed (95% CI 4.1 to 16.8; p<0.05), mainly in those with high-normal baseline BP
Trust score:3/5

Eating the iodine- and chromium-enriched Laminaria jam for 6 months led to larger weight loss, lower blood pressure, and better cholesterol than standard therapy.

Trust comment: Small controlled clinical comparison with statistically significant differences but limited by small sample size and unclear blinding/randomization.

Study Details

PMID:24006749
Participants:50
Impact:-20.5% (main group) vs -10.5% (comparison)
Trust score:3/5

waist circumference (women)

1 evidences

Small randomized double-blind trial in Ecuador suggests 4–6 g/d seaweed (rich in iodine) may reduce systolic blood pressure and modestly reduce waist circumference in women.

Trust comment: Randomized double-blind design but small sample size limits generalizability and power.

Study Details

PMID:19713172
Participants:27
Impact:Group 1 placebo: −2.4 cm; Group 2 women: −2.1 cm after 4 g/d and further −1.8 cm after 6 g/d (all p<0.05)
Trust score:3/5

other metabolic markers

1 evidences

Small randomized double-blind trial in Ecuador suggests 4–6 g/d seaweed (rich in iodine) may reduce systolic blood pressure and modestly reduce waist circumference in women.

Trust comment: Randomized double-blind design but small sample size limits generalizability and power.

Study Details

PMID:19713172
Participants:27
Impact:no other significant changes observed
Trust score:3/5

tumor response / objective response rate

1 evidences

Pilot randomized study: molecular iodine (5 mg/day) given with chemotherapy reduced some toxicities, increased tumor response rates, and was associated with longer disease‑free survival in breast cancer patients.

Trust comment: Randomized pilot with molecular and clinical endpoints and 5‑year follow-up, but limited sample size and some design complexity reduce certainty.

Study Details

PMID:31319484
Participants:45
Impact:FEC/TE + I2 group reported ORR 100% with pCR 36.3% in advanced group (chemoresistance absent)
Trust score:3/5

chemotherapy toxicity (neutropenia, GI, hand–foot syndrome, cardiotoxicity)

1 evidences

Pilot randomized study: molecular iodine (5 mg/day) given with chemotherapy reduced some toxicities, increased tumor response rates, and was associated with longer disease‑free survival in breast cancer patients.

Trust comment: Randomized pilot with molecular and clinical endpoints and 5‑year follow-up, but limited sample size and some design complexity reduce certainty.

Study Details

PMID:31319484
Participants:45
Impact:I2 supplementation reduced severity of neutropenia, markedly less GI discomfort, prevented hand–foot syndrome (0% vs 27.3% in FEC/TE alone), and prevented CK‑MB elevation (cardioprotection)
Trust score:3/5

disease‑free survival (DFS)

1 evidences

Pilot randomized study: molecular iodine (5 mg/day) given with chemotherapy reduced some toxicities, increased tumor response rates, and was associated with longer disease‑free survival in breast cancer patients.

Trust comment: Randomized pilot with molecular and clinical endpoints and 5‑year follow-up, but limited sample size and some design complexity reduce certainty.

Study Details

PMID:31319484
Participants:45
Impact:mean DFS: control 35 ±13 mo, I2 alone 45 ±7 mo, FEC/TE 29 ±6 mo, FEC/TE + I2 49 ±1.4 mo (FEC/TE + I2 > FEC/TE, P=0.04)
Trust score:3/5

total thyroxine (TT4)

1 evidences

In moderately iodine‑deficient children, a single oral iodized oil dose improved iodine and thyroid status and produced significant gains on several cognitive and motor tests at 24 weeks.

Trust comment: Large double-blind randomized trial with objective biochemical and psychometric outcomes supports reliability.

Study Details

PMID:16400058
Participants:310
Impact:mean TT4 increased ≈40%; prevalence of hypothyroxinemia fell to <1% at 24 weeks
Trust score:4/5

cognitive/motor performance

1 evidences

In moderately iodine‑deficient children, a single oral iodized oil dose improved iodine and thyroid status and produced significant gains on several cognitive and motor tests at 24 weeks.

Trust comment: Large double-blind randomized trial with objective biochemical and psychometric outcomes supports reliability.

Study Details

PMID:16400058
Participants:310
Impact:significant improvement on 4 of 7 tests (rapid target marking, symbol search, rapid object naming, Raven's Coloured Progressive Matrices; P<0.0001)
Trust score:4/5

maternal thyroglobulin (Tg) / thyroid stress

1 evidences

In moderately iodine-deficient Gambian women, prenatal MMN containing 300 μg iodine improved maternal iodine biomarkers during pregnancy and reduced maternal thyroglobulin, but had minimal impact on maternal thyroid hormones and limited postnatal benefit for breastmilk or infant iodine status.

Trust comment: Randomized trial with good sample size, high compliance, repeated biochemical measures and ICP-MS assays (high quality).

Study Details

PMID:32183608
Participants:397
Impact:MMN median Tg decreased 20.8→16.8 μg/L (−4.0) while FeFol increased 21.8→24.4 μg/L (+2.6); p<0.001; prevalence of elevated Tg reduced with MMN
Trust score:5/5

maternal free thyroxine (free T4)

1 evidences

Secondary analysis of an RCT in mildly iodine-deficient Thai pregnant women: daily 200 μg iodine raised maternal UIC but produced small declines in maternal thyroxine and no clear benefit on child cognitive outcomes (no significant benefit at 5.7 y; some borderline lower motor scores at 2 y).

Trust comment: Large randomized trial with long follow-up and objective measures, but this is a secondary analysis and power was limited for some long-term outcomes.

Study Details

PMID:33123091
Participants:514
Impact:Iodine group median free T4 1.08→0.78 ng/dL (baseline→2nd tri) vs placebo 1.07→0.81; decline greater in iodine group (p=0.0003)
Trust score:4/5

maternal thyroglobulin (Tg)

1 evidences

Secondary analysis of an RCT in mildly iodine-deficient Thai pregnant women: daily 200 μg iodine raised maternal UIC but produced small declines in maternal thyroxine and no clear benefit on child cognitive outcomes (no significant benefit at 5.7 y; some borderline lower motor scores at 2 y).

Trust comment: Large randomized trial with long follow-up and objective measures, but this is a secondary analysis and power was limited for some long-term outcomes.

Study Details

PMID:33123091
Participants:514
Impact:Maternal Tg lower in iodine group during pregnancy (baseline median 9.38 μg/L; 2nd tri 8.60) vs placebo (p=0.0006)
Trust score:4/5

child motor development at 2 years

1 evidences

Secondary analysis of an RCT in mildly iodine-deficient Thai pregnant women: daily 200 μg iodine raised maternal UIC but produced small declines in maternal thyroxine and no clear benefit on child cognitive outcomes (no significant benefit at 5.7 y; some borderline lower motor scores at 2 y).

Trust comment: Large randomized trial with long follow-up and objective measures, but this is a secondary analysis and power was limited for some long-term outcomes.

Study Details

PMID:33123091
Participants:514
Impact:Iodine group had lower gross motor and combined motor scores at 2 y with mean diffs −0.8 (p=0.07) and −1.1 (p=0.05) respectively; no significant differences at 5.7 y
Trust score:4/5

final response / recurrence rate

1 evidences

Long-term follow-up of randomized low/intermediate-risk differentiated thyroid cancer patients receiving 1.1 vs 3.7 GBq radioactive iodine (RAI) ablation found no difference in long-term outcomes; excellent response in most patients.

Trust comment: Randomized clinical trial with substantial sample and median 4.5-year follow-up assessing therapeutic radioactive iodine dosing.

Study Details

PMID:34368999
Participants:506
Impact:499/506 (98.6%) patients had an excellent response at final follow-up; no difference between 1.1 and 3.7 GBq RAI doses
Trust score:4/5

risk factor for incomplete response

1 evidences

Long-term follow-up of randomized low/intermediate-risk differentiated thyroid cancer patients receiving 1.1 vs 3.7 GBq radioactive iodine (RAI) ablation found no difference in long-term outcomes; excellent response in most patients.

Trust comment: Randomized clinical trial with substantial sample and median 4.5-year follow-up assessing therapeutic radioactive iodine dosing.

Study Details

PMID:34368999
Participants:506
Impact:Stimulated serum Tg ≥10 ng/mL at ablation associated with higher risk of incomplete response (p=0.003)
Trust score:4/5

thyroid hormones and cognitive/motor outcomes

1 evidences

Double-blind randomized trial in moderately iodine-deficient schoolchildren: Lipiodol increased urinary iodine but remained below normal and produced no short-term improvement in T4, TSH, weight, cognitive or motor tests at 4 months.

Trust comment: Randomized, double-blind trial with objective measures but relatively short follow-up and residual iodine deficiency limit inference on cognitive outcomes.

Study Details

PMID:11208941
Participants:305
Impact:No significant change in serum T4, TSH, weight gain, cognitive or motor function at 4 months
Trust score:3/5

verbal IQ (WPPSI-III)

1 evidences

Daily 200 µg iodine in mildly iodine-deficient pregnant women showed no effect on child IQ or executive function at age 5-6 years.

Trust comment: Well-conducted randomized double-blind trial with good compliance but substantial loss to follow-up for primary child outcomes and some interim unmasking.

Study Details

PMID:29030199
Participants:313
Impact:-0.7 points
Trust score:4/5

performance IQ (WPPSI-III)

1 evidences

Daily 200 µg iodine in mildly iodine-deficient pregnant women showed no effect on child IQ or executive function at age 5-6 years.

Trust comment: Well-conducted randomized double-blind trial with good compliance but substantial loss to follow-up for primary child outcomes and some interim unmasking.

Study Details

PMID:29030199
Participants:313
Impact:-1.6 points
Trust score:4/5

global executive function (BRIEF-P)

1 evidences

Daily 200 µg iodine in mildly iodine-deficient pregnant women showed no effect on child IQ or executive function at age 5-6 years.

Trust comment: Well-conducted randomized double-blind trial with good compliance but substantial loss to follow-up for primary child outcomes and some interim unmasking.

Study Details

PMID:29030199
Participants:313
Impact:-0.9 points
Trust score:4/5

hypothyroidism incidence after radioiodine

1 evidences

In patients randomized after recurrence, radioiodine treatment resulted in higher rates of hypothyroidism and higher serum cholesterol/LDL compared with continued methimazole.

Trust comment: Randomized long-term follow-up but limited randomized sample size (subset of original cohort) which reduces precision.

Study Details

PMID:15879354
Participants:104
Impact:25/41 patients (~61%) became hypothyroid
Trust score:3/5

serum total cholesterol

1 evidences

In patients randomized after recurrence, radioiodine treatment resulted in higher rates of hypothyroidism and higher serum cholesterol/LDL compared with continued methimazole.

Trust comment: Randomized long-term follow-up but limited randomized sample size (subset of original cohort) which reduces precision.

Study Details

PMID:15879354
Participants:104
Impact:increased (RR 1.8; 1.12–2.95)
Trust score:3/5

LDL cholesterol

1 evidences

In patients randomized after recurrence, radioiodine treatment resulted in higher rates of hypothyroidism and higher serum cholesterol/LDL compared with continued methimazole.

Trust comment: Randomized long-term follow-up but limited randomized sample size (subset of original cohort) which reduces precision.

Study Details

PMID:15879354
Participants:104
Impact:increased (RR 1.6; 1.09–2.34)
Trust score:3/5

alpha diversity (Shannon, ACE)

1 evidences

Quintuply-fortified salt (including iodine) did not alter gut microbiome alpha or beta diversity or relative abundance of measured taxa after 12 months compared with standard iodized salt.

Trust comment: Randomized, double-blind community trial but microbiome substudy had a small sequencing-complete sample, limiting power to detect modest effects.

Study Details

PMID:40246238
Participants:86
Impact:no significant change
Trust score:4/5

beta diversity (Bray-Curtis)

1 evidences

Quintuply-fortified salt (including iodine) did not alter gut microbiome alpha or beta diversity or relative abundance of measured taxa after 12 months compared with standard iodized salt.

Trust comment: Randomized, double-blind community trial but microbiome substudy had a small sequencing-complete sample, limiting power to detect modest effects.

Study Details

PMID:40246238
Participants:86
Impact:no significant change
Trust score:4/5

relative abundance of measured taxa

1 evidences

Quintuply-fortified salt (including iodine) did not alter gut microbiome alpha or beta diversity or relative abundance of measured taxa after 12 months compared with standard iodized salt.

Trust comment: Randomized, double-blind community trial but microbiome substudy had a small sequencing-complete sample, limiting power to detect modest effects.

Study Details

PMID:40246238
Participants:86
Impact:no significant change
Trust score:4/5

surgical specimen volume

1 evidences

Using iodine-125 seeds for preoperative lesion marking produced similar margin rates but significantly smaller surgical specimens compared with metallic clips.

Trust comment: Randomized preliminary study with small sample size; clinically relevant outcomes but limited precision.

Study Details

PMID:31300213
Participants:98
Impact:-60.69 cm3 (128.68 vs 189.37 cm3; ≈ -32%)
Trust score:3/5

involved margins

1 evidences

Using iodine-125 seeds for preoperative lesion marking produced similar margin rates but significantly smaller surgical specimens compared with metallic clips.

Trust comment: Randomized preliminary study with small sample size; clinically relevant outcomes but limited precision.

Study Details

PMID:31300213
Participants:98
Impact:no significant difference (11.4% vs 13.2%)
Trust score:3/5

remnant ablation rate

1 evidences

A randomized trial testing different fixed radioiodine (I-131) doses found that doses ≥25 mCi achieved higher rates of remnant ablation than lower doses.

Trust comment: Large randomized clinical trial with 509 analyzed patients and clear outcome measures supports high trustworthiness.

Study Details

PMID:15070929
Participants:509
Impact:overall 77.6%; 61.8% (<25 mCi) vs 81.6% (≥25 mCi), +19.8 percentage points
Trust score:5/5

successful ablation odds with ≥25 mCi

1 evidences

A randomized trial testing different fixed radioiodine (I-131) doses found that doses ≥25 mCi achieved higher rates of remnant ablation than lower doses.

Trust comment: Large randomized clinical trial with 509 analyzed patients and clear outcome measures supports high trustworthiness.

Study Details

PMID:15070929
Participants:509
Impact:≈3-fold higher chance of ablation vs <25 mCi
Trust score:5/5

parotid gland radioiodine uptake

1 evidences

In patients receiving radioiodine ablation, parotid gland massage reduced radioiodine retention in the gland; 1 minute of massage was as effective as 2 minutes.

Trust comment: Prospective study with direct measurements and significant results but modest sample size (n=44).

Study Details

PMID:25121980
Participants:44
Impact:massage reduced uptake by ~10 percentage points compared with control (1-min control 11.54% vs 1-min massage 0.97%; P<0.001)
Trust score:4/5

massage duration effect

1 evidences

In patients receiving radioiodine ablation, parotid gland massage reduced radioiodine retention in the gland; 1 minute of massage was as effective as 2 minutes.

Trust comment: Prospective study with direct measurements and significant results but modest sample size (n=44).

Study Details

PMID:25121980
Participants:44
Impact:1-min massage effect comparable to 2-min massage (no significant difference)
Trust score:4/5

iodine status prevalence

1 evidences

A 12-week RCT in adolescents comparing fatty fish meals, meat meals, and n-3 supplements found increases in omega-3 biomarkers but no significant change in urinary iodine concentration between groups.

Trust comment: Randomized controlled trial with objective biomarker measurements but limited by dietary compliance variability.

Study Details

PMID:29475446
Participants:478
Impact:40% of participants had UIC <100 μg/L at baseline (indicating concerns for iodine insufficiency)
Trust score:4/5

thyroid lobe ablation rate

1 evidences

Randomized trial showing higher radioiodine activity (3.7 GBq) produced better lobe ablation than 1.1 GBq with no relevant side effects.

Trust comment: Randomized clinical trial with clear primary outcome and adequate reporting, moderate sample size.

Study Details

PMID:23652210
Participants:136
Impact:75% with 3.7 GBq vs 54% with 1.1 GBq (difference +21 percentage points, P<0.01)
Trust score:4/5

treatment safety

1 evidences

Randomized trial showing higher radioiodine activity (3.7 GBq) produced better lobe ablation than 1.1 GBq with no relevant side effects.

Trust comment: Randomized clinical trial with clear primary outcome and adequate reporting, moderate sample size.

Study Details

PMID:23652210
Participants:136
Impact:No relevant side effects reported in either group
Trust score:4/5

thyroid function

2 evidences

Single oral dose of iodized oil corrected iodine deficiency and reduced goiter prevalence in schoolchildren for over a year.

Trust comment: Prospective study with objective measures (urinary iodine, ultrasound), adequate sample and follow-up.

Study Details

PMID:12207166
Participants:214
Impact:Serum TSH, free T4, thyroglobulin and autoantibodies remained normal up to 2 years
Trust score:4/5

Randomized trial found no infectious events in either group and minimal differences in symptom scores; povidone-iodine suppository was safe.

Trust comment: Prospective randomized trial with adequate sample size but not double-blind and antibiotic prophylaxis likely masked any effect on infections.

Study Details

PMID:30896629
Participants:250
Impact:no abnormal change (within normal range post-procedure)
Trust score:4/5

urinary iodine/creatinine (I/C)

1 evidences

In postmenopausal women, 7 weeks of seaweed (high iodine) raised urinary iodine and produced a small increase in TSH; soy had no effect.

Trust comment: Double-blind crossover design is strong but sample size is small, limiting generalizability.

Study Details

PMID:17472472
Participants:25
Impact:Increased significantly with seaweed ingestion (P < 0.0001)
Trust score:3/5

effect of soy on thyroid hormones

1 evidences

In postmenopausal women, 7 weeks of seaweed (high iodine) raised urinary iodine and produced a small increase in TSH; soy had no effect.

Trust comment: Double-blind crossover design is strong but sample size is small, limiting generalizability.

Study Details

PMID:17472472
Participants:25
Impact:No effect detected on thyroid end points during supplementation
Trust score:3/5

overall surgical-site infection (SSI) incidence

1 evidences

Large cluster-randomized trial found no significant difference in surgical-site infection rates between iodine–alcohol and chlorhexidine–alcohol skin antiseptics.

Trust comment: Robust cluster-randomized crossover design with large sample and validated surveillance data, though slightly underpowered vs initial plan.

Study Details

PMID:31592513
Participants:3665
Impact:Iodine–alcohol 4.0% vs chlorhexidine–alcohol 3.8%; multivariable OR 0.96 (95% CI 0.69–1.35), no significant difference
Trust score:4/5

superficial SSI

1 evidences

Large cluster-randomized trial found no significant difference in surgical-site infection rates between iodine–alcohol and chlorhexidine–alcohol skin antiseptics.

Trust comment: Robust cluster-randomized crossover design with large sample and validated surveillance data, though slightly underpowered vs initial plan.

Study Details

PMID:31592513
Participants:3665
Impact:Iodine–alcohol 1.9% vs chlorhexidine–alcohol 1.7%; no significant difference
Trust score:4/5

deep SSI

1 evidences

Large cluster-randomized trial found no significant difference in surgical-site infection rates between iodine–alcohol and chlorhexidine–alcohol skin antiseptics.

Trust comment: Robust cluster-randomized crossover design with large sample and validated surveillance data, though slightly underpowered vs initial plan.

Study Details

PMID:31592513
Participants:3665
Impact:Both groups 2.1%; no difference
Trust score:4/5

iodine status

1 evidences

In very low birth weight preterm infants, oral iodine supplementation corrected iodine status and affected thyroid hormones but did not change Bayley-III composite neurodevelopmental scores at 24 months.

Trust comment: Randomized assessor-blinded pilot trial with objective biochemical and developmental outcomes, but modest sample size.

Study Details

PMID:34651206
Participants:94
Impact:Supplemented infants reached recommended iodine levels from the first days of life
Trust score:4/5

neurodevelopment (Bayley-III composites)

1 evidences

In very low birth weight preterm infants, oral iodine supplementation corrected iodine status and affected thyroid hormones but did not change Bayley-III composite neurodevelopmental scores at 24 months.

Trust comment: Randomized assessor-blinded pilot trial with objective biochemical and developmental outcomes, but modest sample size.

Study Details

PMID:34651206
Participants:94
Impact:No effect of supplementation on composite scores at 24 months
Trust score:4/5

vascular contrast enhancement (aorta)

1 evidences

In 110 patients, two contrast media with different iodine concentrations produced similar liver and vascular enhancement with no statistically significant differences.

Trust comment: Randomized non-inferiority clinical trial with clear quantitative imaging endpoints; single-centre limits generalizability.

Study Details

PMID:22683195
Participants:110
Impact:no significant difference (Iomeprol 400 vs Iodixanol 320; 305.3 vs 288.4 HU; P=0.32)
Trust score:4/5

liver parenchymal contrast enhancement

1 evidences

In 110 patients, two contrast media with different iodine concentrations produced similar liver and vascular enhancement with no statistically significant differences.

Trust comment: Randomized non-inferiority clinical trial with clear quantitative imaging endpoints; single-centre limits generalizability.

Study Details

PMID:22683195
Participants:110
Impact:no significant difference (portal/equilibrium phases; P=0.78 and P=0.55)
Trust score:4/5

maternal urinary iodine concentration

1 evidences

Supplementing lactating women with 75 or 150 μg I/day raised maternal urinary iodine and breast-milk iodine but did not fully correct iodine deficiency in mothers or infants.

Trust comment: Randomized, double-blind, placebo-controlled trial with repeated measures and clinically relevant endpoints.

Study Details

PMID:20702609
Participants:109
Impact:2.1–2.4× higher in supplemented versus unsupplemented women (P<0.001)
Trust score:5/5

maternal thyroid function (TSH, free T4)

1 evidences

Supplementing lactating women with 75 or 150 μg I/day raised maternal urinary iodine and breast-milk iodine but did not fully correct iodine deficiency in mothers or infants.

Trust comment: Randomized, double-blind, placebo-controlled trial with repeated measures and clinically relevant endpoints.

Study Details

PMID:20702609
Participants:109
Impact:no significant difference between groups at 24 wk
Trust score:5/5

diagnostic quality score

1 evidences

Low-concentration (150 mg I/ml) contrast yielded lower diagnostic quality and confidence and fewer diagnostic exams (69% vs 96%) compared with 300 mg I/ml, but can be diagnostic in non-obese, normal cardiac-output patients.

Trust comment: Randomized patient study with blinded readers and quantitative/qualitative endpoints; moderate sample size and clear limitations documented.

Study Details

PMID:21147298
Participants:95
Impact:lower with low-concentration CM (median 2.5 vs 3.5; p<0.01)
Trust score:4/5

diagnostic confidence score

1 evidences

Low-concentration (150 mg I/ml) contrast yielded lower diagnostic quality and confidence and fewer diagnostic exams (69% vs 96%) compared with 300 mg I/ml, but can be diagnostic in non-obese, normal cardiac-output patients.

Trust comment: Randomized patient study with blinded readers and quantitative/qualitative endpoints; moderate sample size and clear limitations documented.

Study Details

PMID:21147298
Participants:95
Impact:lower with low-concentration CM (median 3 vs 4; p<0.01)
Trust score:4/5

proportion of diagnostic examinations

1 evidences

Low-concentration (150 mg I/ml) contrast yielded lower diagnostic quality and confidence and fewer diagnostic exams (69% vs 96%) compared with 300 mg I/ml, but can be diagnostic in non-obese, normal cardiac-output patients.

Trust comment: Randomized patient study with blinded readers and quantitative/qualitative endpoints; moderate sample size and clear limitations documented.

Study Details

PMID:21147298
Participants:95
Impact:69% diagnostic in low-concentration group vs 96% in high-concentration group
Trust score:4/5

neonatal urinary iodine excretion

1 evidences

Newborns of mothers who took prenatal iodine supplements had higher urinary iodine (+62%) and smaller thyroid volumes (−18%) compared with non-supplemented newborns; neonatal TSH remained normal.

Trust comment: Cross-sectional study with limited sample size and observational design, but clear measured endpoints.

Study Details

PMID:10626570
Participants:89
Impact:+62% in prenatally iodine-supplemented newborns
Trust score:3/5

neonatal thyroid volume

1 evidences

Newborns of mothers who took prenatal iodine supplements had higher urinary iodine (+62%) and smaller thyroid volumes (−18%) compared with non-supplemented newborns; neonatal TSH remained normal.

Trust comment: Cross-sectional study with limited sample size and observational design, but clear measured endpoints.

Study Details

PMID:10626570
Participants:89
Impact:reduced by 18% in prenatally iodine-supplemented newborns
Trust score:3/5

neonatal TSH screening values

1 evidences

Newborns of mothers who took prenatal iodine supplements had higher urinary iodine (+62%) and smaller thyroid volumes (−18%) compared with non-supplemented newborns; neonatal TSH remained normal.

Trust comment: Cross-sectional study with limited sample size and observational design, but clear measured endpoints.

Study Details

PMID:10626570
Participants:89
Impact:remained within normal limits (no clinically significant change)
Trust score:3/5

overall acceptability

1 evidences

Women evaluated taste/acceptability of salt fortified with iodine and other micronutrients; QFS was well accepted.

Trust comment: Randomized crossover design with appropriate analyses and a moderate sample size supports reasonably high trust.

Study Details

PMID:39490799
Participants:77
Impact:no significant difference (QFS 7.8 vs DFS 7.7; P=0.68)
Trust score:4/5

household salt use

1 evidences

Women evaluated taste/acceptability of salt fortified with iodine and other micronutrients; QFS was well accepted.

Trust comment: Randomized crossover design with appropriate analyses and a moderate sample size supports reasonably high trust.

Study Details

PMID:39490799
Participants:77
Impact:no significant difference (weighed use)
Trust score:4/5

sensory discrimination (rice dishes)

1 evidences

Women evaluated taste/acceptability of salt fortified with iodine and other micronutrients; QFS was well accepted.

Trust comment: Randomized crossover design with appropriate analyses and a moderate sample size supports reasonably high trust.

Study Details

PMID:39490799
Participants:77
Impact:samples not distinguishable
Trust score:4/5

postpartum thyroid dysfunction incidence

1 evidences

Randomized double-blind trial found iodine supplementation (150 µg) during pregnancy/postpartum did not increase postpartum thyroid dysfunction in TPO-Ab positive women.

Trust comment: Randomized, double-blind design in a defined population with biochemical outcomes provides credible evidence.

Study Details

PMID:10999807
Participants:66
Impact:55% overall; no significant difference between supplementation groups (+/+ 59%, +/- 60%, -/- 46%)
Trust score:4/5

PPTD incidence by TPO-Ab level

1 evidences

Randomized double-blind trial found iodine supplementation (150 µg) during pregnancy/postpartum did not increase postpartum thyroid dysfunction in TPO-Ab positive women.

Trust comment: Randomized, double-blind design in a defined population with biochemical outcomes provides credible evidence.

Study Details

PMID:10999807
Participants:66
Impact:increased with higher TPO-Ab (35% if <200 U/L; 54% if 200–900 U/L; 75% if >900 U/L)
Trust score:4/5

new or worsened ophthalmopathy after radioiodine

1 evidences

Randomized study comparing radioiodine, radioiodine+prednisone, and methimazole showed radioiodine increased risk of new/worsening ophthalmopathy unless prednisone was given.

Trust comment: Large randomized trial with frequent follow-up and clear clinical endpoints provides high-quality evidence.

Study Details

PMID:9420337
Participants:443
Impact:15% developed or worsened (23/150); 5% persistent requiring treatment (8/150)
Trust score:5/5

effect of prednisone with radioiodine

1 evidences

Randomized study comparing radioiodine, radioiodine+prednisone, and methimazole showed radioiodine increased risk of new/worsening ophthalmopathy unless prednisone was given.

Trust comment: Large randomized trial with frequent follow-up and clear clinical endpoints provides high-quality evidence.

Study Details

PMID:9420337
Participants:443
Impact:radioiodine+prednisone prevented progression and improved ophthalmopathy in 67% of baseline cases
Trust score:5/5

radiation-induced sialadenitis occurrence

1 evidences

Single-blind prospective trial found pilocarpine did not reduce salivary complications after 131I therapy under the study's supportive measures.

Trust comment: Controlled prospective design but single-blind and small sample limit confidence; concurrent supportive measures may confound effect.

Study Details

PMID:18344428
Participants:60
Impact:no reduction with pilocarpine (no statistical difference vs control)
Trust score:3/5

xerostomia/stomatitis/dysgeusia occurrence

1 evidences

Single-blind prospective trial found pilocarpine did not reduce salivary complications after 131I therapy under the study's supportive measures.

Trust comment: Controlled prospective design but single-blind and small sample limit confidence; concurrent supportive measures may confound effect.

Study Details

PMID:18344428
Participants:60
Impact:no statistical differences between groups
Trust score:3/5

intravascular aortic attenuation

1 evidences

Reduced-iodine-dose dual-energy CT with low-energy virtual monochromatic images produced higher vascular attenuation and CNR than standard-iodine-dose single-energy CT.

Trust comment: Prospective randomized design with objective imaging metrics supports good reliability for imaging outcomes.

Study Details

PMID:27610820
Participants:66
Impact:26–185% higher with reduced-iodine dual-energy low-energy images vs standard single-energy
Trust score:4/5

contrast-to-noise ratio (CNR)

3 evidences

Reduced-iodine-dose dual-energy CT with low-energy virtual monochromatic images produced higher vascular attenuation and CNR than standard-iodine-dose single-energy CT.

Trust comment: Prospective randomized design with objective imaging metrics supports good reliability for imaging outcomes.

Study Details

PMID:27610820
Participants:66
Impact:20–25% higher with reduced-iodine dual-energy low-energy images
Trust score:4/5

Tailoring iodine dose to both body weight and BMI removes the positive correlation between BMI and arterial attenuation seen when dosing by body weight alone.

Trust comment: Well-sized clinical study with randomized allocation to dosing strategies and objective CT measures, supporting internal validity.

Study Details

PMID:23171529
Participants:233
Impact:inversely related to BW and BMI
Trust score:4/5

Using 80 kVp plus iterative reconstruction allowed reduction of iodine contrast dose while maintaining or improving some image metrics and lowering radiation dose.

Trust comment: Randomized 3-arm human study with objective image and dose metrics and adequate sample size.

Study Details

PMID:25677790
Participants:90
Impact:significantly higher under protocol B
Trust score:4/5

diagnostic adequacy

1 evidences

Reduced-iodine-dose dual-energy CT with low-energy virtual monochromatic images produced higher vascular attenuation and CNR than standard-iodine-dose single-energy CT.

Trust comment: Prospective randomized design with objective imaging metrics supports good reliability for imaging outcomes.

Study Details

PMID:27610820
Participants:66
Impact:all 66 examinations rated diagnostic
Trust score:4/5

parotid excretion function

1 evidences

Randomized study in 89 patients receiving 131I comparing vitamin E, vitamin C, and supragingival scaling with vitamin C; vitamin E protected parotid excretion function, and supragingival scaling with vitamin C improved uptake indices and excretion rates and attenuated serum amylase reduction.

Trust comment: Checklist performed (outcomes, participants, quality); randomized trial n=89 with objective imaging measures and statistically significant protective effects reported.

Study Details

PMID:35950355
Participants:89
Impact:protected (vitamin E; less decline post-131I, significant)
Trust score:4/5

parotid uptake index

1 evidences

Randomized study in 89 patients receiving 131I comparing vitamin E, vitamin C, and supragingival scaling with vitamin C; vitamin E protected parotid excretion function, and supragingival scaling with vitamin C improved uptake indices and excretion rates and attenuated serum amylase reduction.

Trust comment: Checklist performed (outcomes, participants, quality); randomized trial n=89 with objective imaging measures and statistically significant protective effects reported.

Study Details

PMID:35950355
Participants:89
Impact:increased (group C; bilateral parotid, P<0.05)
Trust score:4/5

serum amylase reduction

1 evidences

Randomized study in 89 patients receiving 131I comparing vitamin E, vitamin C, and supragingival scaling with vitamin C; vitamin E protected parotid excretion function, and supragingival scaling with vitamin C improved uptake indices and excretion rates and attenuated serum amylase reduction.

Trust comment: Checklist performed (outcomes, participants, quality); randomized trial n=89 with objective imaging measures and statistically significant protective effects reported.

Study Details

PMID:35950355
Participants:89
Impact:attenuated reduction (group C; P<0.05)
Trust score:4/5

good/excellent cosmetic outcome

1 evidences

Multicenter randomized trial comparing ROLLIS (iodine-125 seeds) to hookwire localization in breast conserving surgery; overall good cosmetic outcomes in both, with a higher proportion of good/excellent results in the ROLLIS group (82% vs 74%, P=0.02).

Trust comment: Checklist performed (outcomes, participants, quality); multicenter randomized trial n=123 with objective outcome measures showing a modest significant cosmetic benefit with iodine-125 seeds.

Study Details

PMID:33844409
Participants:123
Impact:+8 percentage points (82% vs 74%, P=0.02) favoring iodine-125 seed localization
Trust score:4/5

re-excision rate

1 evidences

Multicenter randomized trial comparing ROLLIS (iodine-125 seeds) to hookwire localization in breast conserving surgery; overall good cosmetic outcomes in both, with a higher proportion of good/excellent results in the ROLLIS group (82% vs 74%, P=0.02).

Trust comment: Checklist performed (outcomes, participants, quality); multicenter randomized trial n=123 with objective outcome measures showing a modest significant cosmetic benefit with iodine-125 seeds.

Study Details

PMID:33844409
Participants:123
Impact:lower in ROLLIS (4.5% vs 14%) but not statistically significant (P=0.06)
Trust score:4/5

neonatal TSH (median)

1 evidences

Prospective randomized trial in 266 pregnant women comparing iodine supplementation versus none; neonatal median TSH was lower in the iodine group (3.44 vs 3.95 mIU/L, p<0.05) without clinical differences in neonatal outcomes.

Trust comment: Checklist performed (outcomes, participants, quality); randomized trial n=266 showing a small but statistically significant reduction in neonatal TSH with no clinical neonatal differences.

Study Details

PMID:29952487
Participants:266
Impact:decreased by 0.51 mIU/L (3.95 → 3.44; p<0.05)
Trust score:4/5

adverse neonatal outcomes (preterm, low birthweight)

1 evidences

Prospective randomized trial in 266 pregnant women comparing iodine supplementation versus none; neonatal median TSH was lower in the iodine group (3.44 vs 3.95 mIU/L, p<0.05) without clinical differences in neonatal outcomes.

Trust comment: Checklist performed (outcomes, participants, quality); randomized trial n=266 showing a small but statistically significant reduction in neonatal TSH with no clinical neonatal differences.

Study Details

PMID:29952487
Participants:266
Impact:no difference between groups
Trust score:4/5

baseline TSH

1 evidences

Adding iodide to levothyroxine produced similar short-term thyroid hormone changes as levothyroxine alone.

Trust comment: Randomized, double-blind human study with clear hormone measures but short (6-day) duration and small sample.

Study Details

PMID:9711053
Participants:48
Impact:decreased (group A: 1.26 → 0.35 mU/ml; group B: 1.37 → 0.39 mU/ml)
Trust score:4/5

delta TSH (TRH-test)

1 evidences

Adding iodide to levothyroxine produced similar short-term thyroid hormone changes as levothyroxine alone.

Trust comment: Randomized, double-blind human study with clear hormone measures but short (6-day) duration and small sample.

Study Details

PMID:9711053
Participants:48
Impact:decreased (group A: 5.66 → 2.61 mU/ml; group B: 6.30 → 2.95 mU/ml)
Trust score:4/5

total T4 (TT4)

1 evidences

Adding iodide to levothyroxine produced similar short-term thyroid hormone changes as levothyroxine alone.

Trust comment: Randomized, double-blind human study with clear hormone measures but short (6-day) duration and small sample.

Study Details

PMID:9711053
Participants:48
Impact:increased (group A: 7.1 → 9.1 µU/dL; group B: 7.2 → 9.4 µU/dL)
Trust score:4/5

disease remission rate

1 evidences

Randomized clinical study in advanced NSCLC patients showing bronchial artery chemoembolization combined with 125I seed implantation improved remission rates, tumor markers, immune markers, and 6‑ and 12‑month survival versus 125I alone.

Trust comment: Randomized clinical study using 125I seeds with multiple outcome measures, but appears single-center and not blinded.

Study Details

PMID:35782072
Participants:102
Impact:higher in combined group (62.75% vs 41.18%)
Trust score:3/5

tumor markers (CEA, CYFRA21-1, CA125)

1 evidences

Randomized clinical study in advanced NSCLC patients showing bronchial artery chemoembolization combined with 125I seed implantation improved remission rates, tumor markers, immune markers, and 6‑ and 12‑month survival versus 125I alone.

Trust comment: Randomized clinical study using 125I seeds with multiple outcome measures, but appears single-center and not blinded.

Study Details

PMID:35782072
Participants:102
Impact:decreased after treatment and lower in combined group (significant)
Trust score:3/5

short-term survival

1 evidences

Randomized clinical study in advanced NSCLC patients showing bronchial artery chemoembolization combined with 125I seed implantation improved remission rates, tumor markers, immune markers, and 6‑ and 12‑month survival versus 125I alone.

Trust comment: Randomized clinical study using 125I seeds with multiple outcome measures, but appears single-center and not blinded.

Study Details

PMID:35782072
Participants:102
Impact:longer progression time (129.85 vs 89.74 days) and higher 6‑month and 1‑year survival (6‑mo: 98.0% vs 81.63%; 1‑yr: 76.0% vs 53.06%)
Trust score:3/5

24‑h urinary iodine excretion

1 evidences

A flexible restricted-iodine diet lowered urinary iodine as effectively as a strict diet before radioiodine therapy.

Trust comment: Randomized trial with objective urinary iodine outcomes; adequate sample but limited to preparation context.

Study Details

PMID:36514927
Participants:144
Impact:reduced in both groups (mean 47.9 µg/day); strict 43.06 vs flexible 52.89 µg/day (P=0.147, no significant difference)
Trust score:4/5

spot urine iodine/creatinine reduction

1 evidences

A flexible restricted-iodine diet lowered urinary iodine as effectively as a strict diet before radioiodine therapy.

Trust comment: Randomized trial with objective urinary iodine outcomes; adequate sample but limited to preparation context.

Study Details

PMID:36514927
Participants:144
Impact:similar percent reductions (68.20% vs 60.53%; P=0.377)
Trust score:4/5

serum iodine concentration (SIC)

1 evidences

Higher iodine nutrition markers (e.g., serum iodine) were associated with greater risk of lateral lymph node metastasis; including iodine markers improved predictive model performance.

Trust comment: Retrospective single‑center cohort with internal validation and moderate sample size; causality limited by design.

Study Details

PMID:37671703
Participants:476
Impact:high SIC associated with increased LLNM risk (OR 3.302, 95%CI 1.009–10.799)
Trust score:3/5

predictive model discrimination (AUC)

1 evidences

Higher iodine nutrition markers (e.g., serum iodine) were associated with greater risk of lateral lymph node metastasis; including iodine markers improved predictive model performance.

Trust comment: Retrospective single‑center cohort with internal validation and moderate sample size; causality limited by design.

Study Details

PMID:37671703
Participants:476
Impact:AUC improved when iodine indicators included (.795 vs .722 without iodine indicators)
Trust score:3/5

overall tumour response (PR + NC)

1 evidences

125I seed implantation improved tumor response, clinical benefit, and median survival versus control in unresectable pancreatic cancer.

Trust comment: Randomized clinical trial reporting survival benefit with 125I seeds but relatively small sample and limited detail on blinding/center.

Study Details

PMID:20356489
Participants:66
Impact:80.6% in 125I group
Trust score:3/5

clinical benefit response

1 evidences

125I seed implantation improved tumor response, clinical benefit, and median survival versus control in unresectable pancreatic cancer.

Trust comment: Randomized clinical trial reporting survival benefit with 125I seeds but relatively small sample and limited detail on blinding/center.

Study Details

PMID:20356489
Participants:66
Impact:54.8% in 125I group
Trust score:3/5

survival (median and rates)

1 evidences

125I seed implantation improved tumor response, clinical benefit, and median survival versus control in unresectable pancreatic cancer.

Trust comment: Randomized clinical trial reporting survival benefit with 125I seeds but relatively small sample and limited detail on blinding/center.

Study Details

PMID:20356489
Participants:66
Impact:median survival 8.0 vs 4.0 months; 6‑ and 12‑month survival higher in 125I group (56.0% vs 31.4%; 16.8% vs 2.9%)
Trust score:3/5

Serum TSH normalization

1 evidences

Compared radioiodine (I-131) versus interstitial laser photocoagulation for hot thyroid nodules; radioiodine normalized TSH more often and reduced total thyroid volume more.

Trust comment: Randomized prospective study with clear endpoints but small sample size limits precision.

Study Details

PMID:17609407
Participants:29
Impact:ILP 50% (7/14) vs Radioiodine 100% (15/15); radioiodine superior (p=0.0025)
Trust score:4/5

Thyroid nodule volume reduction

1 evidences

Compared radioiodine (I-131) versus interstitial laser photocoagulation for hot thyroid nodules; radioiodine normalized TSH more often and reduced total thyroid volume more.

Trust comment: Randomized prospective study with clear endpoints but small sample size limits precision.

Study Details

PMID:17609407
Participants:29
Impact:ILP −44% (mean) vs Radioiodine −47% (mean) at 6 months (no between-group difference)
Trust score:4/5

Total thyroid volume reduction

1 evidences

Compared radioiodine (I-131) versus interstitial laser photocoagulation for hot thyroid nodules; radioiodine normalized TSH more often and reduced total thyroid volume more.

Trust comment: Randomized prospective study with clear endpoints but small sample size limits precision.

Study Details

PMID:17609407
Participants:29
Impact:ILP −7% (mean, ns) vs Radioiodine −26% (mean, p=0.006); greater reduction with radioiodine
Trust score:4/5

Stent patency

1 evidences

Compared irradiation stent (125I seeds) versus conventional stent for malignant biliary obstruction; irradiation stent relieved jaundice and extended survival and patency.

Trust comment: Randomized but small single-center preliminary trial; outcomes clinically relevant but limited sample.

Study Details

PMID:22266605
Participants:23
Impact:3-mo patency 91.7% vs 36.4%; 6-mo 58.3% vs 9.1%; 12-mo 8.3% vs 0% (irradiation vs control)
Trust score:3/5

Procedure-related complications

2 evidences

Compared irradiation stent (125I seeds) versus conventional stent for malignant biliary obstruction; irradiation stent relieved jaundice and extended survival and patency.

Trust comment: Randomized but small single-center preliminary trial; outcomes clinically relevant but limited sample.

Study Details

PMID:22266605
Participants:23
Impact:No significant difference in complications between groups
Trust score:3/5

Randomized study of biliary stent ± I-125 seeds in malignant biliary obstruction: I-125 seeds increased stent patency and overall survival without added procedure complications.

Trust comment: Prospective randomized study with clear endpoints and statistically significant differences in patency and survival, though sample size is modest.

Study Details

PMID:28162906
Participants:55
Impact:no significant difference between groups
Trust score:4/5

GI distension

1 evidences

Randomized comparison of four oral CT contrast agents; pasteurized whole milk provided best GI distension and tended to give better mural visualization than diluted iodine contrast, but milk had more GI adverse effects.

Trust comment: Randomized small imaging study with subjective radiologist ratings; findings applicable to CT enteric contrast choice.

Study Details

PMID:23691702
Participants:60
Impact:Diluted iodine contrast inferior to pasteurized whole milk for GI distension (pasteurized milk superior)
Trust score:3/5

Mural visualization and GI landmark distinction

1 evidences

Randomized comparison of four oral CT contrast agents; pasteurized whole milk provided best GI distension and tended to give better mural visualization than diluted iodine contrast, but milk had more GI adverse effects.

Trust comment: Randomized small imaging study with subjective radiologist ratings; findings applicable to CT enteric contrast choice.

Study Details

PMID:23691702
Participants:60
Impact:Diluted iodine contrast tended to be worse than pasteurized whole milk for mural visualization and landmark distinction
Trust score:3/5

GI adverse effects

1 evidences

Randomized comparison of four oral CT contrast agents; pasteurized whole milk provided best GI distension and tended to give better mural visualization than diluted iodine contrast, but milk had more GI adverse effects.

Trust comment: Randomized small imaging study with subjective radiologist ratings; findings applicable to CT enteric contrast choice.

Study Details

PMID:23691702
Participants:60
Impact:Whole milk groups had more GI adverse symptoms than diluted iodine contrast
Trust score:3/5

Peak aortic enhancement

1 evidences

Compared low- and high-osmolality iodinated IV contrast agents for abdominal CT angiography; low-osmolality agent with higher iodine concentration provided longer aortic opacification.

Trust comment: Good-sized randomized imaging study with objective attenuation measures; clinically relevant for CT angiography protocol choice.

Study Details

PMID:11016777
Participants:212
Impact:Iobitridol 350 produced higher mean peak enhancement than iobitridol 300; ioxithalamate 350 similar to iobitridol 350
Trust score:4/5

Aortic opacification duration

1 evidences

Compared low- and high-osmolality iodinated IV contrast agents for abdominal CT angiography; low-osmolality agent with higher iodine concentration provided longer aortic opacification.

Trust comment: Good-sized randomized imaging study with objective attenuation measures; clinically relevant for CT angiography protocol choice.

Study Details

PMID:11016777
Participants:212
Impact:Iobitridol 350 had slower post-peak decrease of aortic opacification (longer opacification) versus iobitridol 300 and ioxithalamate 350
Trust score:4/5

Iodine to creatinine ratio (I/Cr) at 12 weeks

1 evidences

Preconception daily iodine-containing supplement (SQ-LNS, 250 μg iodine) raised maternal urinary iodine (I/Cr) at 12 weeks and was nominally associated with greater newborn length and head circumference.

Trust comment: Large multicenter randomized controlled trial (secondary analysis) with robust laboratory methods and appropriate statistical adjustment.

Study Details

PMID:34036728
Participants:842
Impact:Arm1 (preconception) adj mean I/Cr 203 μg/g vs Arm2 163 μg/g (fold change 1.24; p<0.0001)
Trust score:5/5

I/Cr at 34 weeks

1 evidences

Preconception daily iodine-containing supplement (SQ-LNS, 250 μg iodine) raised maternal urinary iodine (I/Cr) at 12 weeks and was nominally associated with greater newborn length and head circumference.

Trust comment: Large multicenter randomized controlled trial (secondary analysis) with robust laboratory methods and appropriate statistical adjustment.

Study Details

PMID:34036728
Participants:842
Impact:Arms 1 & 2 had higher adjusted mean I/Cr (235 and 254 μg/g) than control Arm3 (200 μg/g); overall differences significant
Trust score:5/5

Birth anthropometry association

1 evidences

Preconception daily iodine-containing supplement (SQ-LNS, 250 μg iodine) raised maternal urinary iodine (I/Cr) at 12 weeks and was nominally associated with greater newborn length and head circumference.

Trust comment: Large multicenter randomized controlled trial (secondary analysis) with robust laboratory methods and appropriate statistical adjustment.

Study Details

PMID:34036728
Participants:842
Impact:LAZ +0.07 per 100 μg/g I/Cr and HCAZ +0.09 per 100 μg/g I/Cr (nominal significance, mainly driven by Guatemala and India)
Trust score:5/5

Local lesion response rate

1 evidences

Compared 125I-seed esophageal stent plus hyperbaric oxygen versus 125I stent alone; combination therapy produced higher local response rates and overall effective rate.

Trust comment: Small randomized clinical study with positive efficacy signal but limited sample and sparse methodological detail.

Study Details

PMID:33261505
Participants:45
Impact:Treatment group CR 19.2%, PR 61.5% (total 80.7%) vs control CR 10.5%, PR 52.6% (total 63.1%); total effective rate higher (p<0.05)
Trust score:3/5

Overall efficacy

2 evidences

Compared artificial dermis + rb‑FGF versus standard povidone‑iodine gauze for residual infected burn wounds; artificial dermis + rb‑FGF showed better healing and bacterial clearance.

Trust comment: Randomized clinical study with 56 patients and clear, significant primary outcome differences (P<0.01); moderate-to-high internal validity.

Study Details

PMID:17605253
Participants:56
Impact:89.3% vs 67.9%; P<0.01
Trust score:4/5

Compared 125I-seed esophageal stent plus hyperbaric oxygen versus 125I stent alone; combination therapy produced higher local response rates and overall effective rate.

Trust comment: Small randomized clinical study with positive efficacy signal but limited sample and sparse methodological detail.

Study Details

PMID:33261505
Participants:45
Impact:Combination (125I stent + hyperbaric oxygen) improved short- and long-term efficacy versus stent alone
Trust score:3/5

Postoperative thyroglobulin

1 evidences

Compared use of intraoperative hand-held gamma probe versus no probe for completion thyroidectomy; probe use associated with lower postoperative thyroglobulin, similar complication rates.

Trust comment: Prospective randomized surgical study with objective biochemical endpoints; moderate sample size.

Study Details

PMID:24186588
Participants:75
Impact:Navigator group Tg 3.32 ± 2.09 ng/mL vs control 4.58 ± 2.5 (p=0.021); lower Tg with probe
Trust score:4/5

Iodine (I-131) uptake

1 evidences

Compared use of intraoperative hand-held gamma probe versus no probe for completion thyroidectomy; probe use associated with lower postoperative thyroglobulin, similar complication rates.

Trust comment: Prospective randomized surgical study with objective biochemical endpoints; moderate sample size.

Study Details

PMID:24186588
Participants:75
Impact:Navigator 6.29 ± 3.38% vs control 7.31 ± 2.29% (p=0.187) — not statistically significant
Trust score:4/5

postoperative complications

2 evidences

Compared use of intraoperative hand-held gamma probe versus no probe for completion thyroidectomy; probe use associated with lower postoperative thyroglobulin, similar complication rates.

Trust comment: Prospective randomized surgical study with objective biochemical endpoints; moderate sample size.

Study Details

PMID:24186588
Participants:75
Impact:No significant difference in complication frequency between groups (p=0.109)
Trust score:4/5

Topical tranexamic acid applied with povidone-iodine in knee replacement increased postoperative hemoglobin and tended to reduce blood loss without more complications.

Trust comment: Prospective randomized controlled trial with adequate sample size and clear outcomes.

Study Details

PMID:25541338
Participants:125
Impact:no increase
Trust score:4/5

Iodine burden (iodine weight)

1 evidences

Compared low- vs high-iodine contrast protocols in 100 patients undergoing aortic CT to assess image quality, radiation dose, and adverse effects.

Trust comment: Randomized allocation, clear methodology and objective measures in 100 patients, but single-center and modest sample size per group.

Study Details

PMID:25643353
Participants:100
Impact:-27% (20.36 g vs 28.0 g; low-iodine vs high-iodine)
Trust score:4/5

Image noise

2 evidences

Compared low- vs high-iodine contrast protocols in 100 patients undergoing aortic CT to assess image quality, radiation dose, and adverse effects.

Trust comment: Randomized allocation, clear methodology and objective measures in 100 patients, but single-center and modest sample size per group.

Study Details

PMID:25643353
Participants:100
Impact:decreased (e.g., ascending aorta noise 18.9 vs 23.0 HU; significant, p<0.01)
Trust score:4/5

Tailoring iodine dose to both body weight and BMI removes the positive correlation between BMI and arterial attenuation seen when dosing by body weight alone.

Trust comment: Well-sized clinical study with randomized allocation to dosing strategies and objective CT measures, supporting internal validity.

Study Details

PMID:23171529
Participants:233
Impact:increased with higher BW and BMI
Trust score:4/5

Breast milk iodine concentration

1 evidences

Pilot study of 36 pregnant/lactating women given 150 µg/day iodine from 20 weeks gestation; urinary and breast milk iodine measured.

Trust comment: Well-measured biochemical endpoints but small pilot sample (n=36) limits generalizability.

Study Details

PMID:30019676
Participants:36
Impact:median 1.2 µmol/L (range 0.5–3.0); 33% infants below IOM-AI and 0% below Nordic-AI
Trust score:3/5

Visual evaluation of hepatic arteries

1 evidences

Randomized comparison of contrast media at 300 vs 370 mg I/mL for 3D CT angiography of hepatic arteries; assessed visual quality and enhancement.

Trust comment: Randomized design with objective imaging endpoints but modest evaluable sample (72) and limited clinical outcome relevance.

Study Details

PMID:18043345
Participants:72
Impact:no difference between 300 and 370 mg I/mL groups
Trust score:3/5

Aortic late arterial phase enhancement

1 evidences

Randomized comparison of contrast media at 300 vs 370 mg I/mL for 3D CT angiography of hepatic arteries; assessed visual quality and enhancement.

Trust comment: Randomized design with objective imaging endpoints but modest evaluable sample (72) and limited clinical outcome relevance.

Study Details

PMID:18043345
Participants:72
Impact:increased with 370 mg I/mL (statistically significant)
Trust score:3/5

Liver portal phase enhancement

1 evidences

Randomized comparison of contrast media at 300 vs 370 mg I/mL for 3D CT angiography of hepatic arteries; assessed visual quality and enhancement.

Trust comment: Randomized design with objective imaging endpoints but modest evaluable sample (72) and limited clinical outcome relevance.

Study Details

PMID:18043345
Participants:72
Impact:increased with 370 mg I/mL (statistically significant)
Trust score:3/5

Infant iodine status via breastmilk (maternal supplementation)

1 evidences

Double-blind RCT in Morocco comparing maternal oral iodised oil (400 mg) vs direct infant iodine supplementation to assess infant iodine status and thyroid function.

Trust comment: High-quality double-blind randomized placebo-controlled trial with robust sample size (241 pairs) and clinically relevant biochemical/endocrine endpoints.

Study Details

PMID:24622750
Participants:241
Impact:Maternal 400 mg iodised oil provided adequate iodine to infants via breastmilk for ≥6 months and enabled infant euthyroidism (sustained sufficiency)
Trust score:5/5

Direct infant supplementation vs maternal supplementation

1 evidences

Double-blind RCT in Morocco comparing maternal oral iodised oil (400 mg) vs direct infant iodine supplementation to assess infant iodine status and thyroid function.

Trust comment: High-quality double-blind randomized placebo-controlled trial with robust sample size (241 pairs) and clinically relevant biochemical/endocrine endpoints.

Study Details

PMID:24622750
Participants:241
Impact:Direct supplementation less effective for improving infant iodine status; maternal dosing produced more consistent infant UIC sufficiency
Trust score:5/5

Median urinary iodine concentration (UIC)

1 evidences

Population-based random sample (spot urine) measuring urinary iodine concentration across age groups in Bern region before planned salt iodization increase.

Trust comment: Large area-covering random sample with reasonable methodology, though participation biases and spot urine limitations affect precision.

Study Details

PMID:11078987
Participants:412
Impact:median UIC 94 µg/L indicating mild iodine deficiency overall
Trust score:4/5

Age and gender differences in UIC

1 evidences

Population-based random sample (spot urine) measuring urinary iodine concentration across age groups in Bern region before planned salt iodization increase.

Trust comment: Large area-covering random sample with reasonable methodology, though participation biases and spot urine limitations affect precision.

Study Details

PMID:11078987
Participants:412
Impact:women had lower UIC than men; infants showed no deficiency
Trust score:4/5

manifest postpartum thyroid dysfunction

1 evidences

Postpartum iodine (50 or 250 µg) reduced thyroid size by 3 months and produced few mild transient thyroid dysfunctions.

Trust comment: Randomized intervention with objective measures but modest sample size and relatively short follow-up.

Study Details

PMID:9533929
Participants:126
Impact:4/70 (5.7%) manifest dysfunction; all changes clinically mild and transient
Trust score:4/5

dose effect (50 vs 250 µg)

1 evidences

Postpartum iodine (50 or 250 µg) reduced thyroid size by 3 months and produced few mild transient thyroid dysfunctions.

Trust comment: Randomized intervention with objective measures but modest sample size and relatively short follow-up.

Study Details

PMID:9533929
Participants:126
Impact:no clear difference between 50 µg and 250 µg on thyroid outcomes
Trust score:4/5

contrast enhancement (HU)

1 evidences

In cardiac CT patients, an iodine injection rate of ~1 g iodine/s provided optimal vascular contrast enhancement.

Trust comment: Randomized imaging protocol in 60 patients with clear quantitative endpoints, reasonably reliable.

Study Details

PMID:14566178
Participants:60
Impact:≈1 g iodine/s injection resulted in optimal enhancement (250–300 HU)
Trust score:4/5

low iodine slow flow performance

1 evidences

In cardiac CT patients, an iodine injection rate of ~1 g iodine/s provided optimal vascular contrast enhancement.

Trust comment: Randomized imaging protocol in 60 patients with clear quantitative endpoints, reasonably reliable.

Study Details

PMID:14566178
Participants:60
Impact:low concentration at slow flow acceptable in 53.8% of patients
Trust score:4/5

high concentration high flow risk

1 evidences

In cardiac CT patients, an iodine injection rate of ~1 g iodine/s provided optimal vascular contrast enhancement.

Trust comment: Randomized imaging protocol in 60 patients with clear quantitative endpoints, reasonably reliable.

Study Details

PMID:14566178
Participants:60
Impact:high concentration with high flow may exceed 350 HU and obscure calcifications
Trust score:4/5

FEV1 (baseline)

1 evidences

8-week oral iodinated activated charcoal modestly improved baseline FEV1 in moderate COPD versus placebo.

Trust comment: Double-blind randomized placebo-controlled trial but small sample and mechanism unclear.

Study Details

PMID:24742364
Participants:40
Impact:+130 ml vs placebo (8.2% improvement; p = 0.031)
Trust score:4/5

thyroid hormone abnormalities (adverse effect)

1 evidences

8-week oral iodinated activated charcoal modestly improved baseline FEV1 in moderate COPD versus placebo.

Trust comment: Double-blind randomized placebo-controlled trial but small sample and mechanism unclear.

Study Details

PMID:24742364
Participants:40
Impact:8 patients developed transient abnormal thyroid hormone levels during treatment
Trust score:4/5

nasolacrimal duct obstruction (NLDO) — overall exposed eyes

1 evidences

High cumulative I-131 (≥11.1 GBq) was associated with higher rates of nasolacrimal duct obstruction.

Trust comment: Historical cohort with matched controls and dose stratification but retrospective selection limits causality.

Study Details

PMID:22825036
Participants:81
Impact:29/162 exposed eyes (18%) showed NLDO vs 3/34 control eyes (9%)
Trust score:3/5

NLDO with high cumulative I-131 (≥11.1 GBq)

1 evidences

High cumulative I-131 (≥11.1 GBq) was associated with higher rates of nasolacrimal duct obstruction.

Trust comment: Historical cohort with matched controls and dose stratification but retrospective selection limits causality.

Study Details

PMID:22825036
Participants:81
Impact:27.4% (23/84 eyes) in high-dose group; complete NLDO 23.8% in high-dose group
Trust score:3/5

NLDO with lower cumulative I-131 (<11.1 GBq)

1 evidences

High cumulative I-131 (≥11.1 GBq) was associated with higher rates of nasolacrimal duct obstruction.

Trust comment: Historical cohort with matched controls and dose stratification but retrospective selection limits causality.

Study Details

PMID:22825036
Participants:81
Impact:7.7% (6/78 eyes) in low-dose group; complete NLDO 3.8%
Trust score:3/5

GO exacerbation after RAI

1 evidences

After radioiodine therapy, ~9.8% had GO exacerbation; low-dose prophylactic corticosteroid (15 mg) did not significantly prevent exacerbation.

Trust comment: Large prospective randomized study with imaging endpoints and sufficient sample, though single population.

Study Details

PMID:25965082
Participants:295
Impact:29/295 (9.8%) experienced exacerbation at 1 year
Trust score:4/5

ophthalmic treatment requirement

1 evidences

After radioiodine therapy, ~9.8% had GO exacerbation; low-dose prophylactic corticosteroid (15 mg) did not significantly prevent exacerbation.

Trust comment: Large prospective randomized study with imaging endpoints and sufficient sample, though single population.

Study Details

PMID:25965082
Participants:295
Impact:7/295 (2.4%) required ophthalmic treatment
Trust score:4/5

low-dose prophylactic corticosteroid effect

1 evidences

After radioiodine therapy, ~9.8% had GO exacerbation; low-dose prophylactic corticosteroid (15 mg) did not significantly prevent exacerbation.

Trust comment: Large prospective randomized study with imaging endpoints and sufficient sample, though single population.

Study Details

PMID:25965082
Participants:295
Impact:no significant difference (PCS-On 12.1% vs PCS-Off 7.5%; P = .17)
Trust score:4/5

parotid uptake fraction (UF)

1 evidences

Randomized trial in 82 thyroid cancer patients receiving 100 mCi radioiodine; vitamin E (100–300 mg/day) around therapy preserved salivary gland function on scintigraphy compared with control.

Trust comment: Randomized-controlled design with objective scintigraphy endpoints but moderate sample size.

Study Details

PMID:28806348
Participants:82
Impact:Control: significant UF decrease after I therapy (P<0.01); Group C (300 mg) showed UF increase in left parotid (P<0.05)
Trust score:4/5

submandibular uptake index (UI)

1 evidences

Randomized trial in 82 thyroid cancer patients receiving 100 mCi radioiodine; vitamin E (100–300 mg/day) around therapy preserved salivary gland function on scintigraphy compared with control.

Trust comment: Randomized-controlled design with objective scintigraphy endpoints but moderate sample size.

Study Details

PMID:28806348
Participants:82
Impact:Group A/B/C: significant UI increases in various glands (group A right submandibular UI P<0.05; group B right parotid and both submandibular UI P<0.01; group C UI both submandibulars P<0.01)
Trust score:4/5

parotid excretion fraction (EF)

1 evidences

Randomized trial in 82 thyroid cancer patients receiving 100 mCi radioiodine; vitamin E (100–300 mg/day) around therapy preserved salivary gland function on scintigraphy compared with control.

Trust comment: Randomized-controlled design with objective scintigraphy endpoints but moderate sample size.

Study Details

PMID:28806348
Participants:82
Impact:Group A: EF of right parotid increased significantly (P<0.01)
Trust score:4/5

treatment response to 131I therapy (excellent response)

1 evidences

Retrospective cohort (N=854) developing machine-learning models to predict response to 131I therapy and TSH suppression; stimulated/suppressed thyroglobulin and radioiodine uptake were top predictors; RF models achieved high AUCs.

Trust comment: Large retrospective single-center dataset with rigorous ML methods; limitations include retrospective design and limited external validation.

Study Details

PMID:37669005
Participants:854
Impact:RF model accuracy 81.3%, AUC 0.896 for predicting ER
Trust score:4/5

biochemical remission to TSH suppression (ΔTg_on%)

1 evidences

Retrospective cohort (N=854) developing machine-learning models to predict response to 131I therapy and TSH suppression; stimulated/suppressed thyroglobulin and radioiodine uptake were top predictors; RF models achieved high AUCs.

Trust comment: Large retrospective single-center dataset with rigorous ML methods; limitations include retrospective design and limited external validation.

Study Details

PMID:37669005
Participants:854
Impact:RF model accuracy 78.7%, AUC 0.857 for predicting BR (ΔTg_on% ≥25%)
Trust score:4/5

key predictive biomarkers

1 evidences

Retrospective cohort (N=854) developing machine-learning models to predict response to 131I therapy and TSH suppression; stimulated/suppressed thyroglobulin and radioiodine uptake were top predictors; RF models achieved high AUCs.

Trust comment: Large retrospective single-center dataset with rigorous ML methods; limitations include retrospective design and limited external validation.

Study Details

PMID:37669005
Participants:854
Impact:Stimulated and suppressed thyroglobulin and pre-therapy radioiodine uptake strongly associated with ER (identified as top predictors)
Trust score:4/5

iodine solution reflux (starch indicator positive)

1 evidences

Randomized controlled trial (n=204) testing assistant distance countdown during Lugol chromoendoscopy; countdown markedly reduced iodine reflux and multiple post-procedure adverse events.

Trust comment: Prospective randomized controlled trial with clear, clinically relevant endpoints and adequate sample size.

Study Details

PMID:39836052
Participants:204
Impact:DC group 1.0% vs No-DC 26.5% (P<0.001)
Trust score:5/5

bucking during procedure

1 evidences

Randomized controlled trial (n=204) testing assistant distance countdown during Lugol chromoendoscopy; countdown markedly reduced iodine reflux and multiple post-procedure adverse events.

Trust comment: Prospective randomized controlled trial with clear, clinically relevant endpoints and adequate sample size.

Study Details

PMID:39836052
Participants:204
Impact:DC group 1.0% vs No-DC 9.8% (P=0.005); in overweight subgroup DC 0.0% vs No-DC 13.0% (P=0.014)
Trust score:5/5

post-procedure throat/upper airway symptoms

1 evidences

Randomized controlled trial (n=204) testing assistant distance countdown during Lugol chromoendoscopy; countdown markedly reduced iodine reflux and multiple post-procedure adverse events.

Trust comment: Prospective randomized controlled trial with clear, clinically relevant endpoints and adequate sample size.

Study Details

PMID:39836052
Participants:204
Impact:Sore throat 1.0% vs 13.7% (DC vs No-DC, P<0.001); pharyngeal discomfort/odor 8.8% vs 34.3% (P<0.001); bitter taste 5.9% vs 17.7% (P=0.009); heartburn 3.9% vs 12.8% (P=0.023)
Trust score:5/5

overall breast pain

1 evidences

Randomized double-blind trial in women with cyclic breast pain: molecular iodine (3.0 and 6.0 mg/day) reduced breast pain and related findings versus placebo.

Trust comment: Well-conducted randomized, double-blind, placebo-controlled multicenter trial with clear patient-reported and physician-assessed endpoints.

Study Details

PMID:15239792
Participants:111
Impact:- significant improvement (dose-dependent, p<0.01); 6.0 mg/day: >50% had clinically significant reduction
Trust score:4/5

breast tenderness

1 evidences

Randomized double-blind trial in women with cyclic breast pain: molecular iodine (3.0 and 6.0 mg/day) reduced breast pain and related findings versus placebo.

Trust comment: Well-conducted randomized, double-blind, placebo-controlled multicenter trial with clear patient-reported and physician-assessed endpoints.

Study Details

PMID:15239792
Participants:111
Impact:- decreased in 3.0 and 6.0 mg/day groups (by month 3–5)
Trust score:4/5

free T4

3 evidences

Short clinical study in HCV patients: excess iodine (with or without rIFN-alpha) caused small changes in thyroid function over 2 months.

Trust comment: Small clinical study with short (2-month) follow-up and non-randomized groups, but direct thyroid function measurements were reported.

Study Details

PMID:10341861
Participants:56
Impact:- small significant decrease with iodine alone and rIFN-alpha + iodine (2 months)
Trust score:3/5

Healthy adults given 100–300 μg iodide daily for 6 months showed no meaningful change in thyroid function but had slight anti-inflammatory/antioxidant marker changes.

Trust comment: Small randomized human trial with biochemical endpoints; limited sample size but randomized design supports reliability for observed null effects.

Study Details

PMID:21262066
Participants:30
Impact:Higher at day 60 in 200 and 300 μg groups (p = 0.01) but association lost after baseline adjustment
Trust score:4/5

Screened elderly Chinese for thyroid problems; found thyroid dysfunction mainly in women, with possible contributions from autoimmunity and borderline iodine intake.

Trust comment: Large ambulatory human screening study with objective hormone assays but observational design limits causal inference.

Study Details

PMID:8733881
Participants:1880
Impact:Decreased with age in females (p < 0.01)
Trust score:4/5

free T3

2 evidences

Short clinical study in HCV patients: excess iodine (with or without rIFN-alpha) caused small changes in thyroid function over 2 months.

Trust comment: Small clinical study with short (2-month) follow-up and non-randomized groups, but direct thyroid function measurements were reported.

Study Details

PMID:10341861
Participants:56
Impact:- small significant decrease with iodine alone and rIFN-alpha + iodine (2 months)
Trust score:3/5

Screened elderly Chinese for thyroid problems; found thyroid dysfunction mainly in women, with possible contributions from autoimmunity and borderline iodine intake.

Trust comment: Large ambulatory human screening study with objective hormone assays but observational design limits causal inference.

Study Details

PMID:8733881
Participants:1880
Impact:Increased with age in females (p < 0.001); higher free T3/free T4 ratio with aging (p < 0.001)
Trust score:4/5

palatability (taste VAS)

1 evidences

Blinded randomized tasting study: iodine-based disinfectant (TGHP) worsened water taste, but adding ascorbic acid restored palatability to near plain water.

Trust comment: Randomized, blinded crossover tasting study in 60 participants with clear VAS and ranking outcomes and low risk of bias.

Study Details

PMID:22137863
Participants:60
Impact:TGHP worsened taste vs water; TGHP + ascorbic acid = similar palatability to water
Trust score:4/5

preference ranking

1 evidences

Blinded randomized tasting study: iodine-based disinfectant (TGHP) worsened water taste, but adding ascorbic acid restored palatability to near plain water.

Trust comment: Randomized, blinded crossover tasting study in 60 participants with clear VAS and ranking outcomes and low risk of bias.

Study Details

PMID:22137863
Participants:60
Impact:TGHP ranked least pleasant by 58%; TGHP + ascorbic acid ranked among most pleasant (40% ranked most pleasant)
Trust score:4/5

urinary morbidity (AUA score)

1 evidences

Study of prostate brachytherapy (I-125): short-term urinary symptoms peaked at 1 month; high intraprostatic dose volumes did not predict 12-month urinary or rectal morbidity.

Trust comment: Randomized isotope trial with postimplant dosimetric correlation; moderate sample size and observational dosimetry analyses limit causal strength.

Study Details

PMID:12023136
Participants:82
Impact:peak at 1 month; weak association with higher-dose volumes at 1 month but no correlation at 12 months
Trust score:3/5

rectal morbidity

1 evidences

Study of prostate brachytherapy (I-125): short-term urinary symptoms peaked at 1 month; high intraprostatic dose volumes did not predict 12-month urinary or rectal morbidity.

Trust comment: Randomized isotope trial with postimplant dosimetric correlation; moderate sample size and observational dosimetry analyses limit causal strength.

Study Details

PMID:12023136
Participants:82
Impact:no correlation with high intraprostatic dose volumes
Trust score:3/5

cataract incidence

1 evidences

Large prospective cohort from a randomized trial: I-125 brachytherapy led to high cataract incidence by 5 years and cataract surgery usually improved vision.

Trust comment: Large prospective trial cohort (COMS) with standardized follow-up and objective ocular outcomes, high methodological quality.

Study Details

PMID:17337065
Participants:532
Impact:83% reported cataract by 5 years (68% developed within first 5 years); 12% had cataract surgery by 5 years
Trust score:5/5

visual acuity after cataract surgery

1 evidences

Large prospective cohort from a randomized trial: I-125 brachytherapy led to high cataract incidence by 5 years and cataract surgery usually improved vision.

Trust comment: Large prospective trial cohort (COMS) with standardized follow-up and objective ocular outcomes, high methodological quality.

Study Details

PMID:17337065
Participants:532
Impact:median VA improved from 20/125 to 20/50; 66% improved ≥2 lines after surgery
Trust score:5/5

local recurrence rate

2 evidences

Adding intraoperative iodine-125 seed implantation to surgery reduced local recurrence and improved longer-term survival in advanced esophageal squamous cell carcinoma.

Trust comment: Prospective randomized study with large sample size and survival outcomes reported, though full methodological details are limited in the abstract.

Study Details

PMID:20450603
Participants:298
Impact:14.9% vs 38.7% (−23.8 percentage points) in iodine-125 vs surgery alone
Trust score:4/5

A single postoperative intra-arterial 131I‑lipiodol dose after liver cancer resection reduced local recurrence and improved disease-free and overall survival versus no adjuvant treatment.

Trust comment: Prospective randomized trial (n=43) with statistically significant benefits but small sample size and early stopping.

Study Details

PMID:10459961
Participants:43
Impact:28.5% (treatment) vs 59% (control); P=0.04
Trust score:4/5

3-year survival

2 evidences

Adding intraoperative iodine-125 seed implantation to surgery reduced local recurrence and improved longer-term survival in advanced esophageal squamous cell carcinoma.

Trust comment: Prospective randomized study with large sample size and survival outcomes reported, though full methodological details are limited in the abstract.

Study Details

PMID:20450603
Participants:298
Impact:64.0% vs 52.0% (+12.0 percentage points) in iodine-125 vs surgery alone
Trust score:4/5

Adding I-125 seed brachytherapy to sphincter-preserving surgery reduced local recurrences and improved 3-year survival and some functional outcomes.

Trust comment: Randomized trial but small sample size and limited detail in report; results appear clinically meaningful but sample limited.

Study Details

PMID:16029638
Participants:76
Impact:Group B 93% vs Group A 76.7% at 36 months (absolute +16.3% for Group B)
Trust score:3/5

5-year survival

1 evidences

Adding intraoperative iodine-125 seed implantation to surgery reduced local recurrence and improved longer-term survival in advanced esophageal squamous cell carcinoma.

Trust comment: Prospective randomized study with large sample size and survival outcomes reported, though full methodological details are limited in the abstract.

Study Details

PMID:20450603
Participants:298
Impact:42.7% vs 34.5% (+8.2 percentage points) in iodine-125 vs surgery alone
Trust score:4/5

7-year survival

1 evidences

Adding intraoperative iodine-125 seed implantation to surgery reduced local recurrence and improved longer-term survival in advanced esophageal squamous cell carcinoma.

Trust comment: Prospective randomized study with large sample size and survival outcomes reported, though full methodological details are limited in the abstract.

Study Details

PMID:20450603
Participants:298
Impact:25.1% vs 12.6% (+12.5 percentage points) in iodine-125 vs surgery alone
Trust score:4/5

goitre prevalence

2 evidences

Many schoolchildren had clinical goitre despite biochemical measures reported as indicating adequate environmental iodine and most household salt having recommended iodine levels.

Trust comment: Large cross-sectional survey with clinical and biochemical measures; observational design limits causal inference but sample size is strong.

Study Details

PMID:18003667
Participants:1627
Impact:38% of children examined
Trust score:3/5

A single oral iodised-oil dose increased urinary iodine and markedly reduced goitre prevalence at 40 weeks; efficacy was lower in children with poorer weight-for-height.

Trust comment: Controlled field trial in a severely deficient population with objective biochemical and clinical endpoints; moderate sample size.

Study Details

PMID:10967613
Participants:197
Impact:-42 percentage points (63% to 21%)
Trust score:4/5

median urinary iodine level

1 evidences

Many schoolchildren had clinical goitre despite biochemical measures reported as indicating adequate environmental iodine and most household salt having recommended iodine levels.

Trust comment: Large cross-sectional survey with clinical and biochemical measures; observational design limits causal inference but sample size is strong.

Study Details

PMID:18003667
Participants:1627
Impact:25 microg/dl (reported as indicating no biochemical iodine deficiency)
Trust score:3/5

salt samples with recommended iodine level

1 evidences

Many schoolchildren had clinical goitre despite biochemical measures reported as indicating adequate environmental iodine and most household salt having recommended iodine levels.

Trust comment: Large cross-sectional survey with clinical and biochemical measures; observational design limits causal inference but sample size is strong.

Study Details

PMID:18003667
Participants:1627
Impact:70% of salt samples at recommended iodine level
Trust score:3/5

TSH concentration

2 evidences

Assessed whether povidone-iodine skin prep affects infants' thyroid hormones after cardiac surgery; cardiopulmonary bypass had larger effects than antiseptic used.

Trust comment: Prospective randomized trial in infants but small N (37) and cardiopulmonary bypass is a strong confounder.

Study Details

PMID:9295836
Participants:37
Impact:TSH decreased immediately after surgery in bypass groups (greater decrease than thoracotomy group)
Trust score:3/5

Short-term iodine supplementation raised urinary iodine and TSH; higher supplement doses led to reduced thyroid volume at the highest doses and caused subclinical hypothyroidism at and above certain intake levels.

Trust comment: Randomized double-blind placebo-controlled trial with multiple dose arms and objective thyroid outcomes, though short duration (4 weeks) limits long-term conclusions.

Study Details

PMID:22205314
Participants:256
Impact:Significantly increased in all iodide-supplemented groups vs placebo
Trust score:4/5

subclinical hypothyroidism incidence

1 evidences

Short-term iodine supplementation raised urinary iodine and TSH; higher supplement doses led to reduced thyroid volume at the highest doses and caused subclinical hypothyroidism at and above certain intake levels.

Trust comment: Randomized double-blind placebo-controlled trial with multiple dose arms and objective thyroid outcomes, though short duration (4 weeks) limits long-term conclusions.

Study Details

PMID:22205314
Participants:256
Impact:5% in 400 μg supplement group; 15–47% in 500–2000 μg supplement groups (total intake ≈800 μg/d and above)
Trust score:4/5

complete tumor response (iodine-125 brachytherapy)

1 evidences

EUS-guided iodine-125 brachytherapy achieved high complete response rates and better tumor control than ethanol ablation for selected refractory left-sided liver tumors, with a good safety profile.

Trust comment: Prospective case series with small sample size and limited follow-up; shows promising efficacy but limited generalizability.

Study Details

PMID:27958384
Participants:26
Impact:92.3% (12/13) complete response at 12 months in iodine-125 group vs 30% (3/10) in ethanol ablation group
Trust score:3/5

initial treatment success rate

1 evidences

EUS-guided iodine-125 brachytherapy achieved high complete response rates and better tumor control than ethanol ablation for selected refractory left-sided liver tumors, with a good safety profile.

Trust comment: Prospective case series with small sample size and limited follow-up; shows promising efficacy but limited generalizability.

Study Details

PMID:27958384
Participants:26
Impact:23 of 25 treatable cases (after excluding 1 undetectable) were successfully and uneventfully treated as scheduled (92%)
Trust score:3/5

sensitivity for detecting hypervascular HCCs (arterial phase, equilibrium phase, combined)

1 evidences

Using a higher iodine concentration contrast (370 mg I/mL) at fixed volume and rate improved detection sensitivity and diagnostic accuracy for hypervascular hepatocellular carcinomas on MDCT compared with 300 mg I/mL.

Trust comment: Prospective randomized study with clear diagnostic endpoints and objective imaging metrics; sample size moderate.

Study Details

PMID:21067880
Participants:105
Impact:Group B (370 mg I/mL): 0.94, 0.81, 0.93 vs Group A (300 mg I/mL): 0.84, 0.69, 0.80
Trust score:4/5

area under ROC curve (AP and combined)

1 evidences

Using a higher iodine concentration contrast (370 mg I/mL) at fixed volume and rate improved detection sensitivity and diagnostic accuracy for hypervascular hepatocellular carcinomas on MDCT compared with 300 mg I/mL.

Trust comment: Prospective randomized study with clear diagnostic endpoints and objective imaging metrics; sample size moderate.

Study Details

PMID:21067880
Participants:105
Impact:Group B: 0.974 (AP) and 0.981 (combined) vs Group A: 0.939 (AP) and 0.958 (combined)
Trust score:4/5

subclinical hypothyroidism (iodine-treated)

1 evidences

In patients with Hashimoto's thyroiditis, daily 250 μg potassium iodide led to thyroid dysfunction in a minority: several developed subclinical or overt hypothyroidism that in some cases reversed after stopping iodine.

Trust comment: Controlled observational study with defined treated and control groups but not clearly randomized; sample size modest and follow-up variable.

Study Details

PMID:9703374
Participants:83
Impact:7 of 40 patients developed subclinical hypothyroidism (17.5%)
Trust score:3/5

overt hypothyroidism (iodine-treated)

1 evidences

In patients with Hashimoto's thyroiditis, daily 250 μg potassium iodide led to thyroid dysfunction in a minority: several developed subclinical or overt hypothyroidism that in some cases reversed after stopping iodine.

Trust comment: Controlled observational study with defined treated and control groups but not clearly randomized; sample size modest and follow-up variable.

Study Details

PMID:9703374
Participants:83
Impact:1 of 40 patients developed hypothyroidism (2.5%)
Trust score:3/5

subclinical hypothyroidism (control)

1 evidences

In patients with Hashimoto's thyroiditis, daily 250 μg potassium iodide led to thyroid dysfunction in a minority: several developed subclinical or overt hypothyroidism that in some cases reversed after stopping iodine.

Trust comment: Controlled observational study with defined treated and control groups but not clearly randomized; sample size modest and follow-up variable.

Study Details

PMID:9703374
Participants:83
Impact:1 of 43 patients developed subclinical hypothyroidism (2.3%)
Trust score:3/5

salivary gland function (EF/MSP/MUR)

1 evidences

In patients given high-dose I-131, vitamin E around treatment appeared to protect salivary gland function compared with placebo.

Trust comment: Randomized but small study (n=36) with objective scintigraphy measures; limited power and sample size.

Study Details

PMID:23708871
Participants:36
Impact:vitamin E group showed no significant pre–post decline while control had significant decreases (vitamin E protective)
Trust score:3/5

goiter size

1 evidences

In nontoxic nodular goiter, 131I therapy reduced goiter size substantially more than suppressive levothyroxine but caused more hypothyroidism; levothyroxine caused bone loss.

Trust comment: Randomized trial with 2-year follow-up and objective measures; moderate sample and good design, though modest size.

Study Details

PMID:11238476
Participants:57
Impact:-44% after 2 years with 131I vs -1% with levothyroxine (P<0.001)
Trust score:4/5

Bone mineral density (lumbar spine)

1 evidences

In nontoxic nodular goiter, 131I therapy reduced goiter size substantially more than suppressive levothyroxine but caused more hypothyroidism; levothyroxine caused bone loss.

Trust comment: Randomized trial with 2-year follow-up and objective measures; moderate sample and good design, though modest size.

Study Details

PMID:11238476
Participants:57
Impact:-3.6% after 2 years in levothyroxine group; no BMD change with 131I
Trust score:4/5

treatment outcome (thyroid status at 12 months)

1 evidences

Thyroid ultrasound echogenicity and gland size predict response to radioiodine in Graves' disease: normoechogenic and large glands are more radioresistant.

Trust comment: Prospective cohort with a substantial sample (n=177) and clinically relevant endpoints; observational design limits causal claims.

Study Details

PMID:17609305
Participants:177
Impact:Normoechogenic glands had more hyperthyroid (22% vs 7%) and euthyroid (41% vs 11%) outcomes and less hypothyroid (37% vs 81%) than hypoechogenic glands (P<0.0001)
Trust score:4/5

gland volume

1 evidences

Thyroid ultrasound echogenicity and gland size predict response to radioiodine in Graves' disease: normoechogenic and large glands are more radioresistant.

Trust comment: Prospective cohort with a substantial sample (n=177) and clinically relevant endpoints; observational design limits causal claims.

Study Details

PMID:17609305
Participants:177
Impact:larger gland volume independently predicts increased radioresistance
Trust score:4/5

oral health-related quality of life (OHIP-14)

1 evidences

Placing an iodine-containing tampon into the extraction socket after wisdom tooth removal reduced pain and improved oral health–related quality of life in the first postoperative week.

Trust comment: Randomized controlled trial (n=87) with validated patient-reported outcomes; single-operator and short follow-up but well-conducted.

Study Details

PMID:32862256
Participants:87
Impact:lower mean OHIP-14 scores in iodine tampon group on postoperative days 1–5 (e.g., Day1 20.84 vs 27.79; P=0.001)
Trust score:4/5

pain intensity (PI-NRS)

1 evidences

Placing an iodine-containing tampon into the extraction socket after wisdom tooth removal reduced pain and improved oral health–related quality of life in the first postoperative week.

Trust comment: Randomized controlled trial (n=87) with validated patient-reported outcomes; single-operator and short follow-up but well-conducted.

Study Details

PMID:32862256
Participants:87
Impact:mean PI-NRS 3.33 (iodine) vs 4.46 (control); significantly lower pain days 1–4 (P<0.01 overall)
Trust score:4/5

postoperative sequelae (swelling/trismus/chewing problems)

1 evidences

Placing an iodine-containing tampon into the extraction socket after wisdom tooth removal reduced pain and improved oral health–related quality of life in the first postoperative week.

Trust comment: Randomized controlled trial (n=87) with validated patient-reported outcomes; single-operator and short follow-up but well-conducted.

Study Details

PMID:32862256
Participants:87
Impact:reduced incidence and medication use in iodine group (e.g., Day4 prescribed meds 57% vs 84%)
Trust score:4/5

serum thyroid hormone normalization

1 evidences

Randomized trial in patients with Graves' disease comparing drugs, surgery, or radioactive iodine; thyroid hormones normalized quickly and relapse rates differed by treatment.

Trust comment: Prospective randomized human trial with clear clinical endpoints and follow-up; subgroup stratification noted.

Study Details

PMID:8768863
Participants:179
Impact:normalized within 6 weeks
Trust score:4/5

Relapse rate

1 evidences

Randomized trial in patients with Graves' disease comparing drugs, surgery, or radioactive iodine; thyroid hormones normalized quickly and relapse rates differed by treatment.

Trust comment: Prospective randomized human trial with clear clinical endpoints and follow-up; subgroup stratification noted.

Study Details

PMID:8768863
Participants:179
Impact:medical: 42% (young) and 34% (old); radioiodine: 21%; surgery: 3% (young) and 8% (old)
Trust score:4/5

ophthalmopathy risk (associated factors)

1 evidences

Randomized trial in patients with Graves' disease comparing drugs, surgery, or radioactive iodine; thyroid hormones normalized quickly and relapse rates differed by treatment.

Trust comment: Prospective randomized human trial with clear clinical endpoints and follow-up; subgroup stratification noted.

Study Details

PMID:8768863
Participants:179
Impact:increased risk associated with high serum T3, particularly after iodine-131 treatment (qualitative)
Trust score:4/5

remnant ablation success rate

1 evidences

Randomized trial comparing four empirical 131I doses for thyroid remnant ablation; ablation rates improved up to ~50 mCi and plateaued at higher doses.

Trust comment: Randomized clinical trial with predefined objective ablation criteria and dosimetry analysis.

Study Details

PMID:8640708
Participants:149
Impact:30 mCi: 63%; 50 mCi: 77.8%; 90 mCi: 73.7%; 155 mCi: 76.7% (plateau above ~50 mCi)
Trust score:4/5

radiation-absorbed dose recommendation

1 evidences

Randomized trial comparing four empirical 131I doses for thyroid remnant ablation; ablation rates improved up to ~50 mCi and plateaued at higher doses.

Trust comment: Randomized clinical trial with predefined objective ablation criteria and dosimetry analysis.

Study Details

PMID:8640708
Participants:149
Impact:aim ≈30,000 cGy to remnant (based on dosimetry); higher empirical doses did not increase ablation rate
Trust score:4/5

mean urine iodine concentration (UIC)

1 evidences

Cluster randomized community trial where behavior-change intervention to promote iodized salt increased children's urinary iodine and was associated with improved growth (reduced stunting and greater height gains).

Trust comment: Large cluster-randomized trial with biochemical (UIC) and anthropometric outcomes and appropriate statistical analyses.

Study Details

PMID:38549782
Participants:834
Impact:intervention mean 202 µg/L vs control 104.4 µg/L; mean difference +97.56 µg/L (p=0.001)
Trust score:4/5

iodine deficiency prevalence (UIC <100 µg/L)

1 evidences

Cluster randomized community trial where behavior-change intervention to promote iodized salt increased children's urinary iodine and was associated with improved growth (reduced stunting and greater height gains).

Trust comment: Large cluster-randomized trial with biochemical (UIC) and anthropometric outcomes and appropriate statistical analyses.

Study Details

PMID:38549782
Participants:834
Impact:end-line: intervention 2.6% vs control 12.5% (p=0.001)
Trust score:4/5

child height

1 evidences

Cluster randomized community trial where behavior-change intervention to promote iodized salt increased children's urinary iodine and was associated with improved growth (reduced stunting and greater height gains).

Trust comment: Large cluster-randomized trial with biochemical (UIC) and anthropometric outcomes and appropriate statistical analyses.

Study Details

PMID:38549782
Participants:834
Impact:intervention associated with +7.93 cm end-line height (GEE β=7.93, p=0.001)
Trust score:4/5

median 24-h urinary iodine concentration (UIC)

1 evidences

Among 103 university staff, 24-h urinary measures showed median UIC consistent with mild iodine deficiency and estimated intake below recommended levels; household salt often had low iodine.

Trust comment: Human study using 24-h urinary iodine (gold standard) with validated lab methods; moderate sample size and limited representativeness reduce generalizability.

Study Details

PMID:37079158
Participants:103
Impact:66 µg/L (IQR 42–91) — indicates mild iodine deficiency (median <100 µg/L)
Trust score:4/5

24-h iodine excretion (UIE) / estimated daily intake

1 evidences

Among 103 university staff, 24-h urinary measures showed median UIC consistent with mild iodine deficiency and estimated intake below recommended levels; household salt often had low iodine.

Trust comment: Human study using 24-h urinary iodine (gold standard) with validated lab methods; moderate sample size and limited representativeness reduce generalizability.

Study Details

PMID:37079158
Participants:103
Impact:UIE median 94 µg/day; estimated intake median 113 µg/day; only 22% ≥150 µg/day
Trust score:4/5

household salt iodine concentration

1 evidences

Among 103 university staff, 24-h urinary measures showed median UIC consistent with mild iodine deficiency and estimated intake below recommended levels; household salt often had low iodine.

Trust comment: Human study using 24-h urinary iodine (gold standard) with validated lab methods; moderate sample size and limited representativeness reduce generalizability.

Study Details

PMID:37079158
Participants:103
Impact:Mean 14 mg I/kg in samples; 45% of samples <15 mg I/kg (below WHO recommendation)
Trust score:4/5

treatment response rate (12 mo)

1 evidences

In 92 Graves' patients randomized to three I-131 dosing strategies, higher fixed doses increased cure rates but also produced larger increases in ophthalmopathy (proptosis and CAS); a calculated dose balanced efficacy and fewer eye complications.

Trust comment: Randomized clinical design with objective ophthalmic and biochemical outcomes; moderate sample size and single-center limits precision.

Study Details

PMID:32433165
Participants:92
Impact:FLD 66.7% vs FHD 94.4% vs CD 92.9% (P=0.05) — higher cure with FHD and CD vs FLD
Trust score:4/5

ophthalmopathy (clinical activity score and proptosis)

1 evidences

In 92 Graves' patients randomized to three I-131 dosing strategies, higher fixed doses increased cure rates but also produced larger increases in ophthalmopathy (proptosis and CAS); a calculated dose balanced efficacy and fewer eye complications.

Trust comment: Randomized clinical design with objective ophthalmic and biochemical outcomes; moderate sample size and single-center limits precision.

Study Details

PMID:32433165
Participants:92
Impact:CAS and proptosis increased overall after treatment; significantly greater increases with high fixed dose (FHD) versus other strategies (P<0.05)
Trust score:4/5

cure rate / time to hypothyroidism

1 evidences

In patients receiving radioiodine for Graves' disease, pretreatment with methimazole did not change final cure rates or time to hypothyroidism compared with no pretreatment.

Trust comment: Randomized clinical trial but small sample and post-randomization exclusions reduce certainty of effect estimates.

Study Details

PMID:11916282
Participants:34
Impact:No significant difference between methimazole-pretreated and non-pretreated groups (time to hypothyroidism ~112 vs 106 days)
Trust score:3/5

free T4 normalization

1 evidences

In patients receiving radioiodine for Graves' disease, pretreatment with methimazole did not change final cure rates or time to hypothyroidism compared with no pretreatment.

Trust comment: Randomized clinical trial but small sample and post-randomization exclusions reduce certainty of effect estimates.

Study Details

PMID:11916282
Participants:34
Impact:Similar normalization times between groups (≈35±30 vs 44±39 days; p=0.57)
Trust score:3/5

hub colonization (culture-positive hubs without bacteremia)

1 evidences

In ICU patients, a catheter hub containing 3% iodinated alcohol markedly reduced hub colonization and catheter-related bloodstream infections compared with standard connectors.

Trust comment: Prospective, randomized multicenter ICU trial with clear clinical endpoints and adequate sample size; high quality evidence for this intervention.

Study Details

PMID:12771597
Participants:230
Impact:Reduced from 14.4% (control) to 4.3% (intervention); p<0.001
Trust score:5/5

catheter-related bloodstream infection from hub

1 evidences

In ICU patients, a catheter hub containing 3% iodinated alcohol markedly reduced hub colonization and catheter-related bloodstream infections compared with standard connectors.

Trust comment: Prospective, randomized multicenter ICU trial with clear clinical endpoints and adequate sample size; high quality evidence for this intervention.

Study Details

PMID:12771597
Participants:230
Impact:Reduced from 7% (control) to 1.7% (intervention); p<0.049
Trust score:5/5

catheter withdrawal for suspected infection

1 evidences

In ICU patients, a catheter hub containing 3% iodinated alcohol markedly reduced hub colonization and catheter-related bloodstream infections compared with standard connectors.

Trust comment: Prospective, randomized multicenter ICU trial with clear clinical endpoints and adequate sample size; high quality evidence for this intervention.

Study Details

PMID:12771597
Participants:230
Impact:Decreased from 43.8% (control) to 30.1% (intervention); p<0.035
Trust score:5/5

maternal TSH elevation

1 evidences

Many postpartum Colombian mothers had high TSH; salt restriction was associated with higher TSH and levels fell by 14 days and term.

Trust comment: Large observational cohort with clear measurements but non-randomized and potential confounders.

Study Details

PMID:14611705
Participants:404
Impact:~50% >10 mU/L initially; 9.3% at 14 days; 7.5% at term
Trust score:3/5

effect of salt restriction on maternal TSH

1 evidences

Many postpartum Colombian mothers had high TSH; salt restriction was associated with higher TSH and levels fell by 14 days and term.

Trust comment: Large observational cohort with clear measurements but non-randomized and potential confounders.

Study Details

PMID:14611705
Participants:404
Impact:initially 20.1 vs 14.6 mU/L (salt-restricted vs control), ≈+5.5 mU/L
Trust score:3/5

correlation of maternal TSH with infant outcomes

1 evidences

Many postpartum Colombian mothers had high TSH; salt restriction was associated with higher TSH and levels fell by 14 days and term.

Trust comment: Large observational cohort with clear measurements but non-randomized and potential confounders.

Study Details

PMID:14611705
Participants:404
Impact:TSH correlated with lower birth weight and gestational age (r=0.47 and r=0.49)
Trust score:3/5

hepatic parenchymal enhancement (ΔHU)

1 evidences

In CT imaging, higher iodine mass produced greater liver enhancement; estimated 0.28 gI/kg yields a 50-HU increase.

Trust comment: Randomized imaging trial with objective quantitative endpoints and adequate sample size.

Study Details

PMID:24865696
Participants:150
Impact:0.5 gI/kg: 84.2 HU; 0.4 gI/kg: 66.1 HU; 0.3 gI/kg: 53.7 HU
Trust score:4/5

estimated iodine dose for 50-HU increase

1 evidences

In CT imaging, higher iodine mass produced greater liver enhancement; estimated 0.28 gI/kg yields a 50-HU increase.

Trust comment: Randomized imaging trial with objective quantitative endpoints and adequate sample size.

Study Details

PMID:24865696
Participants:150
Impact:~0.28 gI/kg (or 9.6 gI/m²)
Trust score:4/5

glomerular filtration rate (GFR) change with hypothyroidism

1 evidences

Thyroid hormone withdrawal caused a significant drop in GFR (~18–22%), while rhTSH stimulation preserved GFR.

Trust comment: Small prospective study with objective isotope GFR measurement but limited by small sample size.

Study Details

PMID:26446582
Participants:28
Impact:decrease from 94±19 to 76±16 mL/min/1.73m² (~18–22% decline) after THW
Trust score:3/5

GFR with rhTSH stimulation

1 evidences

Thyroid hormone withdrawal caused a significant drop in GFR (~18–22%), while rhTSH stimulation preserved GFR.

Trust comment: Small prospective study with objective isotope GFR measurement but limited by small sample size.

Study Details

PMID:26446582
Participants:28
Impact:no significant change (91±18 to 93±15 mL/min/1.73m²)
Trust score:3/5

blood lymphocyte micronuclei frequency after 131I

1 evidences

Radioiodine (131I) increased genotoxic markers (micronuclei and clastogenic factors) in placebo patients; Ginkgo biloba prevented these increases.

Trust comment: Randomized double-blind controlled trial but small sample limits generalizability.

Study Details

PMID:22181338
Participants:23
Impact:significant increase in placebo (peak at day 7); no significant increase in GBE group
Trust score:4/5

plasma clastogenic factor activity after 131I

1 evidences

Radioiodine (131I) increased genotoxic markers (micronuclei and clastogenic factors) in placebo patients; Ginkgo biloba prevented these increases.

Trust comment: Randomized double-blind controlled trial but small sample limits generalizability.

Study Details

PMID:22181338
Participants:23
Impact:progressive increase in placebo (peak day 14); not increased in GBE group
Trust score:4/5

parotid gland Tc-99m uptake (accumulation ratio)

1 evidences

Parotid gland massage reduced salivary gland radioisotope accumulation and may help prevent salivary damage from radioiodine therapy.

Trust comment: Moderate-sized study with objective measures but unclear randomization and short-term endpoints.

Study Details

PMID:22524471
Participants:60
Impact:mean accumulation ratio 0.5%±3.3% with massage vs 6.8%±3.8% without (difference ≈6.3 percentage points decrease)
Trust score:3/5

change in parotid gland counts between scans

1 evidences

Parotid gland massage reduced salivary gland radioisotope accumulation and may help prevent salivary damage from radioiodine therapy.

Trust comment: Moderate-sized study with objective measures but unclear randomization and short-term endpoints.

Study Details

PMID:22524471
Participants:60
Impact:no significant change with massage; significant increase without massage (p<0.01)
Trust score:3/5

iodine contrast dose reduction

1 evidences

Weight-adapted low-kVp CT protocols maintain image quality and allow substantial reduction in iodine contrast dose (>50% in lighter patients).

Trust comment: Well-conducted imaging study with randomized preliminary allocation and clear objective outcomes.

Study Details

PMID:15068946
Participants:142
Impact:protocol A reduced iodine dose by 54% and protocol B by 39% versus standard
Trust score:4/5

image noise and diagnostic quality

1 evidences

Weight-adapted low-kVp CT protocols maintain image quality and allow substantial reduction in iodine contrast dose (>50% in lighter patients).

Trust comment: Well-conducted imaging study with randomized preliminary allocation and clear objective outcomes.

Study Details

PMID:15068946
Participants:142
Impact:higher noise with low-kVp but no significant difference in qualitative diagnostic image quality overall
Trust score:4/5

discomfort

1 evidences

Compared two iodinated contrast agents; iodixanol caused less discomfort and had similar diagnostic efficacy with differing short-term renal enzyme and creatinine effects.

Trust comment: Double-blind randomized phase-III trial with objective measures and moderate sample size.

Study Details

PMID:8797943
Participants:117
Impact:milder with iodixanol (qualitative)
Trust score:4/5

renal N-acetyl-beta-glucosaminidase (NAG) excretion

1 evidences

Compared two iodinated contrast agents; iodixanol caused less discomfort and had similar diagnostic efficacy with differing short-term renal enzyme and creatinine effects.

Trust comment: Double-blind randomized phase-III trial with objective measures and moderate sample size.

Study Details

PMID:8797943
Participants:117
Impact:significantly higher with iopamidol in first 24 h (p<0.01)
Trust score:4/5

creatinine clearance

1 evidences

Compared two iodinated contrast agents; iodixanol caused less discomfort and had similar diagnostic efficacy with differing short-term renal enzyme and creatinine effects.

Trust comment: Double-blind randomized phase-III trial with objective measures and moderate sample size.

Study Details

PMID:8797943
Participants:117
Impact:slightly more reduced with iodixanol (qualitative)
Trust score:4/5

radioiodine-induced hyperthyroidism

1 evidences

Radioiodine reduced thyroid volume substantially; adjunct lithium prevented early radioiodine-induced hyperthyroidism.

Trust comment: Randomized clinical trial with 24-month follow-up and clear objective endpoints.

Study Details

PMID:15871016
Participants:80
Impact:observed in 58.8% overall at 1–4 weeks; prevented by lithium (qualitative)
Trust score:4/5

height-for-age (growth)

1 evidences

Iodine administration normalized thyroid tests and improved growth; adding selenium did not alter established disease outcomes at 12 months.

Trust comment: Double-blind randomized trial in 324 children with biochemical and clinical outcomes assessed at 12 months.

Study Details

PMID:12816783
Participants:324
Impact:significant increase in iodine-treated groups; unsupplemented controls showed no recovery
Trust score:4/5

Kashin-Beck clinical/radiologic signs

1 evidences

Iodine administration normalized thyroid tests and improved growth; adding selenium did not alter established disease outcomes at 12 months.

Trust comment: Double-blind randomized trial in 324 children with biochemical and clinical outcomes assessed at 12 months.

Study Details

PMID:12816783
Participants:324
Impact:no significant difference between groups at 12 months (selenium had no effect)
Trust score:4/5

AUA urinary symptom score

2 evidences

Compared two radioisotopes for prostate brachytherapy; Pd-103 gave quicker recovery and lower early urinary symptom scores than I-125.

Trust comment: Prospective randomized multicenter trial with patient-reported morbidity outcomes but interim smaller sample reported.

Study Details

PMID:11895205
Participants:110
Impact:6 months: I-125 mean 16 vs Pd-103 mean 11; 12 months: I-125 13 vs Pd-103 12
Trust score:4/5

Randomized trial comparing I-125 and Pd-103 seeds for prostate brachytherapy found differences in early and mid-term urinary and rectal side effects: Pd-103 produced worse urinary symptoms early but recovered sooner; I-125 showed a trend toward more rectal bleeding.

Trust comment: Prospective randomized multicenter trial with 352 patients and objective outcome measures, though not the full planned sample and some endpoints are symptomatic.

Study Details

PMID:16259869
Participants:352
Impact:At 1 month: Pd-103 mean 18.6 vs I-125 14.8 (Pd-103 +3.8 points); at 6 months: I-125 mean 12.0 vs Pd-103 9.9 (I-125 +2.1 points)
Trust score:4/5

time to recovery from radiation prostatitis

1 evidences

Compared two radioisotopes for prostate brachytherapy; Pd-103 gave quicker recovery and lower early urinary symptom scores than I-125.

Trust comment: Prospective randomized multicenter trial with patient-reported morbidity outcomes but interim smaller sample reported.

Study Details

PMID:11895205
Participants:110
Impact:quicker recovery with Pd-103 (qualitative)
Trust score:4/5

mean aortic enhancement (MAE)

1 evidences

Higher iodine concentration (≥300 mg/ml) produced superior aortic and porto-venous hepatic enhancement; lower concentrations risk insufficient hepatic porto-venous enhancement.

Trust comment: Randomized allocation across 100 patients with objective CT HU measurements and clear thresholds for adequacy.

Study Details

PMID:15088181
Participants:100
Impact:350 mg/ml 222 HU; 300 mg/ml 213 HU; 250 mg/ml 196 HU; 200 mg/ml 169 HU (arterial phase)
Trust score:4/5

porto-venous mean hepatic enhancement (MHE) sufficiency

1 evidences

Higher iodine concentration (≥300 mg/ml) produced superior aortic and porto-venous hepatic enhancement; lower concentrations risk insufficient hepatic porto-venous enhancement.

Trust comment: Randomized allocation across 100 patients with objective CT HU measurements and clear thresholds for adequacy.

Study Details

PMID:15088181
Participants:100
Impact:only 300 and 350 mg/ml met required porto-venous MHE in all individuals; 200 mg/ml had 8 patients and 250 mg/ml 3 patients below minimum
Trust score:4/5

required PTU dosage

1 evidences

Patients with hyperthyroidism randomized to iodated vs non-iodated salt; antithyroid drug needs were tracked over 6 months.

Trust comment: Randomized human trial with clear participant numbers and measurable endpoints; some minor reporting inconsistencies in hormone values but primary drug-dose outcome is robust.

Study Details

PMID:14720423
Participants:101
Impact:+24 mg/day (month 2), +42 mg/day (month 3), +62 mg/day (month 6) for iodated-salt group vs non-iodated
Trust score:4/5

arterial attenuation (main renal artery)

1 evidences

Prospective comparison of 80 kVp with moderate-concentration iodinated contrast vs 120 kVp with high-concentration contrast for renal CTA in 50 patients.

Trust comment: Prospective human study with balanced groups and objective imaging metrics; sample size moderate but appropriate for imaging endpoints.

Study Details

PMID:22733899
Participants:50
Impact:+100.1 HU (370.0 ±65.0 vs 269.9 ±27.8 HU; p<0.001) with 80 kVp + moderate-concentration CM
Trust score:4/5

SNR and CNR

3 evidences

Randomized volunteer study showing 70-kVp CT angiography improves vascular enhancement and image quality and allows reduced iodine contrast volume and lower radiation dose.

Trust comment: Randomized study with objective imaging metrics and reasonable sample size; applicable to clinical imaging practice.

Study Details

PMID:25510446
Participants:69
Impact:increased at 70 kVp (groups B > A)
Trust score:4/5

Randomized trial showing low-concentration contrast with low tube voltage + iterative reconstruction reduces radiation dose while maintaining or improving vascular attenuation and image quality.

Trust comment: Prospective randomized trial with objective and subjective image-quality metrics and dose reporting; trustworthy for imaging protocol conclusions.

Study Details

PMID:28888094
Participants:136
Impact:Higher SNR and CNR in Group B versus Group A (p<0.05); subjective image quality not decreased
Trust score:4/5

Prospective comparison of 80 kVp with moderate-concentration iodinated contrast vs 120 kVp with high-concentration contrast for renal CTA in 50 patients.

Trust comment: Prospective human study with balanced groups and objective imaging metrics; sample size moderate but appropriate for imaging endpoints.

Study Details

PMID:22733899
Participants:50
Impact:no significant difference between protocols
Trust score:4/5

stent restenosis rate

1 evidences

Randomized trial comparing I-125–seed radioactive stent vs conventional stent for malignant airway obstruction; restenosis, survival, and complications assessed.

Trust comment: Single-center randomized controlled trial with clear primary and secondary endpoints and statistically significant findings for restenosis and survival, but modest sample size.

Study Details

PMID:29909977
Participants:66
Impact:reduced from 45.45% (CBMS) to 21.2% (RBMS) (−24.25 percentage points; p=0.037)
Trust score:4/5

median overall survival

3 evidences

Stents loaded with 125I seeds prolonged median overall survival compared with conventional stents in unresectable oesophageal cancer.

Trust comment: Multicenter randomized phase 3 trial with a clear survival benefit and adequate sample size and follow-up.

Study Details

PMID:24742740
Participants:160
Impact:177 days (irradiation) vs 147 days (control); p=0.0046
Trust score:5/5

CT-guided permanent 125I seed implantation improved local tumor control and resulted in longer survival compared with radiochemotherapy for pelvic recurrence after cervical cancer surgery.

Trust comment: Randomized comparative study (n=62) showing improved local control and longer median survival with 125I implantation; moderate sample size and single/regional centers limit broad generalizability.

Study Details

PMID:34059692
Participants:62
Impact:+0.75 years (125I median 4.34 years vs radiochemotherapy 3.59 years; P < 0.05)
Trust score:4/5

Randomized trial comparing I-125–seed radioactive stent vs conventional stent for malignant airway obstruction; restenosis, survival, and complications assessed.

Trust comment: Single-center randomized controlled trial with clear primary and secondary endpoints and statistically significant findings for restenosis and survival, but modest sample size.

Study Details

PMID:29909977
Participants:66
Impact:increased by 47 days (170 vs 123 days; p=0.015) with I-125 stent
Trust score:4/5

overall complications

1 evidences

Randomized trial comparing I-125–seed radioactive stent vs conventional stent for malignant airway obstruction; restenosis, survival, and complications assessed.

Trust comment: Single-center randomized controlled trial with clear primary and secondary endpoints and statistically significant findings for restenosis and survival, but modest sample size.

Study Details

PMID:29909977
Participants:66
Impact:no significant increase in complications (incidence comparable between groups)
Trust score:4/5

partial remission rate

1 evidences

Open randomized trial comparing I-125 seed interstitial brachytherapy vs local chemotherapy perfusion in advanced pancreatic cancer patients; tumor response, pain, tumor markers, and survival assessed.

Trust comment: Prospective randomized study with a relatively large sample (n=165) and multiple clinically relevant endpoints; open-label design may introduce bias for subjective outcomes.

Study Details

PMID:32865062
Participants:165
Impact:higher in I-125 group (statistically significant)
Trust score:4/5

Pain (VAS)

3 evidences

Compared a new topical dressing to Alvogyl (which contains iodoform); new dressing gave faster short-term pain relief (30–60 min) but Alvogyl provided better pain control at 24–72 hours; no complications.

Trust comment: Double-blind randomized trial with complete follow-up but small sample size (n=36).

Study Details

PMID:39582403
Participants:36
Impact:experimental dressing < Alvogyl at 30 and 60 min (p<0.001); experimental dressing > Alvogyl at 24, 48, 72 h (p=0.029 to 0.001)
Trust score:4/5

Open randomized trial comparing I-125 seed interstitial brachytherapy vs local chemotherapy perfusion in advanced pancreatic cancer patients; tumor response, pain, tumor markers, and survival assessed.

Trust comment: Prospective randomized study with a relatively large sample (n=165) and multiple clinically relevant endpoints; open-label design may introduce bias for subjective outcomes.

Study Details

PMID:32865062
Participants:165
Impact:greater decrease in VAS scores in I-125 group (significant)
Trust score:4/5

Randomized trial comparing Alvogyl (contains iodoform) versus black seed mixture and saline for dry socket; black seed produced fastest pain relief and Alvogyl improved pain gradually.

Trust comment: Randomized double-blind trial with clear clinical outcomes, but small group sizes (≈20 per arm) and some baseline differences in age/gender noted.

Study Details

PMID:35685605
Participants:60
Impact:black seed group pain-free by day 2 and lower VAS vs Alvogyl and saline (ANOVA p≤0.031 overall; black seed superior to Alvogyl and saline)
Trust score:3/5

Karnofsky performance score

1 evidences

Open randomized trial comparing I-125 seed interstitial brachytherapy vs local chemotherapy perfusion in advanced pancreatic cancer patients; tumor response, pain, tumor markers, and survival assessed.

Trust comment: Prospective randomized study with a relatively large sample (n=165) and multiple clinically relevant endpoints; open-label design may introduce bias for subjective outcomes.

Study Details

PMID:32865062
Participants:165
Impact:higher after I-125 treatment (significant)
Trust score:4/5

tumor markers CA19-9 and CA50

1 evidences

Open randomized trial comparing I-125 seed interstitial brachytherapy vs local chemotherapy perfusion in advanced pancreatic cancer patients; tumor response, pain, tumor markers, and survival assessed.

Trust comment: Prospective randomized study with a relatively large sample (n=165) and multiple clinically relevant endpoints; open-label design may introduce bias for subjective outcomes.

Study Details

PMID:32865062
Participants:165
Impact:levels decreased more in I-125 group (significant); CEA no difference
Trust score:4/5

9-year biochemical relapse-free survival (BRFS)

1 evidences

Randomized trial comparing I-125 vs Cs-131 isotopes for prostate brachytherapy with long-term follow-up (~97 months); urinary, sexual, bowel QOL and biochemical relapse assessed.

Trust comment: Well-conducted randomized trial with long follow-up and clear oncologic and QoL endpoints; adequate sample and objective outcomes.

Study Details

PMID:33059997
Participants:140
Impact:no significant difference: 87.2% (125I) vs 84.0% (131Cs); p=0.897
Trust score:4/5

urinary and sexual quality of life

1 evidences

Randomized trial comparing I-125 vs Cs-131 isotopes for prostate brachytherapy with long-term follow-up (~97 months); urinary, sexual, bowel QOL and biochemical relapse assessed.

Trust comment: Well-conducted randomized trial with long follow-up and clear oncologic and QoL endpoints; adequate sample and objective outcomes.

Study Details

PMID:33059997
Participants:140
Impact:no significant difference between isotopes at recorded timepoints
Trust score:4/5

bowel QOL at 2 months

1 evidences

Randomized trial comparing I-125 vs Cs-131 isotopes for prostate brachytherapy with long-term follow-up (~97 months); urinary, sexual, bowel QOL and biochemical relapse assessed.

Trust comment: Well-conducted randomized trial with long follow-up and clear oncologic and QoL endpoints; adequate sample and objective outcomes.

Study Details

PMID:33059997
Participants:140
Impact:worse with 125I at 2 months (transient)
Trust score:4/5

TSH and free T3/free T4

1 evidences

Double-blind RCT in older adults testing selenium, iodine, their combination, or placebo for 3 months; thyroid function, thyroglobulin, selenium status and urinary iodine measured.

Trust comment: Double-blind, placebo-controlled RCT with clear biochemical outcomes and adequate sample for population studied; results consistent and plausible.

Study Details

PMID:19692495
Participants:100
Impact:no significant change with supplementation
Trust score:4/5

thyroid volume (maternal)

1 evidences

Pregnant women randomized to iodised salt or iodine supplements showed no difference in child neurodevelopment; prior long-term iodised salt use raised maternal urinary iodine and reduced thyroid volume.

Trust comment: Randomized trial with objective biochemical and clinical outcomes and moderate sample size; results appear reliable though subgroup baseline iodine status was mild-moderate deficiency.

Study Details

PMID:23375074
Participants:131
Impact:decreased in third trimester (P=0.01) with prior iodised salt use
Trust score:4/5

child neurodevelopment

1 evidences

Pregnant women randomized to iodised salt or iodine supplements showed no difference in child neurodevelopment; prior long-term iodised salt use raised maternal urinary iodine and reduced thyroid volume.

Trust comment: Randomized trial with objective biochemical and clinical outcomes and moderate sample size; results appear reliable though subgroup baseline iodine status was mild-moderate deficiency.

Study Details

PMID:23375074
Participants:131
Impact:no significant difference between treatment groups
Trust score:4/5

β-endorphin

1 evidences

Children with ASD who received iodine-bromine baths showed biochemical changes in stress hormones and reported calming effects in those with severe hyperactivity.

Trust comment: Randomized subgroup allocation and objective hormone measures support findings, but reporting and clinical interpretation are limited and blinding is unclear.

Study Details

PMID:35236065
Participants:44
Impact:significant increase (P<0.001) after iodine-bromine baths
Trust score:3/5

adrenocorticotropic hormone (ACTH)

1 evidences

Children with ASD who received iodine-bromine baths showed biochemical changes in stress hormones and reported calming effects in those with severe hyperactivity.

Trust comment: Randomized subgroup allocation and objective hormone measures support findings, but reporting and clinical interpretation are limited and blinding is unclear.

Study Details

PMID:35236065
Participants:44
Impact:significant increase (P<0.001) after iodine-bromine baths
Trust score:3/5

cortisol

1 evidences

Children with ASD who received iodine-bromine baths showed biochemical changes in stress hormones and reported calming effects in those with severe hyperactivity.

Trust comment: Randomized subgroup allocation and objective hormone measures support findings, but reporting and clinical interpretation are limited and blinding is unclear.

Study Details

PMID:35236065
Participants:44
Impact:significant increase (P<0.001) after iodine-bromine baths
Trust score:3/5

euthyroidism rate

1 evidences

In 460 untreated hyperthyroid patients followed ~9 years, radioiodine (131I) produced higher cure rates and lower recurrence but more hypothyroidism versus antithyroid drugs.

Trust comment: Large randomized prospective trial with blinded endpoint assessment and long follow-up; open-label treatment is a limitation.

Study Details

PMID:19194213
Participants:460
Impact:+28.7 percentage points (69.9% vs 41.2%)
Trust score:4/5

hypothyroidism rate

1 evidences

In 460 untreated hyperthyroid patients followed ~9 years, radioiodine (131I) produced higher cure rates and lower recurrence but more hypothyroidism versus antithyroid drugs.

Trust comment: Large randomized prospective trial with blinded endpoint assessment and long follow-up; open-label treatment is a limitation.

Study Details

PMID:19194213
Participants:460
Impact:+12.5 percentage points (21.5% vs 9.0%)
Trust score:4/5

infant mortality (first 2 months)

1 evidences

Randomized, double-masked trial in 617 Indonesian infants showed oral iodized oil given ~6 weeks of age reduced early infant deaths and delayed time to death among those who died.

Trust comment: Double-masked, randomized, placebo-controlled trial with clear mortality endpoints; credible evidence though context-specific.

Study Details

PMID:9109607
Participants:617
Impact:-72% risk of death (P<0.05)
Trust score:5/5

time to death among infants who died

1 evidences

Randomized, double-masked trial in 617 Indonesian infants showed oral iodized oil given ~6 weeks of age reduced early infant deaths and delayed time to death among those who died.

Trust comment: Double-masked, randomized, placebo-controlled trial with clear mortality endpoints; credible evidence though context-specific.

Study Details

PMID:9109607
Participants:617
Impact:mean 48 d vs 17.5 d (delay; P=0.06)
Trust score:5/5

health-related quality of life (HRQoL) at 131I administration

1 evidences

In 752 thyroid cancer patients, recombinant TSH (rhTSH) avoided the transient HRQoL deterioration caused by thyroid hormone withdrawal (THW) around 131I administration but at higher cost.

Trust comment: Large randomized phase III trial with prospectively collected QoL and cost data; robust methodology.

Study Details

PMID:26240230
Participants:752
Impact:THW caused clinically significant transient deterioration; rhTSH avoided deterioration
Trust score:5/5

quality-adjusted life years (QALYs)

1 evidences

In 752 thyroid cancer patients, recombinant TSH (rhTSH) avoided the transient HRQoL deterioration caused by thyroid hormone withdrawal (THW) around 131I administration but at higher cost.

Trust comment: Large randomized phase III trial with prospectively collected QoL and cost data; robust methodology.

Study Details

PMID:26240230
Participants:752
Impact:+0.013 QALY per patient with rhTSH
Trust score:5/5

incremental cost (rhTSH vs THW)

1 evidences

In 752 thyroid cancer patients, recombinant TSH (rhTSH) avoided the transient HRQoL deterioration caused by thyroid hormone withdrawal (THW) around 131I administration but at higher cost.

Trust comment: Large randomized phase III trial with prospectively collected QoL and cost data; robust methodology.

Study Details

PMID:26240230
Participants:752
Impact:+€474 per patient (rhTSH)
Trust score:5/5

6-month response rate (60 Gy)

1 evidences

Single-blinded randomized trial in 57 completers with Graves' disease found similar 6-month outcomes for 60 Gy versus 90 Gy radioiodine dosing, with notable rates of hypothyroidism and nonresponse.

Trust comment: Randomized single-blinded trial but small sample and limited power to detect dose differences.

Study Details

PMID:11685491
Participants:57
Impact:~39% response at 6 months
Trust score:3/5

overall hypothyroidism rate

1 evidences

Single-blinded randomized trial in 57 completers with Graves' disease found similar 6-month outcomes for 60 Gy versus 90 Gy radioiodine dosing, with notable rates of hypothyroidism and nonresponse.

Trust comment: Randomized single-blinded trial but small sample and limited power to detect dose differences.

Study Details

PMID:11685491
Participants:57
Impact:47% (27/57) overall
Trust score:3/5

dose comparison outcome

1 evidences

Single-blinded randomized trial in 57 completers with Graves' disease found similar 6-month outcomes for 60 Gy versus 90 Gy radioiodine dosing, with notable rates of hypothyroidism and nonresponse.

Trust comment: Randomized single-blinded trial but small sample and limited power to detect dose differences.

Study Details

PMID:11685491
Participants:57
Impact:no significant difference between 60 Gy and 90 Gy (P=0.881)
Trust score:3/5

parotid gland excretory function (EF)

1 evidences

In 69 postoperative thyroid cancer patients receiving 131I, antioxidant regimens (vitamin E+C, selenium, selenium+C) were associated with improved salivary gland function parameters one month after treatment.

Trust comment: Randomized allocation across small groups (n=69) with short (1 month) follow-up; findings significant but sample size limits generalizability.

Study Details

PMID:38312062
Participants:69
Impact:increased (significant vs baseline for vitamin E + C)
Trust score:3/5

parotid and submandibular uptake/excretion (UR20, ER, EF)

1 evidences

In 69 postoperative thyroid cancer patients receiving 131I, antioxidant regimens (vitamin E+C, selenium, selenium+C) were associated with improved salivary gland function parameters one month after treatment.

Trust comment: Randomized allocation across small groups (n=69) with short (1 month) follow-up; findings significant but sample size limits generalizability.

Study Details

PMID:38312062
Participants:69
Impact:increased (significant vs baseline for selenium)
Trust score:3/5

combined selenium + vitamin C effect

1 evidences

In 69 postoperative thyroid cancer patients receiving 131I, antioxidant regimens (vitamin E+C, selenium, selenium+C) were associated with improved salivary gland function parameters one month after treatment.

Trust comment: Randomized allocation across small groups (n=69) with short (1 month) follow-up; findings significant but sample size limits generalizability.

Study Details

PMID:38312062
Participants:69
Impact:improvement in bilateral parotid EF and submandibular UR20/EF (significant)
Trust score:3/5

duration of protection after oral iodized oil (E. histolytica)

1 evidences

In 110 iodine-deficient schoolchildren, treating intestinal parasites before oral iodized oil substantially prolonged the duration of urinary iodine protection compared with untreated children.

Trust comment: Randomized intervention in schoolchildren with objective urinary iodine outcomes; moderate sample size limits subgroup precision.

Study Details

PMID:9394695
Participants:110
Impact:increased from 2.0 to 21.0 weeks (+19.0 weeks with metronidazole)
Trust score:4/5

duration of protection (treated vs untreated overall)

1 evidences

In 110 iodine-deficient schoolchildren, treating intestinal parasites before oral iodized oil substantially prolonged the duration of urinary iodine protection compared with untreated children.

Trust comment: Randomized intervention in schoolchildren with objective urinary iodine outcomes; moderate sample size limits subgroup precision.

Study Details

PMID:9394695
Participants:110
Impact:treated: 16.8 wk vs untreated ~7.6 wk; treated +9.2 weeks (P<0.001)
Trust score:4/5

water iodine concentration

1 evidences

Measured iodine in diet, water and salt of schoolchildren and found intake above recommended but below the upper limit.

Trust comment: Cross-sectional survey with standard chemical measures and moderate sample size; useful for population status though observational.

Study Details

PMID:25035191
Participants:159
Impact:mean 0.979 μg/L (range 0.611–1.473 μg/L)
Trust score:3/5

salt iodine concentration

1 evidences

Measured iodine in diet, water and salt of schoolchildren and found intake above recommended but below the upper limit.

Trust comment: Cross-sectional survey with standard chemical measures and moderate sample size; useful for population status though observational.

Study Details

PMID:25035191
Participants:159
Impact:mean 25.62 mg/kg
Trust score:3/5

intrathyroidal iodine concentration

1 evidences

Randomized comparison of two levothyroxine+iodide dose combos showed both reduced goitre size similarly with different TSH responses.

Trust comment: Randomized clinical trial with objective ultrasound measures but small sample and short follow-up.

Study Details

PMID:11256036
Participants:44
Impact:no significant change between groups
Trust score:4/5

TSH suppression

1 evidences

Randomized comparison of two levothyroxine+iodide dose combos showed both reduced goitre size similarly with different TSH responses.

Trust comment: Randomized clinical trial with objective ultrasound measures but small sample and short follow-up.

Study Details

PMID:11256036
Participants:44
Impact:greater suppression in group A (higher levothyroxine dose)
Trust score:4/5

RAIU (radioiodine uptake)

1 evidences

Giving short-course methimazole before 131I increased radioiodine uptake and sped goitre shrinkage compared with placebo+131I.

Trust comment: Double-blind randomized trial with objective measures (RAIU, ultrasound) but modest sample size (n=31).

Study Details

PMID:31586293
Participants:31
Impact:ΔRAIU24h +36% (to 65%); ΔRAIU48h +31% (to 59%)
Trust score:4/5

thyroid volume reduction (TVR)

1 evidences

Giving short-course methimazole before 131I increased radioiodine uptake and sped goitre shrinkage compared with placebo+131I.

Trust comment: Double-blind randomized trial with objective measures (RAIU, ultrasound) but modest sample size (n=31).

Study Details

PMID:31586293
Participants:31
Impact:34% greater at 6 months and 22% greater at 2 years (MMI+131I vs 131I alone)
Trust score:4/5

time to therapeutic endpoint (TV <40 ml)

1 evidences

Giving short-course methimazole before 131I increased radioiodine uptake and sped goitre shrinkage compared with placebo+131I.

Trust comment: Double-blind randomized trial with objective measures (RAIU, ultrasound) but modest sample size (n=31).

Study Details

PMID:31586293
Participants:31
Impact:median 9 months (MMI+131I) vs 18 months (131I alone)
Trust score:4/5

dysphagia relief

1 evidences

In patients with advanced esophageal cancer, stents loaded with 125I seeds provided slightly longer dysphagia relief and improved survival versus covered stents.

Trust comment: Prospective randomized assignment with clinical endpoints and significant survival differences, but single-center and modest sample size.

Study Details

PMID:18349316
Participants:53
Impact:both groups improved at 1 month; irradiation-stent group better at 2 months (P < 0.05)
Trust score:4/5

survival time

1 evidences

In patients with advanced esophageal cancer, stents loaded with 125I seeds provided slightly longer dysphagia relief and improved survival versus covered stents.

Trust comment: Prospective randomized assignment with clinical endpoints and significant survival differences, but single-center and modest sample size.

Study Details

PMID:18349316
Participants:53
Impact:median and mean survival significantly longer in irradiation-stent group (P < 0.001)
Trust score:4/5

Hemorrhage incidence

1 evidences

In patients with advanced esophageal cancer, stents loaded with 125I seeds provided slightly longer dysphagia relief and improved survival versus covered stents.

Trust comment: Prospective randomized assignment with clinical endpoints and significant survival differences, but single-center and modest sample size.

Study Details

PMID:18349316
Participants:53
Impact:16/53 patients (30%) experienced hemorrhage during follow-up
Trust score:4/5

ferritin

1 evidences

In iron-deficient adolescent girls, improving iron status (with or without added iodine) improved some thyroid hormone indices; iodine alone increased urinary iodine but not thyroid indices.

Trust comment: Double-blind randomized intervention with good completion (94) and objective biochemical outcomes; supported by clear statistical differences.

Study Details

PMID:16340950
Participants:94
Impact:in iron+iodine group increased from 8.7 to 17.6 μg/dl (Δ +8.9 μg/dl)
Trust score:4/5

transferrin saturation

1 evidences

In iron-deficient adolescent girls, improving iron status (with or without added iodine) improved some thyroid hormone indices; iodine alone increased urinary iodine but not thyroid indices.

Trust comment: Double-blind randomized intervention with good completion (94) and objective biochemical outcomes; supported by clear statistical differences.

Study Details

PMID:16340950
Participants:94
Impact:in iron+iodine group increased from 7.2% to 18.8% (Δ +11.6 percentage points)
Trust score:4/5

thyroid hormones (tT4, tT3, rT3, T3RU)

1 evidences

In iron-deficient adolescent girls, improving iron status (with or without added iodine) improved some thyroid hormone indices; iodine alone increased urinary iodine but not thyroid indices.

Trust comment: Double-blind randomized intervention with good completion (94) and objective biochemical outcomes; supported by clear statistical differences.

Study Details

PMID:16340950
Participants:94
Impact:iron+iodine group: tT4 8.9→10 μg/dl, tT3 138→143 μg/dl, rT3 44.2→24.8 ng/dl; indices improved post-treatment
Trust score:4/5

D90

1 evidences

Compared dosimetric coverage and uniformity between HDR brachytherapy and permanent iodine-125 prostate implants; HDR provided better coverage and homogeneity.

Trust comment: Comparative human dosimetric study with reasonable sample size but not a randomized clinical outcome trial, so moderate confidence.

Study Details

PMID:17118319
Participants:126
Impact:HDR 111.5% vs PPI preplan 120.2% (−8.7 percentage points)
Trust score:3/5

V100

1 evidences

Compared dosimetric coverage and uniformity between HDR brachytherapy and permanent iodine-125 prostate implants; HDR provided better coverage and homogeneity.

Trust comment: Comparative human dosimetric study with reasonable sample size but not a randomized clinical outcome trial, so moderate confidence.

Study Details

PMID:17118319
Participants:126
Impact:HDR 97.2% vs PPI preplan 99.6% (−2.4 percentage points)
Trust score:3/5

Homogeneity index

1 evidences

Compared dosimetric coverage and uniformity between HDR brachytherapy and permanent iodine-125 prostate implants; HDR provided better coverage and homogeneity.

Trust comment: Comparative human dosimetric study with reasonable sample size but not a randomized clinical outcome trial, so moderate confidence.

Study Details

PMID:17118319
Participants:126
Impact:HDR 0.63 vs PPI preplan 0.52 (+0.11)
Trust score:3/5

Positive blood culture rate

1 evidences

Large randomized crossover study comparing skin antisepsis with chlorhexidine versus iodine tincture for blood cultures; found no difference in contamination rates.

Trust comment: Prospective randomized crossover design with large sample of blood culture sets supports high trustworthiness.

Study Details

PMID:27707940
Participants:6095
Impact:Iodine tincture 10.86% vs chlorhexidine 11.03% (no significant difference)
Trust score:4/5

Treatment success rate (standard 15 mCi)

1 evidences

Prospective randomized study of radioiodine dosing for Graves' disease showing success rates depend on dose and thyroid volume.

Trust comment: Prospective randomized clinical trial with complete follow-up reported for defined groups, moderate-high confidence.

Study Details

PMID:9133695
Participants:205
Impact:71% overall (group 1)
Trust score:4/5

Treatment success rate (target 100 Gy)

1 evidences

Prospective randomized study of radioiodine dosing for Graves' disease showing success rates depend on dose and thyroid volume.

Trust comment: Prospective randomized clinical trial with complete follow-up reported for defined groups, moderate-high confidence.

Study Details

PMID:9133695
Participants:205
Impact:~40–50% in most subgroups; ≈80% in thyroid volume <15 mL (likely higher delivered dose)
Trust score:4/5

Dose–response (calculated)

1 evidences

Prospective randomized study of radioiodine dosing for Graves' disease showing success rates depend on dose and thyroid volume.

Trust comment: Prospective randomized clinical trial with complete follow-up reported for defined groups, moderate-high confidence.

Study Details

PMID:9133695
Participants:205
Impact:Estimated 200 Gy associated with ~80% success rate
Trust score:4/5

Mean hepatic contrast enhancement (HCE)

1 evidences

Randomized comparison of contrast concentration/volume protocols showing that reducing iodine dose lowers hepatic contrast enhancement and may reduce lesion detectability.

Trust comment: Prospective randomized imaging study with clear quantitative endpoints; results directly relevant to iodine contrast dosing.

Study Details

PMID:7568860
Participants:111
Impact:Decrease in volume (150→100 mL) decreased mean HCE by 27%
Trust score:4/5

Contrast enhancement index (CEI)

1 evidences

Randomized comparison of contrast concentration/volume protocols showing that reducing iodine dose lowers hepatic contrast enhancement and may reduce lesion detectability.

Trust comment: Prospective randomized imaging study with clear quantitative endpoints; results directly relevant to iodine contrast dosing.

Study Details

PMID:7568860
Participants:111
Impact:Decrease in volume decreased CEI by 69%
Trust score:4/5

Iodine dose reduction effect

1 evidences

Randomized comparison of contrast concentration/volume protocols showing that reducing iodine dose lowers hepatic contrast enhancement and may reduce lesion detectability.

Trust comment: Prospective randomized imaging study with clear quantitative endpoints; results directly relevant to iodine contrast dosing.

Study Details

PMID:7568860
Participants:111
Impact:Reducing iodine dose from ~45–48 g to 30–32 g significantly decreased all HCE values (worse enhancement)
Trust score:4/5

CT value (HU) — pulmonary artery, BMI ≤23

1 evidences

Prospective study testing two fixed-time iodine injection protocols for triple‑rule‑out chest CT showing protocol differences by BMI groups with no radiation dose penalty.

Trust comment: Prospective randomized protocol trial with objective image-quality metrics and clear BMI-stratified results; reliable for imaging outcomes.

Study Details

PMID:31198144
Participants:92
Impact:Protocol 2 584±110 HU vs Protocol 1 472±86 HU (higher with protocol 2)
Trust score:4/5

CNR and primary image score — BMI groups

1 evidences

Prospective study testing two fixed-time iodine injection protocols for triple‑rule‑out chest CT showing protocol differences by BMI groups with no radiation dose penalty.

Trust comment: Prospective randomized protocol trial with objective image-quality metrics and clear BMI-stratified results; reliable for imaging outcomes.

Study Details

PMID:31198144
Participants:92
Impact:Protocol 2 produced higher CNR and primary scores for pulmonary (BMI≤23) and coronary/aortic images (BMI>23) (all P<0.05 where reported)
Trust score:4/5

Radiation dose (effective dose)

1 evidences

Prospective study testing two fixed-time iodine injection protocols for triple‑rule‑out chest CT showing protocol differences by BMI groups with no radiation dose penalty.

Trust comment: Prospective randomized protocol trial with objective image-quality metrics and clear BMI-stratified results; reliable for imaging outcomes.

Study Details

PMID:31198144
Participants:92
Impact:No significant difference between protocols (e.g., ~6.5–8.0 mSv, P>0.05)
Trust score:4/5

Hepatic parenchymal enhancement (portal & equilibrium phases)

1 evidences

Randomized trial comparing two iodine contrast concentrations (300 vs 370 mg/mL) showing higher concentration yields greater hepatic and vascular enhancement on multiphasic CT.

Trust comment: Well-designed prospective randomized imaging study with clear quantitative endpoints and statistical significance.

Study Details

PMID:15468944
Participants:100
Impact:Higher with 370 mg/mL vs 300 mg/mL (p<0.01)
Trust score:4/5

Aortic enhancement (early arterial phase)

1 evidences

Randomized trial comparing two iodine contrast concentrations (300 vs 370 mg/mL) showing higher concentration yields greater hepatic and vascular enhancement on multiphasic CT.

Trust comment: Well-designed prospective randomized imaging study with clear quantitative endpoints and statistical significance.

Study Details

PMID:15468944
Participants:100
Impact:Higher with 370 mg/mL at middle/lower liver levels (p<0.05)
Trust score:4/5

Portal and hepatic venous enhancement

1 evidences

Randomized trial comparing two iodine contrast concentrations (300 vs 370 mg/mL) showing higher concentration yields greater hepatic and vascular enhancement on multiphasic CT.

Trust comment: Well-designed prospective randomized imaging study with clear quantitative endpoints and statistical significance.

Study Details

PMID:15468944
Participants:100
Impact:Higher with 370 mg/mL (p<0.01)
Trust score:4/5

Radiation dose (CTDIvol, DLP, ED)

1 evidences

Randomized trial showing low-concentration contrast with low tube voltage + iterative reconstruction reduces radiation dose while maintaining or improving vascular attenuation and image quality.

Trust comment: Prospective randomized trial with objective and subjective image-quality metrics and dose reporting; trustworthy for imaging protocol conclusions.

Study Details

PMID:28888094
Participants:136
Impact:Group B decreased CTDIvol 38.6%, DLP 37.2%, ED 37.2% versus Group A
Trust score:4/5

Vascular attenuation (CT value)

1 evidences

Randomized trial showing low-concentration contrast with low tube voltage + iterative reconstruction reduces radiation dose while maintaining or improving vascular attenuation and image quality.

Trust comment: Prospective randomized trial with objective and subjective image-quality metrics and dose reporting; trustworthy for imaging protocol conclusions.

Study Details

PMID:28888094
Participants:136
Impact:Group B showed significantly higher CT values in renal arteries and aorta (p=0.000)
Trust score:4/5

CT image quality (CT value, SNR, CNR)

1 evidences

Individualized iodine-contrast injection based on body mass gave similar image quality while reducing contrast volume.

Trust comment: Prospective randomized clinical imaging study with adequate sample (n=270) and objective image-quality metrics supports reliability.

Study Details

PMID:33238677
Participants:270
Impact:no significant difference among groups (P>0.05)
Trust score:4/5

contrast agent flow rate

1 evidences

Individualized iodine-contrast injection based on body mass gave similar image quality while reducing contrast volume.

Trust comment: Prospective randomized clinical imaging study with adequate sample (n=270) and objective image-quality metrics supports reliability.

Study Details

PMID:33238677
Participants:270
Impact:group A/B flow rates (≈4.5±0.5 ml/s) lower than group C (5 ml/s), P=0.015
Trust score:4/5

total contrast volume

1 evidences

Individualized iodine-contrast injection based on body mass gave similar image quality while reducing contrast volume.

Trust comment: Prospective randomized clinical imaging study with adequate sample (n=270) and objective image-quality metrics supports reliability.

Study Details

PMID:33238677
Participants:270
Impact:group A 32±3 ml vs group B 38±4 ml vs group C 53±7 ml (P<0.001)
Trust score:4/5

Body weight

3 evidences

A nutrition intervention increased women's weight, BMI and use of iodized salt in a large sample of destitute women.

Trust comment: Large community intervention with clear anthropometric changes, but non-randomized group allocation and program complexity lower certainty.

Study Details

PMID:18510207
Participants:1275
Impact:+1.333 kg mean increase in intervention group (vs −0.277 kg control, −0.147 kg comparison)
Trust score:3/5

Four-week randomized diet trial in women showing the Paleolithic diet led to greater short-term weight and fat loss and reduced dietary calcium intake compared to guidelines-based diet.

Trust comment: Small, short-duration randomized trial with objective biochemical measures but limited power and short follow-up.

Study Details

PMID:27223304
Participants:39
Impact:−4.3% (Paleolithic group)
Trust score:3/5

In a small randomized subsample, an 8-week whole-food plant-based diet reduced weight, HbA1c and several cardiometabolic risk factors but decreased intake of some micronutrients including vitamin D and calcium.

Trust comment: Randomized trial with weighed food records but small analyzed subsample (n=37) and potential reporting/selection bias for dietary records.

Study Details

PMID:36364858
Participants:37
Impact:-3.5 kg mean difference after 8 weeks (PBD)
Trust score:3/5

Body mass index (BMI)

1 evidences

A nutrition intervention increased women's weight, BMI and use of iodized salt in a large sample of destitute women.

Trust comment: Large community intervention with clear anthropometric changes, but non-randomized group allocation and program complexity lower certainty.

Study Details

PMID:18510207
Participants:1275
Impact:significant increase in intervention group (p<0.001)
Trust score:3/5

iodized salt intake

1 evidences

A nutrition intervention increased women's weight, BMI and use of iodized salt in a large sample of destitute women.

Trust comment: Large community intervention with clear anthropometric changes, but non-randomized group allocation and program complexity lower certainty.

Study Details

PMID:18510207
Participants:1275
Impact:increased in intervention group (quantitative change not specified)
Trust score:3/5

acute adverse reaction incidence

1 evidences

Among CT patients, overall acute adverse reactions were low and similar between moderate- and high-iodine concentration contrast; heat sensation was higher with high concentration.

Trust comment: Large prospective randomized study with clear adverse-event reporting; results specific to iodinated contrast media exposure.

Study Details

PMID:17186321
Participants:945
Impact:2.4% (11/458) moderate-concentration vs 3.11% (15/482) high-concentration; no significant difference
Trust score:4/5

heat sensation

2 evidences

Randomized trial comparing high (400 mg/ml) vs lower (300 mg/ml) iodinated contrast concentrations; overall patient-reported discomfort was very low with only a small difference in pain favoring lower concentration.

Trust comment: Large randomized prospective trial (n=253) with patient-reported outcomes and clear reporting; clinically small effect sizes.

Study Details

PMID:32215899
Participants:253
Impact:no significant difference (mean VAS 5.0 vs 5.3; P=0.50)
Trust score:4/5

Among CT patients, overall acute adverse reactions were low and similar between moderate- and high-iodine concentration contrast; heat sensation was higher with high concentration.

Trust comment: Large prospective randomized study with clear adverse-event reporting; results specific to iodinated contrast media exposure.

Study Details

PMID:17186321
Participants:945
Impact:significantly higher incidence in high-concentration group (no exact % reported in snippet)
Trust score:4/5

thyroid hormone/thyroglobulin peaks after rhTSH

1 evidences

Low-dose rhTSH before a fixed radioiodine dose increased thyroid volume reduction compared with placebo in patients with multinodular goitre.

Trust comment: Controlled clinical study with objective thyroid volume outcomes but small sample (n=28) limits precision and generalizability.

Study Details

PMID:18803554
Participants:28
Impact:higher peak TSH, free T4, T3 and Tg in 0.1 mg rhTSH group vs others (p<0.05)
Trust score:4/5

arterial attenuation

2 evidences

Randomized CT angiography study comparing two iodine-containing contrast regimens; arterial image quality similar but lower venous enhancement with lower-volume, higher-concentration contrast.

Trust comment: Randomized study in 58 human patients with objective quantitative and qualitative imaging endpoints; moderate-high quality.

Study Details

PMID:18846455
Participants:58
Impact:no significant difference (402 vs 407 HU; P=0.78)
Trust score:4/5

Tailoring iodine dose to both body weight and BMI removes the positive correlation between BMI and arterial attenuation seen when dosing by body weight alone.

Trust comment: Well-sized clinical study with randomized allocation to dosing strategies and objective CT measures, supporting internal validity.

Study Details

PMID:23171529
Participants:233
Impact:positive correlation with BMI when iodine dose fixed per body weight; no correlation when dose tailored to BW+BMI
Trust score:4/5

venous attenuation (internal jugular vein)

1 evidences

Randomized CT angiography study comparing two iodine-containing contrast regimens; arterial image quality similar but lower venous enhancement with lower-volume, higher-concentration contrast.

Trust comment: Randomized study in 58 human patients with objective quantitative and qualitative imaging endpoints; moderate-high quality.

Study Details

PMID:18846455
Participants:58
Impact:decrease 110 HU (114 vs 224 HU; P<0.001)
Trust score:4/5

vascular attenuation

1 evidences

Randomized volunteer study showing 70-kVp CT angiography improves vascular enhancement and image quality and allows reduced iodine contrast volume and lower radiation dose.

Trust comment: Randomized study with objective imaging metrics and reasonable sample size; applicable to clinical imaging practice.

Study Details

PMID:25510446
Participants:69
Impact:increased at 70 kVp (group B and C vs 120 kVp)
Trust score:4/5

contrast volume

4 evidences

Prospective randomized study in normal-weight patients showing CCTA at 70 kVp with 28 mL iodinated contrast and low injection rate produced diagnostic image quality similar to standard protocol (40 mL).

Trust comment: Randomized trial with clear inclusion criteria and objective/subjective image quality metrics in 104 patients, but applicable mainly to normal-weight, low-HR patients.

Study Details

PMID:28860894
Participants:104
Impact:reduced to 28 mL vs 40 mL (30% reduction) while maintaining diagnostic IQ
Trust score:4/5

Randomized volunteer study showing 70-kVp CT angiography improves vascular enhancement and image quality and allows reduced iodine contrast volume and lower radiation dose.

Trust comment: Randomized study with objective imaging metrics and reasonable sample size; applicable to clinical imaging practice.

Study Details

PMID:25510446
Participants:69
Impact:reduced by 37.5% (40 mL vs 64 mL) while maintaining/improving enhancement
Trust score:4/5

Pilot randomized CTA study showing dual-energy CT allows up to ~60% iodinated contrast volume reduction without loss of image quality.

Trust comment: Prospective randomized pilot with clear randomized groups and objective image quality metrics; small sample but reliable within scope.

Study Details

PMID:25053514
Participants:80
Impact:Group A (SECT full): 90.3±10.1 mL; Group B (DECT 50%): 39.5±4.6 mL; Group C (DECT 40%): 28.3±6.5 mL; Group D (DECT 30%): 23.9±6.0 mL
Trust score:4/5

Randomized trial showing dual-energy CT allowed >50% reduction in iodinated contrast volume (35 mL vs 80 mL) with comparable diagnostic interpretability and similar CNR/SNR after adjustment.

Trust comment: Prospective randomized trial with objective image quality metrics but moderate sample size (n=102); methods well described.

Study Details

PMID:25151920
Participants:102
Impact:reduced by ~56% (35 mL vs 80 mL)
Trust score:4/5

liver peak enhancement

1 evidences

Randomized imaging study showing saline flushing with contrast increases liver and portal vein peak enhancement and that reducing contrast plus flush shortens the optimal imaging window.

Trust comment: Randomized clinical imaging study (n=88) with quantitative time-density analyses; good internal validity for imaging endpoints.

Study Details

PMID:16555564
Participants:88
Impact:significant increase with saline flush (group B vs A; P<0.05)
Trust score:4/5

portal vein peak enhancement

1 evidences

Randomized imaging study showing saline flushing with contrast increases liver and portal vein peak enhancement and that reducing contrast plus flush shortens the optimal imaging window.

Trust comment: Randomized clinical imaging study (n=88) with quantitative time-density analyses; good internal validity for imaging endpoints.

Study Details

PMID:16555564
Participants:88
Impact:significant increase with saline flush (group B vs A; P<0.05)
Trust score:4/5

duration of optimal temporal window

1 evidences

Randomized imaging study showing saline flushing with contrast increases liver and portal vein peak enhancement and that reducing contrast plus flush shortens the optimal imaging window.

Trust comment: Randomized clinical imaging study (n=88) with quantitative time-density analyses; good internal validity for imaging endpoints.

Study Details

PMID:16555564
Participants:88
Impact:shortened when reduced contrast was used with saline flush (P<0.0001)
Trust score:4/5

24-h RAIU increase (rhTSH 24 h)

1 evidences

Randomized double-blind trial showing rhTSH given 24 h before radioiodine produces the largest increase in thyroid radioactive iodine uptake compared with longer intervals.

Trust comment: Prospective, randomized, double-blind study in 90 patients with clear, clinically relevant quantitative outcomes; high quality.

Study Details

PMID:19403877
Participants:90
Impact:from 33.8% to 66.0% (111.2% increase; P<0.001)
Trust score:5/5

48-h RAIU increase (rhTSH 48 h)

1 evidences

Randomized double-blind trial showing rhTSH given 24 h before radioiodine produces the largest increase in thyroid radioactive iodine uptake compared with longer intervals.

Trust comment: Prospective, randomized, double-blind study in 90 patients with clear, clinically relevant quantitative outcomes; high quality.

Study Details

PMID:19403877
Participants:90
Impact:from 36.8% to 64.6% (83.3% increase; P<0.001)
Trust score:5/5

72-h RAIU increase (rhTSH 72 h)

1 evidences

Randomized double-blind trial showing rhTSH given 24 h before radioiodine produces the largest increase in thyroid radioactive iodine uptake compared with longer intervals.

Trust comment: Prospective, randomized, double-blind study in 90 patients with clear, clinically relevant quantitative outcomes; high quality.

Study Details

PMID:19403877
Participants:90
Impact:from 33.0% to 49.6% (62.4% increase; P<0.001)
Trust score:5/5

clinical periodontal indices (GI, PLI, PD, BOP)

1 evidences

Randomized comparison of topical minocycline, metronidazole, and iodine glycerin for periodontitis; all improved but iodine glycerin was less effective than the antibiotics.

Trust comment: Randomized study with a reasonable sample size (n=123) but limited methodological detail and comparative rather than placebo-controlled design.

Study Details

PMID:20335153
Participants:123
Impact:improved after iodine glycerin treatment (significant vs baseline)
Trust score:3/5

comparative efficacy

1 evidences

Randomized comparison of topical minocycline, metronidazole, and iodine glycerin for periodontitis; all improved but iodine glycerin was less effective than the antibiotics.

Trust comment: Randomized study with a reasonable sample size (n=123) but limited methodological detail and comparative rather than placebo-controlled design.

Study Details

PMID:20335153
Participants:123
Impact:iodine glycerin showed less improvement and lower total response rate than minocycline and metronidazole
Trust score:3/5

TSH (day 14 and day 28)

1 evidences

In preterm infants, iodine-containing contrast increased urinary iodine and improved PICC tip visualization but did not alter subsequent thyroid function (TSH).

Trust comment: Randomized controlled trial in preterm infants with objective endpoints but small sample size limits precision.

Study Details

PMID:29807945
Participants:41
Impact:No significant difference between contrast and control (e.g., day 14: 3.1 vs 2.0 mIU/L; day 28: 2.2 vs 1.7 mIU/L)
Trust score:4/5

PICC tip localization

1 evidences

In preterm infants, iodine-containing contrast increased urinary iodine and improved PICC tip visualization but did not alter subsequent thyroid function (TSH).

Trust comment: Randomized controlled trial in preterm infants with objective endpoints but small sample size limits precision.

Study Details

PMID:29807945
Participants:41
Impact:Better in contrast group (85% vs 55%)
Trust score:4/5

Thyroid function (overall: TSH/FT3/FT4)

1 evidences

Healthy adults given 100–300 μg iodide daily for 6 months showed no meaningful change in thyroid function but had slight anti-inflammatory/antioxidant marker changes.

Trust comment: Small randomized human trial with biochemical endpoints; limited sample size but randomized design supports reliability for observed null effects.

Study Details

PMID:21262066
Participants:30
Impact:No meaningful modification of thyroid function in population with adequate iodine intake
Trust score:4/5

Inflammation/oxidative markers

1 evidences

Healthy adults given 100–300 μg iodide daily for 6 months showed no meaningful change in thyroid function but had slight anti-inflammatory/antioxidant marker changes.

Trust comment: Small randomized human trial with biochemical endpoints; limited sample size but randomized design supports reliability for observed null effects.

Study Details

PMID:21262066
Participants:30
Impact:Modest correlations suggesting slight anti-inflammatory and antioxidative actions (e.g., urinary iodine with CRP; FT3 with IL-6)
Trust score:4/5

Catheter-related infection rate

1 evidences

Compared daily povidone-iodine site care with an occlusive dressing for short-term CVCs and found no significant difference in catheter infection rates.

Trust comment: Randomized clinical study but small sample and limited power to detect modest differences in infection rates.

Study Details

PMID:12244905
Participants:72
Impact:No significant difference between povidone-iodine daily care and occlusive dressing (p > 0.05)
Trust score:3/5

Catheter tip colonization

4 evidences

Compared daily povidone-iodine site care with an occlusive dressing for short-term CVCs and found no significant difference in catheter infection rates.

Trust comment: Randomized clinical study but small sample and limited power to detect modest differences in infection rates.

Study Details

PMID:12244905
Participants:72
Impact:Positive tip cultures in 13.9% (10/72); site infection increased tip infection risk
Trust score:3/5

Randomized study in 60 laboring women comparing povidone iodine (PI) versus DuraPrep (iodophor in isopropyl alcohol) for skin antisepsis before epidural catheter insertion, assessing skin cultures and catheter colonization.

Trust comment: Randomized clinical study with clear microbiologic endpoints showing lower skin and catheter colonization with DuraPrep vs povidone iodine; moderate sample size (n=60).

Study Details

PMID:12502993
Participants:60
Impact:6 positive catheter cultures (all in PI group) vs 0 in DuraPrep
Trust score:4/5

No difference found between 10% povidone-iodine and 0.5% chlorhexidine ethanol in catheter site or tip colonization for short-term epidural catheters.

Trust comment: Randomized study but small sample and short catheter duration limit generalizability.

Study Details

PMID:12011520
Participants:62
Impact:No difference between povidone-iodine and chlorhexidine groups (11% vs 9% isolation rates)
Trust score:3/5

In neonates requiring central venous catheters, skin disinfection with 10% povidone-iodine was as effective as a chlorhexidine-impregnated dressing for preventing bloodstream infections, but had higher catheter-tip colonization and no contact dermatitis.

Trust comment: Large multicenter randomized trial with clear randomization and clinically relevant outcomes.

Study Details

PMID:11389271
Participants:705
Impact:PI 24.0% vs chlorhexidine 15.0% (PI higher by +9.0 percentage points)
Trust score:5/5

Risk factors

1 evidences

Compared daily povidone-iodine site care with an occlusive dressing for short-term CVCs and found no significant difference in catheter infection rates.

Trust comment: Randomized clinical study but small sample and limited power to detect modest differences in infection rates.

Study Details

PMID:12244905
Participants:72
Impact:Site infection and age <60 associated with higher tip infection; TPN associated trend (p = 0.06)
Trust score:3/5

remnant effective half-life

1 evidences

In thyroid remnant ablation, rhTSH led to longer remnant radioactive-iodine half-life but shorter whole-body residence times and lower absorbed doses to several non-thyroid organs versus thyroid hormone withdrawal.

Trust comment: Prospective randomized study with robust dosimetric measurements (n=88); clinically relevant endpoints though focused on radioiodine therapy context.

Study Details

PMID:20392868
Participants:88
Impact:significantly longer after rhTSH (P=0.01)
Trust score:4/5

total-body effective half-life / residence time

1 evidences

In thyroid remnant ablation, rhTSH led to longer remnant radioactive-iodine half-life but shorter whole-body residence times and lower absorbed doses to several non-thyroid organs versus thyroid hormone withdrawal.

Trust comment: Prospective randomized study with robust dosimetric measurements (n=88); clinically relevant endpoints though focused on radioiodine therapy context.

Study Details

PMID:20392868
Participants:88
Impact:shorter with rhTSH (reduced systemic residence)
Trust score:4/5

absorbed dose to non-thyroid organs

1 evidences

In thyroid remnant ablation, rhTSH led to longer remnant radioactive-iodine half-life but shorter whole-body residence times and lower absorbed doses to several non-thyroid organs versus thyroid hormone withdrawal.

Trust comment: Prospective randomized study with robust dosimetric measurements (n=88); clinically relevant endpoints though focused on radioiodine therapy context.

Study Details

PMID:20392868
Participants:88
Impact:reduced (lower doses to colon, breasts, ovaries, bone marrow)
Trust score:4/5

total antioxidant status (TAS)

1 evidences

Schoolchildren with moderate iodine deficiency had higher oxidative stress markers and lower antioxidant capacity than children with mild deficiency or iodine sufficiency.

Trust comment: Cross-sectional study (n=196) showing consistent biochemical associations but observational design limits causal inference.

Study Details

PMID:27710914
Participants:196
Impact:lower in moderate ID (6.5±4.1 vs 11.3±4.1; p<0.001)
Trust score:3/5

total oxidant status (TOS)

1 evidences

Schoolchildren with moderate iodine deficiency had higher oxidative stress markers and lower antioxidant capacity than children with mild deficiency or iodine sufficiency.

Trust comment: Cross-sectional study (n=196) showing consistent biochemical associations but observational design limits causal inference.

Study Details

PMID:27710914
Participants:196
Impact:higher in moderate ID (4.8±2.1 vs 3.7±2.1; p<0.001)
Trust score:3/5

oxidative stress index (OSI)

1 evidences

Schoolchildren with moderate iodine deficiency had higher oxidative stress markers and lower antioxidant capacity than children with mild deficiency or iodine sufficiency.

Trust comment: Cross-sectional study (n=196) showing consistent biochemical associations but observational design limits causal inference.

Study Details

PMID:27710914
Participants:196
Impact:higher in moderate ID (p<0.001)
Trust score:3/5

radioiodine ablation efficacy

1 evidences

Report of multinational treatment experience using radioiodine ablation for differentiated thyroid cancer with generally good outcomes.

Trust comment: Large case series/clinical experience report; descriptive with limited quantitative outcome detail.

Study Details

PMID:16791814
Participants:357
Impact:generally high efficacy reported (quantitative rates not specified)
Trust score:3/5

treatment outcomes comparability

1 evidences

Report of multinational treatment experience using radioiodine ablation for differentiated thyroid cancer with generally good outcomes.

Trust comment: Large case series/clinical experience report; descriptive with limited quantitative outcome detail.

Study Details

PMID:16791814
Participants:357
Impact:results similar to Czech patients (no numeric comparison provided)
Trust score:3/5

quality of life (FACIT-F TOI) during RRA

1 evidences

Using rhTSH instead of hypothyroidism to prepare for radioiodine ablation preserved quality of life with similar ablation success.

Trust comment: Prospective randomized controlled trial with clear QoL and efficacy endpoints but modest sample size.

Study Details

PMID:18803678
Participants:74
Impact:significant decrease in hypothyroid group during RRA; QoL preserved in rhTSH group (P<0.001 for FACIT-TOI change)
Trust score:4/5

ablation success rate

6 evidences

Higher therapeutic I-131 dose (3700 MBq) produced more successful removal of residual thyroid tissue than a lower dose (1110 MBq).

Trust comment: Large double-blind randomized clinical trial with clear endpoints and complete reporting.

Study Details

PMID:22124360
Participants:341
Impact:Initial: High 64.1% vs Low 39.2%; 12-month without retreatment: High 68.8% vs Low 41.5%
Trust score:5/5

Using rhTSH instead of hypothyroidism to prepare for radioiodine ablation preserved quality of life with similar ablation success.

Trust comment: Prospective randomized controlled trial with clear QoL and efficacy endpoints but modest sample size.

Study Details

PMID:18803678
Participants:74
Impact:rhTSH 91.7% vs hypothyroidism 97.1% (−5.4 percentage points)
Trust score:4/5

A higher I-131 dose (100 mCi) achieved higher ablation success than 50 mCi in this small randomized trial.

Trust comment: Randomized trial but small sample size limits precision and generalizability.

Study Details

PMID:16967785
Participants:40
Impact:100 mCi 60% vs 50 mCi 40%
Trust score:3/5

In patients with differentiated thyroid cancer and low preablative thyroglobulin, low-dose radioiodine produced similar ablation rates to high-dose with no recurrences during short follow-up.

Trust comment: Randomized human trial (n=102) with clear endpoints but relatively short follow-up (~6.8 months).

Study Details

PMID:25793928
Participants:102
Impact:84.3% (low-dose 1110 MBq) vs 86.3% (high-dose 3700 MBq); no significant difference (P=0.78)
Trust score:4/5

rhTSH preserves quality of life compared with thyroid-hormone withdrawal while achieving comparable low-dose radioiodine remnant ablation success rates.

Trust comment: Large randomized human study directly addressing preparation for radioactive iodine ablation with clear endpoints and significant QoL result.

Study Details

PMID:20151824
Participants:291
Impact:~91.0% (T4-WD), 91.7% (T3-WD), 91.3% (rhTSH); no significant differences
Trust score:4/5

Randomized trial comparing low (1.1 GBq) vs high (3.7 GBq) 131I doses in low/intermediate-risk thyroid cancer: ablation and therapeutic responses similar, but fewer adverse reactions with low dose.

Trust comment: Randomized clinical trial with moderate sample size and objective outcomes; registered and ethically approved, though follow-up subsets reduce some completeness.

Study Details

PMID:27757803
Participants:132
Impact:59.1% (high) vs 52.7% (low); +6.4 percentage points; not significant
Trust score:4/5

persistent thyroid remnants

1 evidences

Using rhTSH instead of hypothyroidism to prepare for radioiodine ablation preserved quality of life with similar ablation success.

Trust comment: Prospective randomized controlled trial with clear QoL and efficacy endpoints but modest sample size.

Study Details

PMID:18803678
Participants:74
Impact:higher rate in rhTSH arm (mostly uptake <0.1%; no numeric overall rate provided)
Trust score:4/5

end-of-procedure pocket-swab culture positivity

1 evidences

In repeat CIED procedures, using an iodine-impregnated adhesive drape reduced pocket contamination and subsequent device infections.

Trust comment: Prospective, randomized, blinded clinical trial with clear primary endpoint and statistically significant outcomes.

Study Details

PMID:40864462
Participants:384
Impact:10.1% with drape vs 20.5% without drape (absolute −10.4 percentage points; RRR 50%; P = .005)
Trust score:5/5

adjudicated CIED infections (1-year)

1 evidences

In repeat CIED procedures, using an iodine-impregnated adhesive drape reduced pocket contamination and subsequent device infections.

Trust comment: Prospective, randomized, blinded clinical trial with clear primary endpoint and statistically significant outcomes.

Study Details

PMID:40864462
Participants:384
Impact:0% with drape vs 1.9% without drape (absolute −1.9 percentage points; P = .02)
Trust score:5/5

treatment effective rate

1 evidences

Adding iodine-131 to levothyroxine after thyroid cancer surgery improved response rate and reduced one-year recurrence without increasing side effects.

Trust comment: Large prospective randomized controlled trial with 1-year follow-up; well-powered but limited detail on blinding.

Study Details

PMID:39307136
Participants:374
Impact:+11.23% (91.98% vs 80.75%)
Trust score:4/5

thyroglobulin level

1 evidences

Adding iodine-131 to levothyroxine after thyroid cancer surgery improved response rate and reduced one-year recurrence without increasing side effects.

Trust comment: Large prospective randomized controlled trial with 1-year follow-up; well-powered but limited detail on blinding.

Study Details

PMID:39307136
Participants:374
Impact:significant decrease after treatment (both groups)
Trust score:4/5

thyroid volume (iodine alone)

1 evidences

Adolescents with endemic goitre given iodine alone or iodine+levothyroxine both corrected deficiency and reduced thyroid volume and lipids, with greater volume reduction in the combination group.

Trust comment: Moderate-sized clinical study with measured biochemical and imaging outcomes, but randomization/blinding and full methodological details are unclear.

Study Details

PMID:8676600
Participants:106
Impact:-11.3%
Trust score:3/5

thyroid volume (iodine + levothyroxine)

1 evidences

Adolescents with endemic goitre given iodine alone or iodine+levothyroxine both corrected deficiency and reduced thyroid volume and lipids, with greater volume reduction in the combination group.

Trust comment: Moderate-sized clinical study with measured biochemical and imaging outcomes, but randomization/blinding and full methodological details are unclear.

Study Details

PMID:8676600
Participants:106
Impact:-23%
Trust score:3/5

cholesterol (lipid parameters)

1 evidences

Adolescents with endemic goitre given iodine alone or iodine+levothyroxine both corrected deficiency and reduced thyroid volume and lipids, with greater volume reduction in the combination group.

Trust comment: Moderate-sized clinical study with measured biochemical and imaging outcomes, but randomization/blinding and full methodological details are unclear.

Study Details

PMID:8676600
Participants:106
Impact:significant decrease (both groups)
Trust score:3/5

iodine retention/elimination rate

1 evidences

A single oral iodised-oil dose increased urinary iodine and markedly reduced goitre prevalence at 40 weeks; efficacy was lower in children with poorer weight-for-height.

Trust comment: Controlled field trial in a severely deficient population with objective biochemical and clinical endpoints; moderate sample size.

Study Details

PMID:10967613
Participants:197
Impact:reduced retention and faster elimination in children with lower weight-for-height (shorter protection periods)
Trust score:4/5

thyroid volume (400 μg iodine)

1 evidences

In euthyroid goitre patients, mono-iodine, combination iodine+levothyroxine, and levothyroxine alone produced similar ~34–39% thyroid volume reductions over 6 months.

Trust comment: Randomized prospective trial with objective volumetric outcomes but small sample size and short (6-month) follow-up.

Study Details

PMID:9139212
Participants:69
Impact:-34%
Trust score:4/5

thyroid volume (100 μg levothyroxine + 100 μg iodine)

1 evidences

In euthyroid goitre patients, mono-iodine, combination iodine+levothyroxine, and levothyroxine alone produced similar ~34–39% thyroid volume reductions over 6 months.

Trust comment: Randomized prospective trial with objective volumetric outcomes but small sample size and short (6-month) follow-up.

Study Details

PMID:9139212
Participants:69
Impact:-39%
Trust score:4/5

thyroid volume (individually dosed levothyroxine)

1 evidences

In euthyroid goitre patients, mono-iodine, combination iodine+levothyroxine, and levothyroxine alone produced similar ~34–39% thyroid volume reductions over 6 months.

Trust comment: Randomized prospective trial with objective volumetric outcomes but small sample size and short (6-month) follow-up.

Study Details

PMID:9139212
Participants:69
Impact:-39%
Trust score:4/5

radiation dose (effective dose, ED)

1 evidences

A reduced-voltage CT protocol with lower-iodine concentration cut iodine dose and radiation while preserving image quality in patients with BMI 18.5–27.9.

Trust comment: Prospective randomized study with 128 patients, objective quantitative endpoints and appropriate statistical analysis; limited to BMI 18.5–27.9 kg/m2.

Study Details

PMID:27368012
Participants:128
Impact:~-20.3% HAP and -20.2% PVP (group A vs group B); ~-21.0% HAP and -20.9% PVP (group A vs group C)
Trust score:4/5

CT attenuation (vessels and hepatic parenchyma)

1 evidences

A reduced-voltage CT protocol with lower-iodine concentration cut iodine dose and radiation while preserving image quality in patients with BMI 18.5–27.9.

Trust comment: Prospective randomized study with 128 patients, objective quantitative endpoints and appropriate statistical analysis; limited to BMI 18.5–27.9 kg/m2.

Study Details

PMID:27368012
Participants:128
Impact:AA +24.1%, PV +13.3%, hepatic parenchyma +6.5–8.4% (group A vs group B)
Trust score:4/5

relapse rate (2 years post-withdrawal)

1 evidences

Randomized trial comparing 18 vs 42 months carbimazole found no significant difference in 2-year relapse rates after stopping treatment.

Trust comment: Prospective randomized trial with 134 patients and clear clinical and immunological endpoints; results include both significant and nonsignificant outcomes.

Study Details

PMID:10341866
Participants:134
Impact:36% (18 mo) vs 29% (42 mo), no significant difference
Trust score:4/5

TSAb positivity at treatment withdrawal

1 evidences

Randomized trial comparing 18 vs 42 months carbimazole found no significant difference in 2-year relapse rates after stopping treatment.

Trust comment: Prospective randomized trial with 134 patients and clear clinical and immunological endpoints; results include both significant and nonsignificant outcomes.

Study Details

PMID:10341866
Participants:134
Impact:42% (18 mo) vs 18% (42 mo), significant (P=0.004)
Trust score:4/5

anti-TPO positivity at withdrawal

1 evidences

Randomized trial comparing 18 vs 42 months carbimazole found no significant difference in 2-year relapse rates after stopping treatment.

Trust comment: Prospective randomized trial with 134 patients and clear clinical and immunological endpoints; results include both significant and nonsignificant outcomes.

Study Details

PMID:10341866
Participants:134
Impact:53% (18 mo) vs 46% (42 mo), no significant difference
Trust score:4/5

pain (NRS)

1 evidences

Wet silver dressings healed skin wounds faster, reduced dressing changes and pain compared with povidone-iodine dressings.

Trust comment: Randomized controlled trial but small sample (58) and described as preliminary, so moderate confidence.

Study Details

PMID:33611826
Participants:58
Impact:- significant decrease
Trust score:3/5

salivary gland function (quantitative scintigraphy)

1 evidences

Amifostine given before high-dose 131I did not prevent decline in salivary gland function measured by quantitative scans.

Trust comment: Randomized assignment of 80 patients with objective imaging endpoints; negative finding reported with statistical analysis.

Study Details

PMID:18341378
Participants:80
Impact:No protective effect of amifostine (F=1.37, P=0.2461)
Trust score:4/5

impact of 131I dose on salivary function

1 evidences

Amifostine given before high-dose 131I did not prevent decline in salivary gland function measured by quantitative scans.

Trust comment: Randomized assignment of 80 patients with objective imaging endpoints; negative finding reported with statistical analysis.

Study Details

PMID:18341378
Participants:80
Impact:Significant effect of 131I dose on salivary function (F=9.72, P=0.0002)
Trust score:4/5

phlebitis rate

1 evidences

Randomized trial in 109 patients found more phlebitis with alcoholic iodine than alcohol alone, but the difference was not statistically significant and the study was underpowered.

Trust comment: Randomized trial with 109 patients but acknowledged low power (0.55) making the primary comparison inconclusive.

Study Details

PMID:9261762
Participants:109
Impact:Alcohol 70%: 6 events vs alcoholic iodine 2%: 12 events (relative risk reduction ~53%, P=0.18, not significant)
Trust score:3/5

interaction effect (theophylline added to prednisone infusion)

1 evidences

Randomized trial in 109 patients found more phlebitis with alcoholic iodine than alcohol alone, but the difference was not statistically significant and the study was underpowered.

Trust comment: Randomized trial with 109 patients but acknowledged low power (0.55) making the primary comparison inconclusive.

Study Details

PMID:9261762
Participants:109
Impact:Higher phlebitis with theophylline addition: 27.3% vs 9.2% (P=0.03)
Trust score:3/5

therapeutic response (excellent rate)

1 evidences

Randomized trial comparing low (1.1 GBq) vs high (3.7 GBq) 131I doses in low/intermediate-risk thyroid cancer: ablation and therapeutic responses similar, but fewer adverse reactions with low dose.

Trust comment: Randomized clinical trial with moderate sample size and objective outcomes; registered and ethically approved, though follow-up subsets reduce some completeness.

Study Details

PMID:27757803
Participants:132
Impact:85% (high) vs 80% (low); +5 percentage points; not significant
Trust score:4/5

adverse reactions incidence

1 evidences

Randomized trial comparing low (1.1 GBq) vs high (3.7 GBq) 131I doses in low/intermediate-risk thyroid cancer: ablation and therapeutic responses similar, but fewer adverse reactions with low dose.

Trust comment: Randomized clinical trial with moderate sample size and objective outcomes; registered and ethically approved, though follow-up subsets reduce some completeness.

Study Details

PMID:27757803
Participants:132
Impact:39% (high) vs 18% (low); +21 percentage points; significant (P=0.007)
Trust score:4/5

thyroglobulin

1 evidences

6-month randomized, double-blind 2x2 trial in children: vitamin A supplementation decreased TSH stimulation, thyroglobulin, and thyroid volume and thus reduced goiter risk in the context of mild-to-moderate iodine deficiency.

Trust comment: Large double-blind randomized factorial trial with clear biochemical and ultrasonographic outcomes and statistically significant effects.

Study Details

PMID:17921382
Participants:404
Impact:Decreased significantly with vitamin A supplementation (P<0.05)
Trust score:5/5

∆HU per gram iodine correlation (aorta)

1 evidences

Randomized study comparing TBW, LBW, and BSA-based iodine dosing for abdominal CT: LBW and BSA provided more consistent contrast enhancement than TBW.

Trust comment: Randomized imaging study with objective quantitative endpoints and adequate sample size for technical comparisons, though single-center.

Study Details

PMID:23508277
Participants:103
Impact:Higher correlation with LBW (r=0.86) and BSA (r=0.85) vs TBW (r=0.67)
Trust score:4/5

adjusted maximum hepatic enhancement (MHE) consistency

1 evidences

Randomized study comparing TBW, LBW, and BSA-based iodine dosing for abdominal CT: LBW and BSA provided more consistent contrast enhancement than TBW.

Trust comment: Randomized imaging study with objective quantitative endpoints and adequate sample size for technical comparisons, though single-center.

Study Details

PMID:23508277
Participants:103
Impact:MHE constant with LBW (70.2) and consistent with BSA (2.69); TBW showed positive correlation with MHE (r=0.58, P<0.001)
Trust score:4/5

mental/psychomotor performance

1 evidences

In an iodine-deficient schoolchildren population, those whose urinary iodine increased over one year showed greater gains in combined mental and psychomotor test performance compared with those whose iodine status did not change.

Trust comment: Intervention affected population access to iodized salt leading to a post-hoc split; results biologically plausible but study lost randomized control and is susceptible to confounding.

Study Details

PMID:11063446
Participants:196
Impact:Greater increase in children with improved urinary iodine status (significant)
Trust score:3/5

signal-to-noise ratio (vessels)

1 evidences

Randomized trial of reduced iodine dose with 80 kVp CT for pancreas: 400 mg/kg iodine at 80 kVp maintained image quality and tumor detectability while reducing iodine load.

Trust comment: Prospective randomized imaging study with objective image-quality and diagnostic performance metrics; adequate sample and clear endpoints.

Study Details

PMID:24834887
Participants:136
Impact:Greater in 400-80 and 500-80 groups vs 600-120 (P<0.05)
Trust score:4/5

image quality and tumor detectability

1 evidences

Randomized trial of reduced iodine dose with 80 kVp CT for pancreas: 400 mg/kg iodine at 80 kVp maintained image quality and tumor detectability while reducing iodine load.

Trust comment: Prospective randomized imaging study with objective image-quality and diagnostic performance metrics; adequate sample and clear endpoints.

Study Details

PMID:24834887
Participants:136
Impact:No significant difference between groups; sensitivity, specificity and AUC comparable with reduced iodine dose
Trust score:4/5

fT3, fT4, TSH, thyroglobulin, thyroid volume

1 evidences

In newborns with congenital hypothyroidism due to iodine deficiency, adding 100 µg/day oral iodine to L-T4 provided no additional benefit over L-T4 alone during the first three months.

Trust comment: Small comparative clinical study with objective thyroid measures but limited sample size and short follow-up reducing power to detect small effects.

Study Details

PMID:24776962
Participants:51
Impact:No significant differences between L-T4 alone and L-T4 plus oral iodine at 1 and 3 months
Trust score:3/5

urinary iodine (median)

1 evidences

One-year multicenter community trial: double-fortified salt (iron + iodine) was stable in storage and improved hemoglobin and corrected iodine deficiency similarly to iodized salt; DFS increased hemoglobin more than iodized salt.

Trust comment: Large multicenter community trial with real-world implementation and objective hemoglobin and urinary iodine outcomes, though some sampling limitations and single-blind design.

Study Details

PMID:17718017
Participants:829
Impact:Experimental median 200 → 205 µg/dL; control 225 → 220 µg/dL; DFS as effective as iodized salt in raising iodine in deficient subjects
Trust score:4/5

euthyroid recovery rate

1 evidences

In patients with Hashimoto's hypothyroidism, restricting iodine intake for 3 months led many to recover normal thyroid function.

Trust comment: Randomized human trial with objective thyroid hormone and urinary iodine measurements but small sample and short follow-up (3 months).

Study Details

PMID:12728462
Participants:45
Impact:78.3% (18/23) with iodine restriction vs 45.5% (10/22) without restriction at 3 months
Trust score:4/5

serum free T4 (fT4)

1 evidences

In patients with Hashimoto's hypothyroidism, restricting iodine intake for 3 months led many to recover normal thyroid function.

Trust comment: Randomized human trial with objective thyroid hormone and urinary iodine measurements but small sample and short follow-up (3 months).

Study Details

PMID:12728462
Participants:45
Impact:increased from 0.80 to 0.98 ng/dL in restriction group (mean change +0.18 ng/dL)
Trust score:4/5

one-year cure rate (Graves' disease)

1 evidences

A randomized trial showing that an individualized 131I dosing method achieved high cure rates while using lower radioactivity than a fixed high-dose approach.

Trust comment: Prospective randomized study in humans with clear clinical endpoints and adequate sample size for the question.

Study Details

PMID:23358401
Participants:147
Impact:Group A 48%, B 64%, C 97%, individualized D 94% (one-year cure rates)
Trust score:4/5

administered 131I activity

2 evidences

A randomized trial showing that an individualized 131I dosing method achieved high cure rates while using lower radioactivity than a fixed high-dose approach.

Trust comment: Prospective randomized study in humans with clear clinical endpoints and adequate sample size for the question.

Study Details

PMID:23358401
Participants:147
Impact:higher for fixed 400 Gy group (524 ± 201 MBq) versus individualized dosing (386 ± 173 MBq)
Trust score:4/5

Pre-treatment with low-dose rhTSH allowed similar goiter volume reduction with ~70% lower administered 131I activity and far fewer hospitalizations.

Trust comment: Double-blind randomized trial with clinically meaningful endpoints and significant reductions in radiation burden, though follow-up limited to 12 months for primary efficacy.

Study Details

PMID:20519346
Participants:90
Impact:median 170 MBq (rhTSH) vs 559 MBq (placebo) — 70% reduction (P<0.0001)
Trust score:4/5

urinary iodine concentration (median, day 28)

1 evidences

A large community trial testing different salt iodine levels showed that 15–24 mg/kg iodization produced adequate urinary iodine levels.

Trust comment: Large randomized field trial with clear urinary iodine outcomes though short intervention period (31 days).

Study Details

PMID:16538734
Participants:1099
Impact:city group medians: 97.2, 198.6, 249.4, 330.7 µg/L for salt iodine 6,15,24,34 mg/kg respectively
Trust score:4/5

recommended salt iodization level

1 evidences

A large community trial testing different salt iodine levels showed that 15–24 mg/kg iodization produced adequate urinary iodine levels.

Trust comment: Large randomized field trial with clear urinary iodine outcomes though short intervention period (31 days).

Study Details

PMID:16538734
Participants:1099
Impact:15–24 mg/kg sufficient for local population
Trust score:4/5

FT4 and FT3 indices

1 evidences

In patients with thyroid autonomy undergoing iodine exposure, short-term prophylactic antithyroid treatment blunted hormone changes compared with controls.

Trust comment: Prospective randomized human study with defined interventions and biochemical endpoints, but small sample size.

Study Details

PMID:8616532
Participants:51
Impact:elevated in control group at 30 days but unchanged in treated groups
Trust score:4/5

99mTc uptake

1 evidences

In patients with thyroid autonomy undergoing iodine exposure, short-term prophylactic antithyroid treatment blunted hormone changes compared with controls.

Trust comment: Prospective randomized human study with defined interventions and biochemical endpoints, but small sample size.

Study Details

PMID:8616532
Participants:51
Impact:decreased ~50% in control group; unchanged in treated groups
Trust score:4/5

tumor-to-liver contrast-to-noise ratio (CNR)

1 evidences

Compared three iodine doses for CT detection of hypervascular liver cancer and identified a minimal effective dose.

Trust comment: Randomized study with clear quantitative imaging endpoints and adequate sample size; well-reported statistical results support conclusions.

Study Details

PMID:26901007
Participants:111
Impact:no significant difference between 0.5, 0.4, 0.3 g I/kg (p=0.34-0.99)
Trust score:4/5

hepatic contrast enhancement (ΔHU)

1 evidences

Compared three iodine doses for CT detection of hypervascular liver cancer and identified a minimal effective dose.

Trust comment: Randomized study with clear quantitative imaging endpoints and adequate sample size; well-reported statistical results support conclusions.

Study Details

PMID:26901007
Participants:111
Impact:0.5 g I/kg = 80.3 HU; 0.4 g I/kg = 63.4 HU; 0.3 g I/kg = 53.3 HU (portal venous phase; 0.5 > 0.4/0.3, p<0.001)
Trust score:4/5

minimal effective iodine dose

1 evidences

Compared three iodine doses for CT detection of hypervascular liver cancer and identified a minimal effective dose.

Trust comment: Randomized study with clear quantitative imaging endpoints and adequate sample size; well-reported statistical results support conclusions.

Study Details

PMID:26901007
Participants:111
Impact:0.3 g I/kg BW (or 11.0 g I/m² BSA) required for acceptable tumor-to-liver CNR
Trust score:4/5

drainage duration

1 evidences

Compared intrapleural aqueous iodine, doxycycline, and drainage for prolonged air leak after lung surgery; iodine shortened drainage and hospital stay but caused more pleural pain.

Trust comment: Comparative clinical study with moderate sample but limited methodological detail in provided text; results reported with statistical significance.

Study Details

PMID:27240198
Participants:99
Impact:shortest in iodine group (mean 10.57, P<0.001)
Trust score:3/5

hospital stay

1 evidences

Compared intrapleural aqueous iodine, doxycycline, and drainage for prolonged air leak after lung surgery; iodine shortened drainage and hospital stay but caused more pleural pain.

Trust comment: Comparative clinical study with moderate sample but limited methodological detail in provided text; results reported with statistical significance.

Study Details

PMID:27240198
Participants:99
Impact:shortest in iodine group (P<0.001)
Trust score:3/5

pleural pain

1 evidences

Compared intrapleural aqueous iodine, doxycycline, and drainage for prolonged air leak after lung surgery; iodine shortened drainage and hospital stay but caused more pleural pain.

Trust comment: Comparative clinical study with moderate sample but limited methodological detail in provided text; results reported with statistical significance.

Study Details

PMID:27240198
Participants:99
Impact:markedly increased with iodine (P<0.0001)
Trust score:3/5

urinary iodine (urban, day 28)

1 evidences

Households randomized to different salt iodine levels; urinary iodine fell after intervention and current standard may produce slight excess intake.

Trust comment: Large field trial with randomized household assignment and serial urinary iodine measurements, supporting reliable population-level inferences.

Study Details

PMID:20460237
Participants:1099
Impact:group A-D medians: 97.2, 199, 249, 331 µg/L
Trust score:4/5

urinary iodine (rural, day 28)

1 evidences

Households randomized to different salt iodine levels; urinary iodine fell after intervention and current standard may produce slight excess intake.

Trust comment: Large field trial with randomized household assignment and serial urinary iodine measurements, supporting reliable population-level inferences.

Study Details

PMID:20460237
Participants:1099
Impact:group A-D medians: 101, 193, 246, 308 µg/L
Trust score:4/5

baseline urinary iodine

1 evidences

Households randomized to different salt iodine levels; urinary iodine fell after intervention and current standard may produce slight excess intake.

Trust comment: Large field trial with randomized household assignment and serial urinary iodine measurements, supporting reliable population-level inferences.

Study Details

PMID:20460237
Participants:1099
Impact:urban median 294 µg/L; rural median 509 µg/L (both declined after intervention)
Trust score:4/5

cure rate

1 evidences

Compared three radioiodine dosing strategies in Graves' disease and found a thyroid-mass–based method cured as many patients with lower administered activity.

Trust comment: Randomized clinical groups with clear outcomes and statistically significant differences; moderate sample size supports validity.

Study Details

PMID:19800827
Participants:97
Impact:GR1 48%; GR2 97%; GR3 97% (GR2 and GR3 significantly higher than GR1)
Trust score:4/5

administered radioactivity (MBq)

1 evidences

Compared three radioiodine dosing strategies in Graves' disease and found a thyroid-mass–based method cured as many patients with lower administered activity.

Trust comment: Randomized clinical groups with clear outcomes and statistically significant differences; moderate sample size supports validity.

Study Details

PMID:19800827
Participants:97
Impact:GR2 mean 393 ± 157 MBq; GR3 mean 524 ± 201 MBq (GR2 < GR3, p=0.007)
Trust score:4/5

thyroid absorbed dose (Gy)

1 evidences

Compared three radioiodine dosing strategies in Graves' disease and found a thyroid-mass–based method cured as many patients with lower administered activity.

Trust comment: Randomized clinical groups with clear outcomes and statistically significant differences; moderate sample size supports validity.

Study Details

PMID:19800827
Participants:97
Impact:GR2 mean 262 ± 78 Gy; GR3 mean 407 ± 23 Gy (GR2 < GR3, p<0.001)
Trust score:4/5

change in best-corrected visual acuity (VA)

1 evidences

Long-term follow-up of fellow (untreated) eyes in ocular melanoma trials found minimal visual change and no increased risk from radiotherapy to the treated eye.

Trust comment: Large multicenter randomized trials with long follow-up and high-quality outcome reporting, providing strong evidence.

Study Details

PMID:15121376
Participants:2290
Impact:mean change ≤1 letter (0.2 lines) from baseline at annual exams
Trust score:5/5

cataract surgery / visually significant cataract (5-year)

1 evidences

Long-term follow-up of fellow (untreated) eyes in ocular melanoma trials found minimal visual change and no increased risk from radiotherapy to the treated eye.

Trust comment: Large multicenter randomized trials with long follow-up and high-quality outcome reporting, providing strong evidence.

Study Details

PMID:15121376
Participants:2290
Impact:5-year cumulative incidence 8% in both trials
Trust score:5/5

cataract surgery / visually significant cataract (10-year)

1 evidences

Long-term follow-up of fellow (untreated) eyes in ocular melanoma trials found minimal visual change and no increased risk from radiotherapy to the treated eye.

Trust comment: Large multicenter randomized trials with long follow-up and high-quality outcome reporting, providing strong evidence.

Study Details

PMID:15121376
Participants:2290
Impact:10-year rates: pre-enucleation trial 18%; I-125 brachytherapy trial 15%
Trust score:5/5

target volume coverage (V100)

1 evidences

Randomized trial comparing low-dose-rate (I-125 seed) versus high-dose-rate prostate brachytherapy planning and dose distributions.

Trust comment: Randomized clinical trial with clear dosimetric endpoints and adequate sample size; results credible for dosimetric comparisons.

Study Details

PMID:28325472
Participants:87
Impact:LDR 99% vs HDR 98% (LDR slightly higher)
Trust score:4/5

high-dose volume (V150)

1 evidences

Randomized trial comparing low-dose-rate (I-125 seed) versus high-dose-rate prostate brachytherapy planning and dose distributions.

Trust comment: Randomized clinical trial with clear dosimetric endpoints and adequate sample size; results credible for dosimetric comparisons.

Study Details

PMID:28325472
Participants:87
Impact:LDR 61% vs HDR 32% (LDR higher)
Trust score:4/5

urethra dose (D10/D30)

1 evidences

Randomized trial comparing low-dose-rate (I-125 seed) versus high-dose-rate prostate brachytherapy planning and dose distributions.

Trust comment: Randomized clinical trial with clear dosimetric endpoints and adequate sample size; results credible for dosimetric comparisons.

Study Details

PMID:28325472
Participants:87
Impact:LDR D10 133% & D30 128% vs HDR D10 114% & D30 111% (lower with HDR)
Trust score:4/5

aortic enhancement (HU) during hepatic arterial phase

1 evidences

Within-patient comparison of moderate- vs high-iodine-concentration CT contrast agents and injection methods to assess HCC conspicuity.

Trust comment: Prospective intraindividual randomized design in 30 patients; appropriate measurements and statistics for imaging endpoints.

Study Details

PMID:21750137
Participants:30
Impact:Scheme B: HCCM +350.5 HU vs MCCM +301.1 HU (higher with high-concentration)
Trust score:4/5

tumour-to-liver contrast-to-noise ratio (CNR)

1 evidences

Within-patient comparison of moderate- vs high-iodine-concentration CT contrast agents and injection methods to assess HCC conspicuity.

Trust comment: Prospective intraindividual randomized design in 30 patients; appropriate measurements and statistics for imaging endpoints.

Study Details

PMID:21750137
Participants:30
Impact:Scheme B: HCCM 7.5 HU vs MCCM 5.5 HU (higher with high-concentration)
Trust score:4/5

post-treatment serum iodine

1 evidences

In 30 maintenance hemodialysis patients, HFR caused greater acute reductions in several micronutrients compared with HDF, including serum calcium.

Trust comment: Randomized crossover with paired measurements and appropriate models; modest sample size but clear primary outcome reporting.

Study Details

PMID:40914150
Participants:30
Impact:No significant difference between HFR and HDF (adjusted mean difference −0.019 μmol/L, p=0.343)
Trust score:4/5

stent patency (median)

1 evidences

Randomized comparison of integrated I-125 seed stents versus conventional metal stents for malignant lower biliary obstruction.

Trust comment: Small randomized study with clinically meaningful endpoints but limited sample size and preliminary nature.

Study Details

PMID:30040791
Participants:32
Impact:Test (125I) 8.1 months vs Control 3.9 months (longer with 125I stent)
Trust score:3/5

patient survival (median days)

1 evidences

Randomized comparison of integrated I-125 seed stents versus conventional metal stents for malignant lower biliary obstruction.

Trust comment: Small randomized study with clinically meaningful endpoints but limited sample size and preliminary nature.

Study Details

PMID:30040791
Participants:32
Impact:Test 298 days vs Control 139 days (longer with 125I stent)
Trust score:3/5

tumor size at 3 months

1 evidences

Randomized comparison of integrated I-125 seed stents versus conventional metal stents for malignant lower biliary obstruction.

Trust comment: Small randomized study with clinically meaningful endpoints but limited sample size and preliminary nature.

Study Details

PMID:30040791
Participants:32
Impact:Test reduced vs Control increased (significant difference)
Trust score:3/5

full-term neonatal urinary iodine (day 5, median)

1 evidences

Cross-sectional sampling shows Belgian neonates improved iodine status versus past but still below recommended levels; formula corrected preterm deficiency.

Trust comment: Observational sampling with clear laboratory measurements; national representativeness limited and some subgroup repeat measures only.

Study Details

PMID:12297896
Participants:155
Impact:86 μg/L (increased from 48 μg/L historically but below 150–200 μg/L target)
Trust score:3/5

breast-milk iodine

1 evidences

Cross-sectional sampling shows Belgian neonates improved iodine status versus past but still below recommended levels; formula corrected preterm deficiency.

Trust comment: Observational sampling with clear laboratory measurements; national representativeness limited and some subgroup repeat measures only.

Study Details

PMID:12297896
Participants:155
Impact:Mean 78 μg/L (~66% of normal)
Trust score:3/5

preterm urinary iodine with iodine-enriched formula

1 evidences

Cross-sectional sampling shows Belgian neonates improved iodine status versus past but still below recommended levels; formula corrected preterm deficiency.

Trust comment: Observational sampling with clear laboratory measurements; national representativeness limited and some subgroup repeat measures only.

Study Details

PMID:12297896
Participants:155
Impact:Median increased from 60 μg/L (day 5) to 150 μg/L (day 30)
Trust score:3/5

goitre volume

1 evidences

Thyroxine plus iodide reduced goitre volume (~24%); weight‑adjusted thyroxine produced more complete TSH suppression than fixed dosing.

Trust comment: Randomized multicenter controlled trial with objective endpoints, but single‑blind and short (12 week) follow-up.

Study Details

PMID:9604230
Participants:105
Impact:-24% (both treatment groups)
Trust score:4/5

Quality of life

3 evidences

rhTSH preserves quality of life compared with thyroid-hormone withdrawal while achieving comparable low-dose radioiodine remnant ablation success rates.

Trust comment: Large randomized human study directly addressing preparation for radioactive iodine ablation with clear endpoints and significant QoL result.

Study Details

PMID:20151824
Participants:291
Impact:rhTSH better preserved QoL vs withdrawal (p<0.0001)
Trust score:4/5

Two randomized trials showed rTSH-stimulated radioiodine scanning plus thyroglobulin testing is at least as sensitive as thyroid-hormone withdrawal (in improved-tech trial) and causes less hypothyroid morbidity.

Trust comment: Two randomized clinical trials with moderate sample sizes directly comparing rTSH vs withdrawal for I-131 scanning and Tg testing, with both diagnostic and QoL outcomes.

Study Details

PMID:12053710
Participants:347
Impact:Significantly fewer hypothyroid symptoms and better QoL with rTSH than with thyroid-hormone withdrawal
Trust score:4/5

Combining I-125 seed implantation with chemotherapy and Chinese medicine increased response rates, reduced tumor markers, and improved quality of life versus chemotherapy alone.

Trust comment: Randomized assignment reported but multi-component intervention and moderate sample size limit attribution to I-125 alone.

Study Details

PMID:22936319
Participants:90
Impact:Improved more in I-125 combination group (significant)
Trust score:3/5

clinical recurrence

1 evidences

In patients with differentiated thyroid cancer and low preablative thyroglobulin, low-dose radioiodine produced similar ablation rates to high-dose with no recurrences during short follow-up.

Trust comment: Randomized human trial (n=102) with clear endpoints but relatively short follow-up (~6.8 months).

Study Details

PMID:25793928
Participants:102
Impact:0 recurrences during mean 6.8 months follow-up
Trust score:4/5

TSH level (suppression)

1 evidences

Adding 150 µg iodine to individualized L-thyroxine increased urinary iodine and produced greater (though modest) reductions in thyroid volume and stronger TSH suppression versus L-thyroxine alone.

Trust comment: Controlled clinical comparison (n=94) showing biochemical and modest clinical benefit of iodine supplementation; limited methodological detail reported here.

Study Details

PMID:8965746
Participants:94
Impact:−39% (combination) vs +17% (L‑T4 alone); p<0.004
Trust score:3/5

disease-free survival (median)

1 evidences

A single postoperative intra-arterial 131I‑lipiodol dose after liver cancer resection reduced local recurrence and improved disease-free and overall survival versus no adjuvant treatment.

Trust comment: Prospective randomized trial (n=43) with statistically significant benefits but small sample size and early stopping.

Study Details

PMID:10459961
Participants:43
Impact:57.2 months (treatment) vs 13.6 months (control); P=0.037
Trust score:4/5

3-year overall survival

1 evidences

A single postoperative intra-arterial 131I‑lipiodol dose after liver cancer resection reduced local recurrence and improved disease-free and overall survival versus no adjuvant treatment.

Trust comment: Prospective randomized trial (n=43) with statistically significant benefits but small sample size and early stopping.

Study Details

PMID:10459961
Participants:43
Impact:86.4% (treatment) vs 46.3% (control); P=0.039
Trust score:4/5

ablation success rate (composite)

1 evidences

In this randomized trial there was no conclusive superiority of high vs low radioiodine activity for ablating thyroid remnant; lower activity caused fewer side effects and shorter isolation.

Trust comment: Randomized, phase III single‑center trial (n=160) with comprehensive outcomes and long follow-up; single‑center limits generalizability.

Study Details

PMID:18382668
Participants:160
Impact:52% (1100 MBq) vs 56% (3700 MBq); P=0.61 (no significant difference)
Trust score:4/5

nausea (early)

1 evidences

In this randomized trial there was no conclusive superiority of high vs low radioiodine activity for ablating thyroid remnant; lower activity caused fewer side effects and shorter isolation.

Trust comment: Randomized, phase III single‑center trial (n=160) with comprehensive outcomes and long follow-up; single‑center limits generalizability.

Study Details

PMID:18382668
Participants:160
Impact:17% (1100 MBq) vs 37% (3700 MBq) at 5 days; P=0.009
Trust score:4/5

duration of isolation stay

1 evidences

In this randomized trial there was no conclusive superiority of high vs low radioiodine activity for ablating thyroid remnant; lower activity caused fewer side effects and shorter isolation.

Trust comment: Randomized, phase III single‑center trial (n=160) with comprehensive outcomes and long follow-up; single‑center limits generalizability.

Study Details

PMID:18382668
Participants:160
Impact:median 2 days (1100 MBq) vs 3 days (3700 MBq); P<0.0001
Trust score:4/5

haemoglobin / iron status

1 evidences

A fortified biscuit increased urinary iodine and improved vitamin A and iron markers during school terms, but many gains (except urinary iodine) fell back after long school holidays.

Trust comment: Longitudinal cohort (n=108) with serial biochemical measures showing short‑term benefits and seasonal loss of effect; limited by school‑term/holiday confounding.

Study Details

PMID:11796083
Participants:108
Impact:initial improvement then gradual deterioration over subsequent assessments
Trust score:3/5

TSH suppression (complete)

1 evidences

Thyroxine plus iodide reduced goitre volume (~24%); weight‑adjusted thyroxine produced more complete TSH suppression than fixed dosing.

Trust comment: Randomized multicenter controlled trial with objective endpoints, but single‑blind and short (12 week) follow-up.

Study Details

PMID:9604230
Participants:105
Impact:↑ proportion with complete suppression in weight‑adjusted group (p<0.05)
Trust score:4/5

prevalence of ThV > 7.0 ml

1 evidences

Small periodic iodine supplements reduced the occurrence of markedly enlarged thyroids in a subgroup of adolescents, though most children showed similar moderate growth.

Trust comment: Longitudinal controlled study with objective ultrasound measures but small sample, some loss to follow-up and subgroup effects limit generalizability.

Study Details

PMID:9678535
Participants:92
Impact:↓ 28.5 percentage points (from 40% in controls to 11.5% in treated after treatment)
Trust score:3/5

median urinary iodine

1 evidences

Iodine deficiency was present in the population; goiter prevalence rose with age and urinary iodine fell, with higher neonatal TSH observed.

Trust comment: Cross‑sectional nutritional survey with measured biomarkers and reasonable sample size, but observational design limits causal inference.

Study Details

PMID:9611400
Participants:294
Impact:Decreases with age: 12, 7.8, 5.6, 4.2 μg/dL (young children, children, teenagers, women)
Trust score:3/5

neonatal TSH

1 evidences

Iodine deficiency was present in the population; goiter prevalence rose with age and urinary iodine fell, with higher neonatal TSH observed.

Trust comment: Cross‑sectional nutritional survey with measured biomarkers and reasonable sample size, but observational design limits causal inference.

Study Details

PMID:9611400
Participants:294
Impact:↑ (significantly higher in Salazie vs Lille; p<0.005)
Trust score:3/5

PSA level

1 evidences

I-125 seed brachytherapy in 36 prostate cancer patients produced large PSA reductions and was reported safe at 6 months.

Trust comment: Small clinical trial with objective PSA outcome and no reported adverse events, but limited sample size and follow-up.

Study Details

PMID:28394521
Participants:36
Impact:-87% (mean decrease from baseline at 6 months)
Trust score:3/5

Incurred ratio (overall)

1 evidences

Large randomized trial comparing Jiakangling plus reduced 131I versus routine 131I in Graves disease showed mixed effects on recurrence/incidence and reduced permanent hypothyroidism.

Trust comment: Large randomized study but reporting/labels in the report are unclear and outcome definitions are not fully explicit.

Study Details

PMID:26955679
Participants:387
Impact:+12.8 percentage points (3.2% → 16.0%, P<0.01)
Trust score:3/5

Incurred ratio (strong positive TGAb/TMAb patients)

1 evidences

Large randomized trial comparing Jiakangling plus reduced 131I versus routine 131I in Graves disease showed mixed effects on recurrence/incidence and reduced permanent hypothyroidism.

Trust comment: Large randomized study but reporting/labels in the report are unclear and outcome definitions are not fully explicit.

Study Details

PMID:26955679
Participants:387
Impact:+23.6 percentage points (3.5% → 27.1%, P<0.01)
Trust score:3/5

Permanent hypothyroidism ratio

1 evidences

Large randomized trial comparing Jiakangling plus reduced 131I versus routine 131I in Graves disease showed mixed effects on recurrence/incidence and reduced permanent hypothyroidism.

Trust comment: Large randomized study but reporting/labels in the report are unclear and outcome definitions are not fully explicit.

Study Details

PMID:26955679
Participants:387
Impact:-17.7 percentage points (21.1% → 3.4%, P<0.05)
Trust score:3/5

Pancreatic CT enhancement (peak)

1 evidences

In randomized CT protocols, a high-concentration contrast at a fast injection rate produced greater pancreatic enhancement than routine protocols.

Trust comment: Randomized imaging study with objective quantitative CT measures across 125 patients.

Study Details

PMID:12816354
Participants:125
Impact:Significantly greater in high-concentration fast-injection group (group E) versus groups A and B (P<0.05)
Trust score:4/5

Active ophthalmopathy incidence

1 evidences

In 46 Graves patients with mild/no eye disease, RAI did not increase the risk of developing or worsening ophthalmopathy over 12 months.

Trust comment: Prospective clinical study with MRI measures but small sample size, limiting power to detect modest effects.

Study Details

PMID:20405165
Participants:46
Impact:No significant change (OR 0.95; P=0.9)
Trust score:3/5

Extra-ocular muscle dysfunction

1 evidences

In 46 Graves patients with mild/no eye disease, RAI did not increase the risk of developing or worsening ophthalmopathy over 12 months.

Trust comment: Prospective clinical study with MRI measures but small sample size, limiting power to detect modest effects.

Study Details

PMID:20405165
Participants:46
Impact:No significant increase (OR 0.52; P=0.074)
Trust score:3/5

Intraoperative CT scans

1 evidences

Using an adjustable-angle template for 125I seed implantation shortened procedures, reduced CT scans and supplementary seeds, and lowered complication rates versus free‑hand implantation in 45 NSCLC patients.

Trust comment: Randomized trial with objective procedural endpoints but small sample and retrospective elements limit generalizability.

Study Details

PMID:38715485
Participants:45
Impact:-0.7 scans (3.9±0.5 vs 4.6±1.2, P=0.016)
Trust score:3/5

Supplementary seed number

1 evidences

Using an adjustable-angle template for 125I seed implantation shortened procedures, reduced CT scans and supplementary seeds, and lowered complication rates versus free‑hand implantation in 45 NSCLC patients.

Trust comment: Randomized trial with objective procedural endpoints but small sample and retrospective elements limit generalizability.

Study Details

PMID:38715485
Participants:45
Impact:Median −2 seeds (2.0 vs 4.0, P=0.001)
Trust score:3/5

Adverse reaction incidence

1 evidences

Using an adjustable-angle template for 125I seed implantation shortened procedures, reduced CT scans and supplementary seeds, and lowered complication rates versus free‑hand implantation in 45 NSCLC patients.

Trust comment: Randomized trial with objective procedural endpoints but small sample and retrospective elements limit generalizability.

Study Details

PMID:38715485
Participants:45
Impact:-9.5 percentage points (23.8% vs 33.3%, P=0.002)
Trust score:3/5

Partial response rate

1 evidences

I-131 metuximab (Licartin) in Phase I/II HCC trials was well tolerated and showed modest antitumor activity and a 21-month survival ~44.5%.

Trust comment: Early-phase (Phase I/II) trials with moderate sample size demonstrating safety and modest activity but lacking randomized controls.

Study Details

PMID:16690431
Participants:134
Impact:8.2% (6/73 patients who completed two cycles)
Trust score:3/5

Minor response rate

1 evidences

I-131 metuximab (Licartin) in Phase I/II HCC trials was well tolerated and showed modest antitumor activity and a 21-month survival ~44.5%.

Trust comment: Early-phase (Phase I/II) trials with moderate sample size demonstrating safety and modest activity but lacking randomized controls.

Study Details

PMID:16690431
Participants:134
Impact:19.2% (14/73)
Trust score:3/5

Stable disease rate

1 evidences

I-131 metuximab (Licartin) in Phase I/II HCC trials was well tolerated and showed modest antitumor activity and a 21-month survival ~44.5%.

Trust comment: Early-phase (Phase I/II) trials with moderate sample size demonstrating safety and modest activity but lacking randomized controls.

Study Details

PMID:16690431
Participants:134
Impact:58.9% (43/73)
Trust score:3/5

21-month survival rate

1 evidences

I-131 metuximab (Licartin) in Phase I/II HCC trials was well tolerated and showed modest antitumor activity and a 21-month survival ~44.5%.

Trust comment: Early-phase (Phase I/II) trials with moderate sample size demonstrating safety and modest activity but lacking randomized controls.

Study Details

PMID:16690431
Participants:134
Impact:44.5%
Trust score:3/5

Constipation incidence

1 evidences

In a double-blind RCT of DTC patients undergoing thyroid hormone withdrawal, probiotics reduced several withdrawal-related symptoms, improved lipid indices and restored gut/oral microbiota diversity.

Trust comment: Randomized, double-blind, placebo‑controlled trial with objective microbiome and lipid measures but small completed sample size (39).

Study Details

PMID:35350100
Participants:39
Impact:-53.8 percentage points (62.5% → 8.7%, P=0.004)
Trust score:4/5

Lack of energy incidence

1 evidences

In a double-blind RCT of DTC patients undergoing thyroid hormone withdrawal, probiotics reduced several withdrawal-related symptoms, improved lipid indices and restored gut/oral microbiota diversity.

Trust comment: Randomized, double-blind, placebo‑controlled trial with objective microbiome and lipid measures but small completed sample size (39).

Study Details

PMID:35350100
Participants:39
Impact:-32.1 percentage points (62.5% → 30.4%, P=0.047)
Trust score:4/5

Weight gain incidence

1 evidences

In a double-blind RCT of DTC patients undergoing thyroid hormone withdrawal, probiotics reduced several withdrawal-related symptoms, improved lipid indices and restored gut/oral microbiota diversity.

Trust comment: Randomized, double-blind, placebo‑controlled trial with objective microbiome and lipid measures but small completed sample size (39).

Study Details

PMID:35350100
Participants:39
Impact:-34.0 percentage points (68.8% → 34.8%, P=0.037)
Trust score:4/5

Dry mouth incidence

1 evidences

In a double-blind RCT of DTC patients undergoing thyroid hormone withdrawal, probiotics reduced several withdrawal-related symptoms, improved lipid indices and restored gut/oral microbiota diversity.

Trust comment: Randomized, double-blind, placebo‑controlled trial with objective microbiome and lipid measures but small completed sample size (39).

Study Details

PMID:35350100
Participants:39
Impact:-38.4 percentage points (68.8% → 30.4%, P=0.018)
Trust score:4/5

Total cholesterol (CHOL)

1 evidences

In a double-blind RCT of DTC patients undergoing thyroid hormone withdrawal, probiotics reduced several withdrawal-related symptoms, improved lipid indices and restored gut/oral microbiota diversity.

Trust comment: Randomized, double-blind, placebo‑controlled trial with objective microbiome and lipid measures but small completed sample size (39).

Study Details

PMID:35350100
Participants:39
Impact:≈-0.99 µmol/L (6.56 → 5.57; P=0.006)
Trust score:4/5

Radiation proctitis (rectal bleeding)

1 evidences

Randomized trial comparing I-125 and Pd-103 seeds for prostate brachytherapy found differences in early and mid-term urinary and rectal side effects: Pd-103 produced worse urinary symptoms early but recovered sooner; I-125 showed a trend toward more rectal bleeding.

Trust comment: Prospective randomized multicenter trial with 352 patients and objective outcome measures, though not the full planned sample and some endpoints are symptomatic.

Study Details

PMID:16259869
Participants:352
Impact:Overall 29/314 (9%); trend toward more proctitis with I-125 (P=0.21) but not statistically significant
Trust score:4/5

Acute radiation prostatitis

1 evidences

Randomized trial comparing I-125 and Pd-103 seeds for prostate brachytherapy found differences in early and mid-term urinary and rectal side effects: Pd-103 produced worse urinary symptoms early but recovered sooner; I-125 showed a trend toward more rectal bleeding.

Trust comment: Prospective randomized multicenter trial with 352 patients and objective outcome measures, though not the full planned sample and some endpoints are symptomatic.

Study Details

PMID:16259869
Participants:352
Impact:Pd-103 caused more intense prostatitis in first month but symptoms resolved sooner than with I-125 (no exact numeric effect size reported)
Trust score:4/5

Stent implantation success rate

1 evidences

Randomized single-center study in elderly patients with advanced esophageal cancer found 125I-coated stents relieved dysphagia acutely and were associated with longer mean survival than ordinary stents.

Trust comment: Small randomized study with clear survival difference reported but limited sample size and single-center design reduce generalizability.

Study Details

PMID:28365964
Participants:43
Impact:100% success in both groups
Trust score:3/5

Short-term dysphagia relief

1 evidences

Randomized single-center study in elderly patients with advanced esophageal cancer found 125I-coated stents relieved dysphagia acutely and were associated with longer mean survival than ordinary stents.

Trust comment: Small randomized study with clear survival difference reported but limited sample size and single-center design reduce generalizability.

Study Details

PMID:28365964
Participants:43
Impact:100% relief in both groups (no short-term difference)
Trust score:3/5

Mean survival

1 evidences

Randomized single-center study in elderly patients with advanced esophageal cancer found 125I-coated stents relieved dysphagia acutely and were associated with longer mean survival than ordinary stents.

Trust comment: Small randomized study with clear survival difference reported but limited sample size and single-center design reduce generalizability.

Study Details

PMID:28365964
Participants:43
Impact:125I stent 9.8 months vs ordinary stent 4.8 months (difference +5.0 months)
Trust score:3/5

Ablation success rate (6–9 months)

1 evidences

Multicenter randomized noninferiority trial showed low-dose radioiodine (30 mCi) plus thyrotropin alfa is as effective as high-dose (100 mCi) for thyroid remnant ablation, with fewer adverse events and shorter hospital stays.

Trust comment: Large multicenter randomized noninferiority trial with robust endpoints and statistical analysis reported.

Study Details

PMID:22551128
Participants:421
Impact:Low-dose 85.0% vs high-dose 88.9% (noninferior)
Trust score:5/5

Adverse events (proportion)

1 evidences

Multicenter randomized noninferiority trial showed low-dose radioiodine (30 mCi) plus thyrotropin alfa is as effective as high-dose (100 mCi) for thyroid remnant ablation, with fewer adverse events and shorter hospital stays.

Trust comment: Large multicenter randomized noninferiority trial with robust endpoints and statistical analysis reported.

Study Details

PMID:22551128
Participants:421
Impact:Low-dose 21% vs high-dose 33% (absolute -12 percentage points, P=0.007)
Trust score:5/5

Hospitalization ≥3 days

1 evidences

Multicenter randomized noninferiority trial showed low-dose radioiodine (30 mCi) plus thyrotropin alfa is as effective as high-dose (100 mCi) for thyroid remnant ablation, with fewer adverse events and shorter hospital stays.

Trust comment: Large multicenter randomized noninferiority trial with robust endpoints and statistical analysis reported.

Study Details

PMID:22551128
Participants:421
Impact:Low-dose 13.0% vs high-dose 36.3% (absolute -23.3 percentage points, P<0.001)
Trust score:5/5

Cure rate of hyperthyroidism (6 months)

1 evidences

Randomized study in Graves' disease patients found adding propylthiouracil three days after 131I did not significantly change cure rates at six months.

Trust comment: Randomized trial with moderate sample size and short (6-month) follow-up; outcome clear but longer-term effects not assessed.

Study Details

PMID:12536591
Participants:187
Impact:131I alone 76.3% (71/93) vs 131I + PTU 80.5% (76/94) (no significant difference)
Trust score:3/5

Goiter volume reduction (final follow-up)

1 evidences

RhTSH prestimulation before 131I therapy produced greater long-term goiter shrinkage and symptom improvement but caused higher rates of permanent hypothyroidism.

Trust comment: Randomized double-blind placebo-controlled trials with long follow-up but limited total sample size.

Study Details

PMID:22577172
Participants:80
Impact:rhTSH 69.7% vs placebo 56.2% (absolute difference ~13.5 percentage points; reported as a 24% gain)
Trust score:4/5

Compression symptom score

1 evidences

RhTSH prestimulation before 131I therapy produced greater long-term goiter shrinkage and symptom improvement but caused higher rates of permanent hypothyroidism.

Trust comment: Randomized double-blind placebo-controlled trials with long follow-up but limited total sample size.

Study Details

PMID:22577172
Participants:80
Impact:Greater reduction with rhTSH (P=0.049)
Trust score:4/5

Permanent hypothyroidism (final follow-up)

1 evidences

RhTSH prestimulation before 131I therapy produced greater long-term goiter shrinkage and symptom improvement but caused higher rates of permanent hypothyroidism.

Trust comment: Randomized double-blind placebo-controlled trials with long follow-up but limited total sample size.

Study Details

PMID:22577172
Participants:80
Impact:rhTSH 52% vs placebo 16% (absolute +36 percentage points)
Trust score:4/5

Remission rate after first-line therapy

1 evidences

Large pragmatic cohort study with 6–10 year follow-up found that many patients ultimately undergo ablative treatment and that long-term euthyroidism without levothyroxine is achieved in only a minority.

Trust comment: Large real-world cohort with long follow-up but observational design and 60% follow-up rate introduce potential biases.

Study Details

PMID:31482765
Participants:1186
Impact:ATD 45.3%; 131I 81.5%; surgery 96.3% (percentages as reported)
Trust score:3/5

Ablative treatment (any)

1 evidences

Large pragmatic cohort study with 6–10 year follow-up found that many patients ultimately undergo ablative treatment and that long-term euthyroidism without levothyroxine is achieved in only a minority.

Trust comment: Large real-world cohort with long follow-up but observational design and 60% follow-up rate introduce potential biases.

Study Details

PMID:31482765
Participants:1186
Impact:763/1186 (64.3%) had undergone ablative treatment by follow-up
Trust score:3/5

Levothyroxine replacement needed

1 evidences

Large pragmatic cohort study with 6–10 year follow-up found that many patients ultimately undergo ablative treatment and that long-term euthyroidism without levothyroxine is achieved in only a minority.

Trust comment: Large real-world cohort with long follow-up but observational design and 60% follow-up rate introduce potential biases.

Study Details

PMID:31482765
Participants:1186
Impact:ATD-in-remission 23%; 131I-treated 77.3%; surgery 96.2% (as reported)
Trust score:3/5

remission rate at 12 months

1 evidences

RCT comparing fixed 370 vs 555 MBq I-131 for Graves disease: similar remission at 12 months; higher (nonsignificant) hypothyroidism with the larger dose; no new/worsened eye disease.

Trust comment: Randomized controlled trial with moderate sample size and 12-month follow-up; outcomes and statistics reported clearly.

Study Details

PMID:22310249
Participants:128
Impact:+7.1% (80.8% vs 73.7%; P=0.35)
Trust score:4/5

post-treatment hypothyroidism incidence

2 evidences

Prospective randomized comparison of four I-131 dosing protocols for single toxic thyroid nodule: high calculated dose (CHD) gave higher cure rates but also higher hypothyroidism; calculated low dose (CLD) had similar cure to fixed low dose with less hypothyroidism.

Trust comment: Prospective randomized design with 97 completers; results reported clearly though excerpt lacked some exact subgroup percentages.

Study Details

PMID:19194214
Participants:97
Impact:significantly higher in CHD and FHD groups compared with CLD and FLD (no exact percentages in excerpt)
Trust score:4/5

RCT comparing fixed 370 vs 555 MBq I-131 for Graves disease: similar remission at 12 months; higher (nonsignificant) hypothyroidism with the larger dose; no new/worsened eye disease.

Trust comment: Randomized controlled trial with moderate sample size and 12-month follow-up; outcomes and statistics reported clearly.

Study Details

PMID:22310249
Participants:128
Impact:+14.6% (71.1% vs 56.5%; P=0.13)
Trust score:4/5

eye disease (Graves orbitopathy) occurrence/worsening

1 evidences

RCT comparing fixed 370 vs 555 MBq I-131 for Graves disease: similar remission at 12 months; higher (nonsignificant) hypothyroidism with the larger dose; no new/worsened eye disease.

Trust comment: Randomized controlled trial with moderate sample size and 12-month follow-up; outcomes and statistics reported clearly.

Study Details

PMID:22310249
Participants:128
Impact:none developed or worsened in either regimen
Trust score:4/5

stent patency (mean)

1 evidences

Randomized study of biliary stent ± I-125 seeds in malignant biliary obstruction: I-125 seeds increased stent patency and overall survival without added procedure complications.

Trust comment: Prospective randomized study with clear endpoints and statistically significant differences in patency and survival, though sample size is modest.

Study Details

PMID:28162906
Participants:55
Impact:+~116% (mean 191 ±19.8 days vs 88.3 ±16.3 days; P < .001)
Trust score:4/5

overall survival (mean)

1 evidences

Randomized study of biliary stent ± I-125 seeds in malignant biliary obstruction: I-125 seeds increased stent patency and overall survival without added procedure complications.

Trust comment: Prospective randomized study with clear endpoints and statistically significant differences in patency and survival, though sample size is modest.

Study Details

PMID:28162906
Participants:55
Impact:+60% (mean 222.6 ±21.0 days vs 139.1 ±14.5 days; P < .001)
Trust score:4/5

cure of hyperthyroidism (~10 months)

1 evidences

Prospective randomized comparison of four I-131 dosing protocols for single toxic thyroid nodule: high calculated dose (CHD) gave higher cure rates but also higher hypothyroidism; calculated low dose (CLD) had similar cure to fixed low dose with less hypothyroidism.

Trust comment: Prospective randomized design with 97 completers; results reported clearly though excerpt lacked some exact subgroup percentages.

Study Details

PMID:19194214
Participants:97
Impact:higher in CHD group (exact percentage not reported in excerpt)
Trust score:4/5

mean administered radioiodine dose

1 evidences

Prospective randomized comparison of four I-131 dosing protocols for single toxic thyroid nodule: high calculated dose (CHD) gave higher cure rates but also higher hypothyroidism; calculated low dose (CLD) had similar cure to fixed low dose with less hypothyroidism.

Trust comment: Prospective randomized design with 97 completers; results reported clearly though excerpt lacked some exact subgroup percentages.

Study Details

PMID:19194214
Participants:97
Impact:calculated-dose groups received significantly lower mean doses than fixed-dose groups
Trust score:4/5

euthyroid rate at 12 months

2 evidences

Randomized study comparing calculated vs fixed I-131 doses for hyperthyroidism; no difference in 12-month thyroid outcomes; both reduced gland volume.

Trust comment: - Confirm relevance to iodine therapy; - Extract top outcomes (thyroid function, recurrence/persistence, volume); - Determine participant count; - Rate study quality 1–5; - Document quantitative changes; - Simple plain-language summary. Randomized prospective human study with clear outcomes and follow-up (good internal validity) so rated 4.

Study Details

PMID:7586602
Participants:163
Impact:Calculated 50% (39/78) vs Fixed 58% (49/85) (NS)
Trust score:4/5

Randomized trial comparing estimated (palpation) versus calculated I-131 dosing in hyperthyroid patients; outcomes at 12 months did not differ by dosing method.

Trust comment: - Confirm relevance to iodine therapy; - Extract main outcomes (hyperthyroidism persistence, hypothyroidism, euthyroid rate); - Confirm participant count; - Assess quality; - Report numeric impacts; - Simple summary. Prospective randomized human trial with adequate sample and clear outcomes; rated 4 for trustworthiness.

Study Details

PMID:20718174
Participants:128
Impact:34.4% (44/128) overall
Trust score:4/5

persistent/recurrent hyperthyroidism at 12 months

2 evidences

Randomized trial comparing estimated (palpation) versus calculated I-131 dosing in hyperthyroid patients; outcomes at 12 months did not differ by dosing method.

Trust comment: - Confirm relevance to iodine therapy; - Extract main outcomes (hyperthyroidism persistence, hypothyroidism, euthyroid rate); - Confirm participant count; - Assess quality; - Report numeric impacts; - Simple summary. Prospective randomized human trial with adequate sample and clear outcomes; rated 4 for trustworthiness.

Study Details

PMID:20718174
Participants:128
Impact:45.3% (56/128) overall; outcome unrelated to dosing method
Trust score:4/5

Randomized study comparing calculated vs fixed I-131 doses for hyperthyroidism; no difference in 12-month thyroid outcomes; both reduced gland volume.

Trust comment: - Confirm relevance to iodine therapy; - Extract top outcomes (thyroid function, recurrence/persistence, volume); - Determine participant count; - Rate study quality 1–5; - Document quantitative changes; - Simple plain-language summary. Randomized prospective human study with clear outcomes and follow-up (good internal validity) so rated 4.

Study Details

PMID:7586602
Participants:163
Impact:Calculated 41% (32/78) vs Fixed 35% (30/85) (NS)
Trust score:4/5

thyroid volume reduction at 12 months

1 evidences

Randomized study comparing calculated vs fixed I-131 doses for hyperthyroidism; no difference in 12-month thyroid outcomes; both reduced gland volume.

Trust comment: - Confirm relevance to iodine therapy; - Extract top outcomes (thyroid function, recurrence/persistence, volume); - Determine participant count; - Rate study quality 1–5; - Document quantitative changes; - Simple plain-language summary. Randomized prospective human study with clear outcomes and follow-up (good internal validity) so rated 4.

Study Details

PMID:7586602
Participants:163
Impact:Calculated −39% vs Fixed −32% (both P<0.001; between-group NS)
Trust score:4/5

hypothyroidism at 12 months

1 evidences

Randomized trial comparing estimated (palpation) versus calculated I-131 dosing in hyperthyroid patients; outcomes at 12 months did not differ by dosing method.

Trust comment: - Confirm relevance to iodine therapy; - Extract main outcomes (hyperthyroidism persistence, hypothyroidism, euthyroid rate); - Confirm participant count; - Assess quality; - Report numeric impacts; - Simple summary. Prospective randomized human trial with adequate sample and clear outcomes; rated 4 for trustworthiness.

Study Details

PMID:20718174
Participants:128
Impact:20.3% (26/128) overall
Trust score:4/5

euthyroid rate at end of study

1 evidences

Randomized trial in patients with hyperthyroidism relapse after prior RAI: long-term methimazole led to faster and more sustained euthyroidism than repeat RAI.

Trust comment: - Confirm relevance to radioactive iodine treatment; - Extract top outcomes (euthyroid rate, time to euthyroidism, sustained control); - Verify participants; - Rate quality; - Report quantitative differences; - Short plain summary. Randomized trial with clear clinically meaningful endpoints; rated 4 for reliability.

Study Details

PMID:35610532
Participants:64
Impact:LT‑MMI 97% (31/32) vs RAI 25% (8/32)
Trust score:4/5

time to euthyroidism

1 evidences

Randomized trial in patients with hyperthyroidism relapse after prior RAI: long-term methimazole led to faster and more sustained euthyroidism than repeat RAI.

Trust comment: - Confirm relevance to radioactive iodine treatment; - Extract top outcomes (euthyroid rate, time to euthyroidism, sustained control); - Verify participants; - Rate quality; - Report quantitative differences; - Short plain summary. Randomized trial with clear clinically meaningful endpoints; rated 4 for reliability.

Study Details

PMID:35610532
Participants:64
Impact:LT‑MMI mean 3.5 months vs RAI mean 9.4 months (p<0.001)
Trust score:4/5

percent time euthyroid over 60 months

1 evidences

Randomized trial in patients with hyperthyroidism relapse after prior RAI: long-term methimazole led to faster and more sustained euthyroidism than repeat RAI.

Trust comment: - Confirm relevance to radioactive iodine treatment; - Extract top outcomes (euthyroid rate, time to euthyroidism, sustained control); - Verify participants; - Rate quality; - Report quantitative differences; - Short plain summary. Randomized trial with clear clinically meaningful endpoints; rated 4 for reliability.

Study Details

PMID:35610532
Participants:64
Impact:LT‑MMI 95.2% vs RAI 77.7% (p<0.001)
Trust score:4/5

postoperative recurrence rate

1 evidences

Randomized trial in HCC patients: intraoperative implantation of I-125 seeds into remnant liver after resection reduced recurrence and improved overall survival versus control.

Trust comment: - Confirm direct use of iodine-125 brachytherapy; - Extract main oncologic outcomes (recurrence, TTR, OS); - Confirm participants and randomization; - Rate study quality; - Provide numeric results; - Simple summary. Single-center randomized trial with modest sample size but clear effect sizes and ITT analysis; rated 4.

Study Details

PMID:23468980
Participants:68
Impact:I-125 35.3% (12/34) vs Control 70.6% (24/34); HR 0.31 (95% CI 0.145–0.662), p=0.002
Trust score:4/5

mean time to recurrence (TTR)

1 evidences

Randomized trial in HCC patients: intraoperative implantation of I-125 seeds into remnant liver after resection reduced recurrence and improved overall survival versus control.

Trust comment: - Confirm direct use of iodine-125 brachytherapy; - Extract main oncologic outcomes (recurrence, TTR, OS); - Confirm participants and randomization; - Rate study quality; - Provide numeric results; - Simple summary. Single-center randomized trial with modest sample size but clear effect sizes and ITT analysis; rated 4.

Study Details

PMID:23468980
Participants:68
Impact:I-125 mean 60.0 months vs Control mean 36.7 months (log-rank p=0.008)
Trust score:4/5

overall survival (mean and rates)

1 evidences

Randomized trial in HCC patients: intraoperative implantation of I-125 seeds into remnant liver after resection reduced recurrence and improved overall survival versus control.

Trust comment: - Confirm direct use of iodine-125 brachytherapy; - Extract main oncologic outcomes (recurrence, TTR, OS); - Confirm participants and randomization; - Rate study quality; - Provide numeric results; - Simple summary. Single-center randomized trial with modest sample size but clear effect sizes and ITT analysis; rated 4.

Study Details

PMID:23468980
Participants:68
Impact:Mean OS I-125 63.6 vs Control 38.9 months; HR 0.364 (95% CI 0.178–0.741), p=0.005
Trust score:4/5

free T4 change after stopping antithyroid drugs / after RAI

1 evidences

Randomized trial comparing antithyroid‑drug pretreatment vs no pretreatment before I-131 ablation; pretreatment led to transient rises in T4/T3 after stopping drugs, whereas nonpretreated patients had rapid hormone declines after RAI.

Trust comment: - Confirm direct study of radioiodine ablation effects; - Extract top biochemical outcomes (free T4, free T3, exacerbation incidence); - Confirm participant count; - Assess quality; - Report percent changes with CIs where given; - Very short plain summary. Randomized human trial with clear biochemical endpoints and quantified changes; rated 4.

Study Details

PMID:11443161
Participants:42
Impact:Pretreated: average +52.4% (95% CI +26.4% to +78.5%) after stopping drugs; Nonpretreated: average −20.6% over 14 days after RAI (overall), subgroup −52.3% excluding 2 late exacerbations
Trust score:4/5

free T3 change after stopping antithyroid drugs / after RAI

1 evidences

Randomized trial comparing antithyroid‑drug pretreatment vs no pretreatment before I-131 ablation; pretreatment led to transient rises in T4/T3 after stopping drugs, whereas nonpretreated patients had rapid hormone declines after RAI.

Trust comment: - Confirm direct study of radioiodine ablation effects; - Extract top biochemical outcomes (free T4, free T3, exacerbation incidence); - Confirm participant count; - Assess quality; - Report percent changes with CIs where given; - Very short plain summary. Randomized human trial with clear biochemical endpoints and quantified changes; rated 4.

Study Details

PMID:11443161
Participants:42
Impact:Pretreated: average +61.8% (95% CI +23.5% to +100.0%); Nonpretreated: average −24.3% over 14 days after RAI (95% CI −1.2% to −47.4%)
Trust score:4/5

late exacerbation of thyrotoxicosis incidence

1 evidences

Randomized trial comparing antithyroid‑drug pretreatment vs no pretreatment before I-131 ablation; pretreatment led to transient rises in T4/T3 after stopping drugs, whereas nonpretreated patients had rapid hormone declines after RAI.

Trust comment: - Confirm direct study of radioiodine ablation effects; - Extract top biochemical outcomes (free T4, free T3, exacerbation incidence); - Confirm participant count; - Assess quality; - Report percent changes with CIs where given; - Very short plain summary. Randomized human trial with clear biochemical endpoints and quantified changes; rated 4.

Study Details

PMID:11443161
Participants:42
Impact:5/42 patients (11.9%) experienced late exacerbation after RAI
Trust score:4/5

persistent rectal bleeding

2 evidences

In prostate brachytherapy patients, higher rectal wall doses and more seeds very close to the rectal wall were associated with persistent rectal bleeding; overall persistent bleeding occurred in ~5%.

Trust comment: Randomized implant comparison with objective dosimetry and multivariate analysis supports the identified dose–effect relationships, though absolute bleeding events were few.

Study Details

PMID:15234038
Participants:148
Impact:5% (7/144) developed persistent bleeding
Trust score:4/5

Higher rectal radiation dose during prostate brachytherapy was linked to more persistent rectal bleeding; two patients developed rectal‑prostatic fistulas.

Trust comment: Checklist: 1) confirm iodine isotope use in brachytherapy; 2) extract main outcomes (rectal bleeding, fistula, rectal dose); 3) record participants (503); 4) assess quality and report changes; 5) short plain summary — Trust score 4: large prospective randomized multicenter series with long follow-up and objective dose metrics, though associations are observational.

Study Details

PMID:16111583
Participants:503
Impact:44/502 (≈8.8%) incidence
Trust score:4/5

rectal-prostatic fistula

1 evidences

Higher rectal radiation dose during prostate brachytherapy was linked to more persistent rectal bleeding; two patients developed rectal‑prostatic fistulas.

Trust comment: Checklist: 1) confirm iodine isotope use in brachytherapy; 2) extract main outcomes (rectal bleeding, fistula, rectal dose); 3) record participants (503); 4) assess quality and report changes; 5) short plain summary — Trust score 4: large prospective randomized multicenter series with long follow-up and objective dose metrics, though associations are observational.

Study Details

PMID:16111583
Participants:503
Impact:2/503 (0.4%) incidence
Trust score:4/5

rectal volume >100% dose (predictor of bleeding)

1 evidences

Higher rectal radiation dose during prostate brachytherapy was linked to more persistent rectal bleeding; two patients developed rectal‑prostatic fistulas.

Trust comment: Checklist: 1) confirm iodine isotope use in brachytherapy; 2) extract main outcomes (rectal bleeding, fistula, rectal dose); 3) record participants (503); 4) assess quality and report changes; 5) short plain summary — Trust score 4: large prospective randomized multicenter series with long follow-up and objective dose metrics, though associations are observational.

Study Details

PMID:16111583
Participants:503
Impact:significantly predictive of bleeding (multivariate analysis)
Trust score:4/5

complete remission rate

1 evidences

Adding selumetinib to adjuvant radioactive iodine did not increase complete remission rates at 18 months versus placebo, and selumetinib had more grade ≥3 adverse events.

Trust comment: High-quality randomized, double-blind, placebo-controlled phase III trial with predefined endpoints and adequate reporting; primary endpoint not met.

Study Details

PMID:35192411
Participants:233
Impact:selumetinib 62/155 (40%) vs placebo 30/78 (38%); no significant difference (P=0.8205)
Trust score:5/5

grade ≥3 treatment-related adverse events

1 evidences

Adding selumetinib to adjuvant radioactive iodine did not increase complete remission rates at 18 months versus placebo, and selumetinib had more grade ≥3 adverse events.

Trust comment: High-quality randomized, double-blind, placebo-controlled phase III trial with predefined endpoints and adequate reporting; primary endpoint not met.

Study Details

PMID:35192411
Participants:233
Impact:25/154 (16%) with selumetinib vs 0 with placebo
Trust score:5/5

goiter volume reduction (GVR)

1 evidences

Pre-treatment with low-dose rhTSH allowed similar goiter volume reduction with ~70% lower administered 131I activity and far fewer hospitalizations.

Trust comment: Double-blind randomized trial with clinically meaningful endpoints and significant reductions in radiation burden, though follow-up limited to 12 months for primary efficacy.

Study Details

PMID:20519346
Participants:90
Impact:mean relative GVR identical at 12 months: 35% (rhTSH 0.1 mg + 50 Gy) vs 35% (placebo + 100 Gy); P=0.81
Trust score:4/5

hospitalization requirement

1 evidences

Pre-treatment with low-dose rhTSH allowed similar goiter volume reduction with ~70% lower administered 131I activity and far fewer hospitalizations.

Trust comment: Double-blind randomized trial with clinically meaningful endpoints and significant reductions in radiation burden, though follow-up limited to 12 months for primary efficacy.

Study Details

PMID:20519346
Participants:90
Impact:1 patient (rhTSH) vs 14 patients (placebo) required hospitalization (P<0.0001)
Trust score:4/5

time to progression (TTP)

1 evidences

Adding 131I-labeled metuximab to TACE improved time to progression and average survival versus TACE alone in relapsed mid/advanced hepatocellular carcinoma.

Trust comment: Randomized trial (n=60) reporting improved TTP and survival with combined therapy, but moderate quality due to limited size and incomplete reporting in the summary.

Study Details

PMID:24331628
Participants:60
Impact:TG 4.84 ± 4.11 months vs CG 2.54 ± 2.08 months (P<0.05)
Trust score:3/5

average survival time

1 evidences

Adding 131I-labeled metuximab to TACE improved time to progression and average survival versus TACE alone in relapsed mid/advanced hepatocellular carcinoma.

Trust comment: Randomized trial (n=60) reporting improved TTP and survival with combined therapy, but moderate quality due to limited size and incomplete reporting in the summary.

Study Details

PMID:24331628
Participants:60
Impact:TG 7.05 months vs CG 5.15 months (P=0.039)
Trust score:3/5

therapeutic effect rate (CR+PR+MR)

1 evidences

Adding 131I-labeled metuximab to TACE improved time to progression and average survival versus TACE alone in relapsed mid/advanced hepatocellular carcinoma.

Trust comment: Randomized trial (n=60) reporting improved TTP and survival with combined therapy, but moderate quality due to limited size and incomplete reporting in the summary.

Study Details

PMID:24331628
Participants:60
Impact:significantly higher in TG vs CG (P=0.048)
Trust score:3/5

ophthalmopathy progression after radioiodine alone

1 evidences

In patients treated with radioiodine (and other therapies), smokers had worse eye disease outcomes and responded less well to treatments than nonsmokers.

Trust comment: Randomized single-blind component and retrospective cohort with clear outcome measures; moderate-high quality evidence.

Study Details

PMID:9786811
Participants:450
Impact:Nonsmokers 5.9% vs smokers 23.2% (absolute +17.3% higher in smokers)
Trust score:4/5

ophthalmopathy alleviation after radioiodine plus prednisone

1 evidences

In patients treated with radioiodine (and other therapies), smokers had worse eye disease outcomes and responded less well to treatments than nonsmokers.

Trust comment: Randomized single-blind component and retrospective cohort with clear outcome measures; moderate-high quality evidence.

Study Details

PMID:9786811
Participants:450
Impact:Nonsmokers 63.8% vs smokers 14.9% (absolute -48.9% lower in smokers)
Trust score:4/5

response to orbital radiation plus glucocorticoids in severe ophthalmopathy

1 evidences

In patients treated with radioiodine (and other therapies), smokers had worse eye disease outcomes and responded less well to treatments than nonsmokers.

Trust comment: Randomized single-blind component and retrospective cohort with clear outcome measures; moderate-high quality evidence.

Study Details

PMID:9786811
Participants:450
Impact:Nonsmokers 93.8% vs smokers 68.2% (absolute -25.6% lower in smokers)
Trust score:4/5

local recurrence

1 evidences

Adding I-125 seed brachytherapy to sphincter-preserving surgery reduced local recurrences and improved 3-year survival and some functional outcomes.

Trust comment: Randomized trial but small sample size and limited detail in report; results appear clinically meaningful but sample limited.

Study Details

PMID:16029638
Participants:76
Impact:Group B (with I-125) 0% vs Group A 23% at 36 months (absolute -23%)
Trust score:3/5

defecation and erectile function

1 evidences

Adding I-125 seed brachytherapy to sphincter-preserving surgery reduced local recurrences and improved 3-year survival and some functional outcomes.

Trust comment: Randomized trial but small sample size and limited detail in report; results appear clinically meaningful but sample limited.

Study Details

PMID:16029638
Participants:76
Impact:Better in Group B (I-125 brachytherapy) (P<0.05)
Trust score:3/5

goitre prevalence reduction

1 evidences

Radioiodine therapy produced large, dose-dependent reductions in thyroid volume, most of which occurred within six months and progressed by one year.

Trust comment: Prospective randomized multicenter study using ultrasound volumetry with clear dose–response data.

Study Details

PMID:8682157
Participants:92
Impact:Goitre prevalence reduced from 73% pre-treatment to 16% at 1 year
Trust score:4/5

event-free proportion at 5 years

1 evidences

At 5 years, omitting postoperative radioactive iodine in low‑risk thyroid cancer was non-inferior to giving RAI, with similar proportions of patients free of events.

Trust comment: Large multicenter randomized phase 3 trial with 5‑year follow-up demonstrating non-inferiority; high-quality evidence.

Study Details

PMID:39586309
Participants:698
Impact:No-RAI 93.2% vs RAI 94.8% (difference -1.6%; within non-inferiority margin)
Trust score:5/5

euthyroidism rate (tailored dosing)

1 evidences

Tailored radioiodine dosing plus optional low-dose antithyroid drug was assessed for treating Graves' disease versus a fixed-dose control.

Trust comment: Moderate-sized nonrandomized comparison with clear outcome measures but potential selection bias due to nonrandom assignment.

Study Details

PMID:21191313
Participants:118
Impact:75.5% (74/98) vs 50% in control (P=0.03)
Trust score:3/5

hypothyroidism incidence (tailored dosing)

1 evidences

Tailored radioiodine dosing plus optional low-dose antithyroid drug was assessed for treating Graves' disease versus a fixed-dose control.

Trust comment: Moderate-sized nonrandomized comparison with clear outcome measures but potential selection bias due to nonrandom assignment.

Study Details

PMID:21191313
Participants:118
Impact:6.1% (6/98)
Trust score:3/5

persistent hyperthyroidism (tailored dosing)

1 evidences

Tailored radioiodine dosing plus optional low-dose antithyroid drug was assessed for treating Graves' disease versus a fixed-dose control.

Trust comment: Moderate-sized nonrandomized comparison with clear outcome measures but potential selection bias due to nonrandom assignment.

Study Details

PMID:21191313
Participants:118
Impact:18.4% (18/98)
Trust score:3/5

tumor response rate at 2 months (epirubicin)

1 evidences

Compared Lipiodol-targeted epirubicin chemotherapy versus Lipiodol-131I radiotherapy in 95 patients with unresectable liver cancer for tumor response and survival.

Trust comment: Reasonable sample with a randomized subset but heterogeneous groups and some outcome reporting on subsets reduce overall certainty.

Study Details

PMID:8635022
Participants:95
Impact:55% (21/38 subset) static or partial response
Trust score:3/5

tumor response rate at 2 months (131I)

1 evidences

Compared Lipiodol-targeted epirubicin chemotherapy versus Lipiodol-131I radiotherapy in 95 patients with unresectable liver cancer for tumor response and survival.

Trust comment: Reasonable sample with a randomized subset but heterogeneous groups and some outcome reporting on subsets reduce overall certainty.

Study Details

PMID:8635022
Participants:95
Impact:68% (15/22 subset) static or partial response
Trust score:3/5

6-month overall survival (131I vs epirubicin)

1 evidences

Compared Lipiodol-targeted epirubicin chemotherapy versus Lipiodol-131I radiotherapy in 95 patients with unresectable liver cancer for tumor response and survival.

Trust comment: Reasonable sample with a randomized subset but heterogeneous groups and some outcome reporting on subsets reduce overall certainty.

Study Details

PMID:8635022
Participants:95
Impact:58% (131I) vs 40% (epirubicin)
Trust score:3/5

FT4 increase after MMI withdrawal

1 evidences

Randomized study showing short-course lithium prevents rises in serum thyroid hormones after antithyroid drug withdrawal and radioiodine therapy in Graves' disease.

Trust comment: Randomized controlled design but small sample; biochemical endpoints and clear effects support moderate-high trust.

Study Details

PMID:12364424
Participants:36
Impact:Rise from 13.5 ± 6.5 to 19.8 ± 9.2 pmol/L in groups without extended lithium; prevented with lithium started at withdrawal
Trust score:4/5

FT3 change after RAI

1 evidences

Randomized study showing short-course lithium prevents rises in serum thyroid hormones after antithyroid drug withdrawal and radioiodine therapy in Graves' disease.

Trust comment: Randomized controlled design but small sample; biochemical endpoints and clear effects support moderate-high trust.

Study Details

PMID:12364424
Participants:36
Impact:FT3 decreased in all groups (significant) but transient FT4 rise post-RAI was prevented by lithium
Trust score:4/5

hyperthyroidism cure rate by group

1 evidences

Randomized study showing short-course lithium prevents rises in serum thyroid hormones after antithyroid drug withdrawal and radioiodine therapy in Graves' disease.

Trust comment: Randomized controlled design but small sample; biochemical endpoints and clear effects support moderate-high trust.

Study Details

PMID:12364424
Participants:36
Impact:G1 8/12 (67%), G2 11/12 (92%), G3 11/12 (92%)
Trust score:4/5

pain (VAS) after treatment

1 evidences

Randomized trial in 80 patients comparing vertebroplasty alone versus vertebroplasty plus 125I seed implantation for metastatic spinal tumors, focusing on pain and function.

Trust comment: Randomized study with adequate sample size and clinically relevant endpoints; reporting supports moderate-high trust.

Study Details

PMID:19922311
Participants:80
Impact:Combined: 2.26 ± 1.05 vs PVP alone: 5.41 ± 0.94 (combined lower by ~3.15 points)
Trust score:4/5

Karnofsky performance score (KPS) after treatment

1 evidences

Randomized trial in 80 patients comparing vertebroplasty alone versus vertebroplasty plus 125I seed implantation for metastatic spinal tumors, focusing on pain and function.

Trust comment: Randomized study with adequate sample size and clinically relevant endpoints; reporting supports moderate-high trust.

Study Details

PMID:19922311
Participants:80
Impact:Combined: 92.5 ± 7.1 vs PVP alone: 87.7 ± 7.3 (combined higher by ~4.8 points)
Trust score:4/5

clinical benefit rate

1 evidences

Randomized trial in 80 patients comparing vertebroplasty alone versus vertebroplasty plus 125I seed implantation for metastatic spinal tumors, focusing on pain and function.

Trust comment: Randomized study with adequate sample size and clinically relevant endpoints; reporting supports moderate-high trust.

Study Details

PMID:19922311
Participants:80
Impact:100% (combined) vs 95.0% (PVP alone), not statistically different
Trust score:4/5

event-free rate at 3 years (no-radioiodine)

1 evidences

Phase 3 randomized trial showing omission of postoperative radioiodine in low-risk thyroid cancer was noninferior to radioiodine ablation for a 3-year composite outcome.

Trust comment: Large, prospective, randomized phase 3 trial with clear noninferiority endpoint and robust sample size supports high trust.

Study Details

PMID:35263518
Participants:730
Impact:95.6% (95% CI 93.0 to 97.5)
Trust score:5/5

event-free rate at 3 years (radioiodine)

1 evidences

Phase 3 randomized trial showing omission of postoperative radioiodine in low-risk thyroid cancer was noninferior to radioiodine ablation for a 3-year composite outcome.

Trust comment: Large, prospective, randomized phase 3 trial with clear noninferiority endpoint and robust sample size supports high trust.

Study Details

PMID:35263518
Participants:730
Impact:95.9% (95% CI 93.3 to 97.7); difference -0.3 percentage points (90% CI -2.7 to 2.2)
Trust score:5/5

treatment-related adverse events

2 evidences

Compared two iodine-containing contrast agents for safety and image quality; similar efficacy and safety, with fewer cases of contrast-related kidney injury after iosimenol.

Trust comment: Randomized, double-blind phase-2 trial with objective endpoints but relatively small sample size limiting detection of subtle differences.

Study Details

PMID:24938661
Participants:144
Impact:iosimenol 56.9% vs iodixanol 54.3% (patients with ADRs)
Trust score:4/5

Phase 3 randomized trial showing omission of postoperative radioiodine in low-risk thyroid cancer was noninferior to radioiodine ablation for a 3-year composite outcome.

Trust comment: Large, prospective, randomized phase 3 trial with clear noninferiority endpoint and robust sample size supports high trust.

Study Details

PMID:35263518
Participants:730
Impact:No treatment-related adverse events reported
Trust score:5/5

vitality score

1 evidences

Long-term follow-up found Graves' disease patients had reduced vitality and mental quality-of-life compared with population norms; no major QoL differences between antithyroid drugs, radioiodine, or surgery.

Trust comment: Randomized study with long-term follow-up and objective QoL instruments, but response rates and potential selection/response bias over 14–21 years may affect generalizability.

Study Details

PMID:16356093
Participants:179
Impact:decreased (significantly lower vs Swedish reference, p<0.05)
Trust score:4/5

mental component summary

1 evidences

Long-term follow-up found Graves' disease patients had reduced vitality and mental quality-of-life compared with population norms; no major QoL differences between antithyroid drugs, radioiodine, or surgery.

Trust comment: Randomized study with long-term follow-up and objective QoL instruments, but response rates and potential selection/response bias over 14–21 years may affect generalizability.

Study Details

PMID:16356093
Participants:179
Impact:decreased (lower in several subgroups vs reference, p<0.05)
Trust score:4/5

general health (radioiodine-treated)

1 evidences

Long-term follow-up found Graves' disease patients had reduced vitality and mental quality-of-life compared with population norms; no major QoL differences between antithyroid drugs, radioiodine, or surgery.

Trust comment: Randomized study with long-term follow-up and objective QoL instruments, but response rates and potential selection/response bias over 14–21 years may affect generalizability.

Study Details

PMID:16356093
Participants:179
Impact:lower (radioiodine group had reduced General Health score)
Trust score:4/5

overall response rate (CR+PR)

1 evidences

In patients with cervical lymph node metastases, adding CT-guided I-125 seed implantation to chemotherapy produced higher tumor response and lower local progression at 6 months than chemotherapy alone.

Trust comment: Prospective randomized design but relatively small sample and short (6-month) follow-up limit strength and long-term applicability.

Study Details

PMID:30539864
Participants:82
Impact:82.6% at 2 months and 85.5% at 6 months (concurrent 125I+chemo group)
Trust score:3/5

local progression rate

1 evidences

In patients with cervical lymph node metastases, adding CT-guided I-125 seed implantation to chemotherapy produced higher tumor response and lower local progression at 6 months than chemotherapy alone.

Trust comment: Prospective randomized design but relatively small sample and short (6-month) follow-up limit strength and long-term applicability.

Study Details

PMID:30539864
Participants:82
Impact:4.17% vs 17.64% at 6 months (concurrent 125I+chemo vs chemo-only; P<0.05)
Trust score:3/5

lymph node diameter

1 evidences

In patients with cervical lymph node metastases, adding CT-guided I-125 seed implantation to chemotherapy produced higher tumor response and lower local progression at 6 months than chemotherapy alone.

Trust comment: Prospective randomized design but relatively small sample and short (6-month) follow-up limit strength and long-term applicability.

Study Details

PMID:30539864
Participants:82
Impact:marked decrease after treatment (P<0.05)
Trust score:3/5

macular edema (OCT-evident)

1 evidences

Periocular triamcinolone given at radiotherapy and at 4 and 8 months reduced macular edema and lowered rates of moderate and severe vision loss up to 18 months.

Trust comment: Well-conducted randomized controlled trial with high follow-up rate (88% at 18 months) and objective outcomes; applicable to patients undergoing I-125 plaque radiotherapy.

Study Details

PMID:19481812
Participants:163
Impact:reduced (hazard estimate 0.45; P=0.001)
Trust score:4/5

moderate vision loss (≥3 lines)

1 evidences

Periocular triamcinolone given at radiotherapy and at 4 and 8 months reduced macular edema and lowered rates of moderate and severe vision loss up to 18 months.

Trust comment: Well-conducted randomized controlled trial with high follow-up rate (88% at 18 months) and objective outcomes; applicable to patients undergoing I-125 plaque radiotherapy.

Study Details

PMID:19481812
Participants:163
Impact:31% vs 48% at 18 months (triamcinolone vs control; P=0.039)
Trust score:4/5

severe vision loss (BCVA <5/200)

1 evidences

Periocular triamcinolone given at radiotherapy and at 4 and 8 months reduced macular edema and lowered rates of moderate and severe vision loss up to 18 months.

Trust comment: Well-conducted randomized controlled trial with high follow-up rate (88% at 18 months) and objective outcomes; applicable to patients undergoing I-125 plaque radiotherapy.

Study Details

PMID:19481812
Participants:163
Impact:5% vs 15% at 18 months (triamcinolone vs control; P=0.048)
Trust score:4/5

perirectal seeds ≤2.0 mm

1 evidences

In prostate brachytherapy patients, higher rectal wall doses and more seeds very close to the rectal wall were associated with persistent rectal bleeding; overall persistent bleeding occurred in ~5%.

Trust comment: Randomized implant comparison with objective dosimetry and multivariate analysis supports the identified dose–effect relationships, though absolute bleeding events were few.

Study Details

PMID:15234038
Participants:148
Impact:greater number associated with rectal bleeding (P=0.037)
Trust score:4/5

R300 rectal dose

1 evidences

In prostate brachytherapy patients, higher rectal wall doses and more seeds very close to the rectal wall were associated with persistent rectal bleeding; overall persistent bleeding occurred in ~5%.

Trust comment: Randomized implant comparison with objective dosimetry and multivariate analysis supports the identified dose–effect relationships, though absolute bleeding events were few.

Study Details

PMID:15234038
Participants:148
Impact:R300 was significantly associated with likelihood of persistent rectal bleeding (P=0.025)
Trust score:4/5

serum free T4 index

1 evidences

Pretreatment with propylthiouracil (PTU) before 131I therapy altered early thyroid hormone responses and reduced the radioiodine cure rate (significant in regression analysis).

Trust comment: Randomized clinical trial with clear biochemical and clinical endpoints; modest sample sizes limit precision but regression analysis supports the main conclusion.

Study Details

PMID:15356044
Participants:80
Impact:increased in +PTU group (97.7 → 152.3 nmol/L at 3 wk, 140.4 at 6 wk; P<0.001) and decreased in -PTU group
Trust score:4/5

treatment failure rate (toxic nodular goiter)

1 evidences

Pretreatment with propylthiouracil (PTU) before 131I therapy altered early thyroid hormone responses and reduced the radioiodine cure rate (significant in regression analysis).

Trust comment: Randomized clinical trial with clear biochemical and clinical endpoints; modest sample sizes limit precision but regression analysis supports the main conclusion.

Study Details

PMID:15356044
Participants:80
Impact:higher in PTU group 9/20 vs 3/25 (P=0.06); PTU pretreatment had significant adverse effect on cure rate in regression (P=0.03)
Trust score:4/5

vitamin B12 insufficiency

1 evidences

Compared quintuply-fortified salt (including iodine) versus iodized salt in nonpregnant reproductive-age women; QFS improved several micronutrient deficiencies versus iodized salt.

Trust comment: Large double-blind randomized community trial with objective biomarker outcomes and high sample size.

Study Details

PMID:40610127
Participants:998
Impact:-80% odds at 6 mo (OR 0.20 vs iodized salt)
Trust score:5/5

folate insufficiency

1 evidences

Compared quintuply-fortified salt (including iodine) versus iodized salt in nonpregnant reproductive-age women; QFS improved several micronutrient deficiencies versus iodized salt.

Trust comment: Large double-blind randomized community trial with objective biomarker outcomes and high sample size.

Study Details

PMID:40610127
Participants:998
Impact:-86% odds at 6 mo (OR 0.14 vs iodized salt)
Trust score:5/5

Iron deficiency

1 evidences

Compared quintuply-fortified salt (including iodine) versus iodized salt in nonpregnant reproductive-age women; QFS improved several micronutrient deficiencies versus iodized salt.

Trust comment: Large double-blind randomized community trial with objective biomarker outcomes and high sample size.

Study Details

PMID:40610127
Participants:998
Impact:Small/marginal reduction: OR 0.64 at 6 mo and OR 0.58 at 12 mo (marginal significance)
Trust score:5/5

DIL D90 (dose coverage)

1 evidences

Phase II randomized comparison of LDR (I-125 seeds) versus HDR prostate brachytherapy measuring dose coverage to MRI-defined dominant intraprostatic lesions.

Trust comment: Randomized phase II trial with clear dosimetric endpoints but modest sample size.

Study Details

PMID:30795889
Participants:60
Impact:Higher for LDR: mean 151% vs 132% for HDR (≈+19 percentage points)
Trust score:4/5

DIL volume

1 evidences

Phase II randomized comparison of LDR (I-125 seeds) versus HDR prostate brachytherapy measuring dose coverage to MRI-defined dominant intraprostatic lesions.

Trust comment: Randomized phase II trial with clear dosimetric endpoints but modest sample size.

Study Details

PMID:30795889
Participants:60
Impact:No significant difference in mean DIL volume (1.9 cc LDR vs 1.6 cc HDR; p=0.279)
Trust score:4/5

Final thyroid outcome (hypothyroidism/euthyroid/recurrence)

1 evidences

Randomized trial testing whether restarting methimazole 7 days after 131I alters outcomes; no difference in final thyroid function but less early thyrotoxicosis and smaller goitre shrinkage with resumed methimazole.

Trust comment: Randomized clinical trial with adequate sample and objective thyroid endpoints; clear reporting.

Study Details

PMID:14640988
Participants:149
Impact:No significant difference at 12 months (similar counts in both groups)
Trust score:4/5

Serum free-thyroxine index at 3 weeks

1 evidences

Randomized trial testing whether restarting methimazole 7 days after 131I alters outcomes; no difference in final thyroid function but less early thyrotoxicosis and smaller goitre shrinkage with resumed methimazole.

Trust comment: Randomized clinical trial with adequate sample and objective thyroid endpoints; clear reporting.

Study Details

PMID:14640988
Participants:149
Impact:+ATD: -5.7% vs -ATD: +35.9% (P<0.001 between groups) — reduced early thyrotoxicosis with resumed methimazole
Trust score:4/5

Thyroid volume reduction (goitre shrinkage)

1 evidences

Randomized trial testing whether restarting methimazole 7 days after 131I alters outcomes; no difference in final thyroid function but less early thyrotoxicosis and smaller goitre shrinkage with resumed methimazole.

Trust comment: Randomized clinical trial with adequate sample and objective thyroid endpoints; clear reporting.

Study Details

PMID:14640988
Participants:149
Impact:Smaller shrinkage with resumed methimazole: 38.7% vs 48.6% (≈-9.9 percentage points)
Trust score:4/5

Thyroid ablation rate

1 evidences

Phase 3 randomized trial showed low-dose postoperative 131I (1.1 GBq) with recombinant TSH is as effective as higher dose (3.7 GBq) for thyroid ablation in low-risk patients.

Trust comment: Large randomized phase 3 trial with long follow-up and objective ablation endpoints.

Study Details

PMID:22551127
Participants:684
Impact:Complete ablation in 92% (631/684); ablation rates equivalent between low and high 131I doses and between stimulation methods
Trust score:5/5

serum PSA

1 evidences

Randomized study of neoadjuvant hormonal therapy before I-125 seed implantation showed rapid PSA and prostate-volume reductions pre-implant and lower subsequent PSA compared with implantation alone.

Trust comment: Randomized moderate-size study with clear clinical endpoints but limited reporting and single-center design.

Study Details

PMID:23290112
Participants:165
Impact:Median PSA fell from 26.50 to 0.38 µg/L after 3-month neoadjuvant therapy (pre-implant); post-brachytherapy medians 0.62 (NHT) vs 2.56 µg/L (no NHT)
Trust score:3/5

Prostate volume

1 evidences

Randomized study of neoadjuvant hormonal therapy before I-125 seed implantation showed rapid PSA and prostate-volume reductions pre-implant and lower subsequent PSA compared with implantation alone.

Trust comment: Randomized moderate-size study with clear clinical endpoints but limited reporting and single-center design.

Study Details

PMID:23290112
Participants:165
Impact:Median volume decreased from 46.38 ml to 29.33 ml after 3-month NHT (≈-17.05 ml)
Trust score:3/5

Acute urinary retention

1 evidences

Randomized study of neoadjuvant hormonal therapy before I-125 seed implantation showed rapid PSA and prostate-volume reductions pre-implant and lower subsequent PSA compared with implantation alone.

Trust comment: Randomized moderate-size study with clear clinical endpoints but limited reporting and single-center design.

Study Details

PMID:23290112
Participants:165
Impact:6 events (NHT group) vs 9 events (no NHT) after brachytherapy
Trust score:3/5

overall response rate

2 evidences

Randomized comparison in relapsed/refractory NHL showed that conjugating 131I to tositumomab substantially increased response rates and durability but increased hematologic toxicity.

Trust comment: Randomized multicenter trial directly comparing I-131–labeled versus unlabeled antibody with clear efficacy differences, though sample size is modest.

Study Details

PMID:15585610
Participants:78
Impact:55% vs 19% (I-131–tositumomab vs unlabeled; P=0.002)
Trust score:4/5

Randomized comparison in inoperable advanced NSCLC found I-125 seed implantation yielded higher response rates, better survival and improved symptoms/quality of life versus conventional radiotherapy.

Trust comment: Randomized study with positive clinical outcomes but small sample and limited detail on randomization/blinding.

Study Details

PMID:25428394
Participants:71
Impact:88% (I-125) vs 59% (conventional) — +29 percentage points
Trust score:3/5

One- and two-year survival

1 evidences

Randomized comparison in inoperable advanced NSCLC found I-125 seed implantation yielded higher response rates, better survival and improved symptoms/quality of life versus conventional radiotherapy.

Trust comment: Randomized study with positive clinical outcomes but small sample and limited detail on randomization/blinding.

Study Details

PMID:25428394
Participants:71
Impact:Higher survival rates with I-125 implantation (P<0.05)
Trust score:3/5

medical knowledge

1 evidences

A decision aid increased patients' knowledge and reduced decisional conflict about adjuvant radioactive iodine without significantly changing treatment uptake.

Trust comment: Randomized controlled trial with validated outcomes but modest sample size (n=74).

Study Details

PMID:22753906
Participants:74
Impact:Significantly increased (P < .001)
Trust score:4/5

decisional conflict

1 evidences

A decision aid increased patients' knowledge and reduced decisional conflict about adjuvant radioactive iodine without significantly changing treatment uptake.

Trust comment: Randomized controlled trial with validated outcomes but modest sample size (n=74).

Study Details

PMID:22753906
Participants:74
Impact:Significantly reduced (P < .001)
Trust score:4/5

adjuvant radioactive iodine uptake

1 evidences

A decision aid increased patients' knowledge and reduced decisional conflict about adjuvant radioactive iodine without significantly changing treatment uptake.

Trust comment: Randomized controlled trial with validated outcomes but modest sample size (n=74).

Study Details

PMID:22753906
Participants:74
Impact:+10.8 percentage points (29.7% vs 18.9%)
Trust score:4/5

early heart/mediastinum (H/M) ratio

1 evidences

123I-MIBG heart/mediastinum uptake ratios were lower in Parkinson's patients and correlated with some measures of cardiac autonomic dysfunction.

Trust comment: Observational case-control study with objective imaging and physiologic measures; moderate sample and appropriate methods.

Study Details

PMID:14658397
Participants:115
Impact:PD 1.76 vs control 2.56 (−0.80 absolute)
Trust score:3/5

delayed heart/mediastinum (H/M) ratio

1 evidences

123I-MIBG heart/mediastinum uptake ratios were lower in Parkinson's patients and correlated with some measures of cardiac autonomic dysfunction.

Trust comment: Observational case-control study with objective imaging and physiologic measures; moderate sample and appropriate methods.

Study Details

PMID:14658397
Participants:115
Impact:PD 1.61 vs control 2.45 (−0.84 absolute)
Trust score:3/5

QTc interval

1 evidences

123I-MIBG heart/mediastinum uptake ratios were lower in Parkinson's patients and correlated with some measures of cardiac autonomic dysfunction.

Trust comment: Observational case-control study with objective imaging and physiologic measures; moderate sample and appropriate methods.

Study Details

PMID:14658397
Participants:115
Impact:PD 417 ms vs control 409 ms (+8 ms)
Trust score:3/5

back pain relief

1 evidences

Combining percutaneous vertebroplasty with 125I seed implantation provided high rates of pain relief and improved function compared with regular radiotherapy.

Trust comment: Comparative clinical series (50 vs 50) with reported significant improvements but unclear randomization/masking.

Study Details

PMID:23009581
Participants:100
Impact:98% (49/50) of PVP+125I patients had significant pain relief
Trust score:3/5

VAS pain score

1 evidences

Combining percutaneous vertebroplasty with 125I seed implantation provided high rates of pain relief and improved function compared with regular radiotherapy.

Trust comment: Comparative clinical series (50 vs 50) with reported significant improvements but unclear randomization/masking.

Study Details

PMID:23009581
Participants:100
Impact:Significant improvement postoperatively (p < 0.05) vs preop and vs radiotherapy
Trust score:3/5

Karnofsky performance score (KPS)

1 evidences

Combining percutaneous vertebroplasty with 125I seed implantation provided high rates of pain relief and improved function compared with regular radiotherapy.

Trust comment: Comparative clinical series (50 vs 50) with reported significant improvements but unclear randomization/masking.

Study Details

PMID:23009581
Participants:100
Impact:Significant improvement (p < 0.05)
Trust score:3/5

incidence of acute renal insufficiency

1 evidences

Peri-procedural intravenous saline hydration markedly reduced the incidence and early severity of contrast-induced acute renal insufficiency.

Trust comment: Randomized prospective trial with clear clinically relevant endpoints but modest sample size.

Study Details

PMID:12411756
Participants:53
Impact:Hydration 3.7% (1/27) vs no restriction 34.6% (9/26); −30.9 percentage points (p = 0.005)
Trust score:4/5

mean serum creatinine increase at 24 h

1 evidences

Peri-procedural intravenous saline hydration markedly reduced the incidence and early severity of contrast-induced acute renal insufficiency.

Trust comment: Randomized prospective trial with clear clinically relevant endpoints but modest sample size.

Study Details

PMID:12411756
Participants:53
Impact:+8 ± 11 vs +20 ± 21 µmol/L (hydration vs control; p = 0.02)
Trust score:4/5

parotid gland parenchymal function

1 evidences

Amifostine given before high-dose radioiodine prevented salivary gland functional decline and xerostomia compared with placebo.

Trust comment: Double-blind, placebo-controlled randomized trial with objective scintigraphy outcomes; high trust.

Study Details

PMID:9817273
Participants:50
Impact:Control −40.2% ±14.1% after HD-RIT; amifostine group no significant change (P = 0.691)
Trust score:5/5

submandibular gland parenchymal function

1 evidences

Amifostine given before high-dose radioiodine prevented salivary gland functional decline and xerostomia compared with placebo.

Trust comment: Double-blind, placebo-controlled randomized trial with objective scintigraphy outcomes; high trust.

Study Details

PMID:9817273
Participants:50
Impact:Control −39.9% ±15.3% after HD-RIT; amifostine group no significant change (P = 0.691)
Trust score:5/5

xerostomia

1 evidences

Amifostine given before high-dose radioiodine prevented salivary gland functional decline and xerostomia compared with placebo.

Trust comment: Double-blind, placebo-controlled randomized trial with objective scintigraphy outcomes; high trust.

Study Details

PMID:9817273
Participants:50
Impact:0/25 with amifostine vs 11/25 in controls (9 grade I, 2 grade II)
Trust score:5/5

prevalence of ≥1 posterior pole abnormality

1 evidences

After I-125 brachytherapy for medium-sized choroidal melanoma, posterior pole abnormalities and retinopathy/optic neuropathy increased over 8 years.

Trust comment: Large multicenter trial dataset with standardized imaging/grading and long-term follow-up; high-quality observational reporting within trial.

Study Details

PMID:19118701
Participants:650
Impact:49.2% baseline → 84.4% at 2y → 91.2% at 5y → 90.7% at 8y
Trust score:4/5

macular microaneurysms prevalence

1 evidences

After I-125 brachytherapy for medium-sized choroidal melanoma, posterior pole abnormalities and retinopathy/optic neuropathy increased over 8 years.

Trust comment: Large multicenter trial dataset with standardized imaging/grading and long-term follow-up; high-quality observational reporting within trial.

Study Details

PMID:19118701
Participants:650
Impact:75.6% of examinations
Trust score:4/5

optic neuropathy prevalence

1 evidences

After I-125 brachytherapy for medium-sized choroidal melanoma, posterior pole abnormalities and retinopathy/optic neuropathy increased over 8 years.

Trust comment: Large multicenter trial dataset with standardized imaging/grading and long-term follow-up; high-quality observational reporting within trial.

Study Details

PMID:19118701
Participants:650
Impact:27.4% at 5 years
Trust score:4/5

recurrence-free survival

1 evidences

Randomized trial testing intrahepatic 131I-lipiodol after liver cancer surgery found no clear survival benefit and a few radiation-related adverse events.

Trust comment: Prospective multicentre randomized trial but modest sample size and non-significant primary results.

Study Details

PMID:23463394
Participants:103
Impact:HR=0.75 (nonsignificant, p=0.25) — small improvement vs control
Trust score:3/5

hypothyroidism (adverse event)

1 evidences

Randomized trial testing intrahepatic 131I-lipiodol after liver cancer surgery found no clear survival benefit and a few radiation-related adverse events.

Trust comment: Prospective multicentre randomized trial but modest sample size and non-significant primary results.

Study Details

PMID:23463394
Participants:103
Impact:2 serious adverse events included hypothyroidism attributed to 131I-lipiodol
Trust score:3/5

ACVR2A differential expression

1 evidences

Study of thyroid tumor and matched normal tissue from individuals exposed to I-131 after Chernobyl found 11 genes with dose-dependent differential expression.

Trust comment: Human tissue study with individual I-131 dose estimates and independent qRT-PCR validation but limited sample size (exploratory).

Study Details

PMID:22848350
Participants:63
Impact:fold-change per dose categories: 1 → 1.1, 2 → 0.9; P_cat=0.001, P_trend=0.02
Trust score:4/5

CA12 differential expression

1 evidences

Study of thyroid tumor and matched normal tissue from individuals exposed to I-131 after Chernobyl found 11 genes with dose-dependent differential expression.

Trust comment: Human tissue study with individual I-131 dose estimates and independent qRT-PCR validation but limited sample size (exploratory).

Study Details

PMID:22848350
Participants:63
Impact:fold-change per dose categories: 1 → 0.3, 2 → 0.3; P_cat=0.01, P_trend=0.02
Trust score:4/5

CDK12 differential expression

1 evidences

Study of thyroid tumor and matched normal tissue from individuals exposed to I-131 after Chernobyl found 11 genes with dose-dependent differential expression.

Trust comment: Human tissue study with individual I-131 dose estimates and independent qRT-PCR validation but limited sample size (exploratory).

Study Details

PMID:22848350
Participants:63
Impact:fold-change per dose categories: 1 → 0.7, 2 → 0.7; P_cat=0.01, P_trend=0.04
Trust score:4/5

FAM38A differential expression

1 evidences

Study of thyroid tumor and matched normal tissue from individuals exposed to I-131 after Chernobyl found 11 genes with dose-dependent differential expression.

Trust comment: Human tissue study with individual I-131 dose estimates and independent qRT-PCR validation but limited sample size (exploratory).

Study Details

PMID:22848350
Participants:63
Impact:fold-change per dose categories: 1 → 0.8, 2 → 1.3; P_cat=0.0004, P_trend=0.04
Trust score:4/5

LMO3 differential expression

1 evidences

Study of thyroid tumor and matched normal tissue from individuals exposed to I-131 after Chernobyl found 11 genes with dose-dependent differential expression.

Trust comment: Human tissue study with individual I-131 dose estimates and independent qRT-PCR validation but limited sample size (exploratory).

Study Details

PMID:22848350
Participants:63
Impact:fold-change per dose categories: 1 → 0.9, 2 → 0.7; P_cat=0.01, P_trend=0.01 (dose-dependent)
Trust score:4/5

tumor regression rate

1 evidences

Randomized comparison of 125I brachytherapy vs transpupillary thermotherapy for small choroidal melanoma showed distinct long-term choroidal vascular changes, with brachytherapy causing more vessel closure and vascular wall staining.

Trust comment: Randomized study with long follow-up and clear differences in ocular vascular outcomes after 125I brachytherapy.

Study Details

PMID:19551682
Participants:95
Impact:IBT 98% vs TTT 92% (p=0.397) — similar tumor control
Trust score:4/5

closure of medium/large choroidal vessels

1 evidences

Randomized comparison of 125I brachytherapy vs transpupillary thermotherapy for small choroidal melanoma showed distinct long-term choroidal vascular changes, with brachytherapy causing more vessel closure and vascular wall staining.

Trust comment: Randomized study with long follow-up and clear differences in ocular vascular outcomes after 125I brachytherapy.

Study Details

PMID:19551682
Participants:95
Impact:IBT 96% vs TTT 35% (p<0.001) — much more vessel closure after 125I brachytherapy
Trust score:4/5

ICG vascular wall staining and aneurysmal changes

1 evidences

Randomized comparison of 125I brachytherapy vs transpupillary thermotherapy for small choroidal melanoma showed distinct long-term choroidal vascular changes, with brachytherapy causing more vessel closure and vascular wall staining.

Trust comment: Randomized study with long follow-up and clear differences in ocular vascular outcomes after 125I brachytherapy.

Study Details

PMID:19551682
Participants:95
Impact:ICG staining in 65% and aneurysmal changes in 15% of IBT-treated eyes; never detected in TTT (p<0.0001 and p=0.015)
Trust score:4/5

cumulative I-131 activity

1 evidences

Higher therapeutic I-131 dose (3700 MBq) produced more successful removal of residual thyroid tissue than a lower dose (1110 MBq).

Trust comment: Large double-blind randomized clinical trial with clear endpoints and complete reporting.

Study Details

PMID:22124360
Participants:341
Impact:Low-dose group median cumulative 4810 MBq vs High-dose 3700 MBq (P<0.0001)
Trust score:5/5

Hospitalization time

1 evidences

Higher therapeutic I-131 dose (3700 MBq) produced more successful removal of residual thyroid tissue than a lower dose (1110 MBq).

Trust comment: Large double-blind randomized clinical trial with clear endpoints and complete reporting.

Study Details

PMID:22124360
Participants:341
Impact:Median inpatient days: Low 4 vs High 3
Trust score:5/5

successful remnant ablation rate

1 evidences

Using radioiodine uptake and thyroglobulin to guide 131I dose reduced administered activity and increased ablation success versus fixed dosing.

Trust comment: Prospective randomized controlled trial with adequate size but open-label design and unequal randomization ratio.

Study Details

PMID:30560716
Participants:277
Impact:RAIU-Tg-guided 94.2% vs fixed 70.7% (P<0.0001)
Trust score:4/5

administered I-131 activity

1 evidences

Using radioiodine uptake and thyroglobulin to guide 131I dose reduced administered activity and increased ablation success versus fixed dosing.

Trust comment: Prospective randomized controlled trial with adequate size but open-label design and unequal randomization ratio.

Study Details

PMID:30560716
Participants:277
Impact:Mean 3.26 ± 1.54 GBq (RAIU-Tg) vs 3.7 GBq (fixed), P<0.0001
Trust score:4/5

intermediate adverse effects (xerostomia)

1 evidences

Using radioiodine uptake and thyroglobulin to guide 131I dose reduced administered activity and increased ablation success versus fixed dosing.

Trust comment: Prospective randomized controlled trial with adequate size but open-label design and unequal randomization ratio.

Study Details

PMID:30560716
Participants:277
Impact:Significantly lower incidence in RAIU-Tg-guided group
Trust score:4/5

histology-specific response

1 evidences

A higher I-131 dose (100 mCi) achieved higher ablation success than 50 mCi in this small randomized trial.

Trust comment: Randomized trial but small sample size limits precision and generalizability.

Study Details

PMID:16967785
Participants:40
Impact:Follicular carcinoma responded better to 100 mCi; papillary carcinoma response similar between doses
Trust score:3/5

lesion retrieval rate

1 evidences

Using a radioactive I-125 seed to localize nonpalpable breast lesions reduced the need for additional margin resection compared with wire localization.

Trust comment: Well-conducted randomized study of a localization technique, but outcomes assess surgical performance rather than iodine biological effects.

Study Details

PMID:11597011
Participants:97
Impact:100% retrieval with both techniques
Trust score:3/5

additional margin resection

1 evidences

Using a radioactive I-125 seed to localize nonpalpable breast lesions reduced the need for additional margin resection compared with wire localization.

Trust comment: Well-conducted randomized study of a localization technique, but outcomes assess surgical performance rather than iodine biological effects.

Study Details

PMID:11597011
Participants:97
Impact:RSL 26% vs WL 57% (P = .02)
Trust score:3/5

thyroid uptake reduction (stunning)

1 evidences

A diagnostic 185 MBq dose of I-131 reduced subsequent thyroid uptake and impaired immediate therapeutic imaging/therapy in some patients (thyroid stunning).

Trust comment: Prospective randomized study demonstrating a measurable diagnostic 131I-induced decrease in subsequent uptake, though sample size modest.

Study Details

PMID:9580856
Participants:51
Impact:Uptake decreased from 3.76% ± 1.50 to 1.97% ± 0.71 before therapy in G1 (P < 0.05; ≈ -48%)
Trust score:4/5

remnant visibility on post-therapy imaging

1 evidences

A diagnostic 185 MBq dose of I-131 reduced subsequent thyroid uptake and impaired immediate therapeutic imaging/therapy in some patients (thyroid stunning).

Trust comment: Prospective randomized study demonstrating a measurable diagnostic 131I-induced decrease in subsequent uptake, though sample size modest.

Study Details

PMID:9580856
Participants:51
Impact:Remnants unchanged in G0 28/28; in G1 5/17 remnants were hardly identified after diagnostic 131I
Trust score:4/5

left ventricular ejection fraction (LVEF) improvement

1 evidences

I-123 MIBG cardiac imaging before carvedilol treatment predicted which heart failure patients showed LVEF and functional improvement.

Trust comment: Small randomized study using I-123 imaging with significant correlations but limited sample size.

Study Details

PMID:11182704
Participants:23
Impact:Improved only in carvedilol group; MIBG washout rate inversely correlated with LVEF improvement (rho = -0.74, P = .02)
Trust score:3/5

heart failure functional class

1 evidences

I-123 MIBG cardiac imaging before carvedilol treatment predicted which heart failure patients showed LVEF and functional improvement.

Trust comment: Small randomized study using I-123 imaging with significant correlations but limited sample size.

Study Details

PMID:11182704
Participants:23
Impact:Significant improvement in carvedilol group at 1 year
Trust score:3/5

exercise capacity (peak VO2)

1 evidences

I-123 MIBG cardiac imaging before carvedilol treatment predicted which heart failure patients showed LVEF and functional improvement.

Trust comment: Small randomized study using I-123 imaging with significant correlations but limited sample size.

Study Details

PMID:11182704
Participants:23
Impact:MIBG washout rate inversely related (rho = -0.65, P = .08; not statistically significant)
Trust score:3/5

first-dose remnant ablation rate

1 evidences

Large randomized noninferiority trial showing lower I-131 activities (0.93 and 1.85 GBq) are equivalent to 3.7 GBq for remnant ablation at 6 months.

Trust comment: Large randomized equivalence/noninferiority trial with allocation concealment and predefined margin; high-quality evidence.

Study Details

PMID:22760303
Participants:422
Impact:0.93 GBq 81.5%; 1.85 GBq 84.9%; 3.7 GBq 88.5%; overall 84.2% — lower doses equivalent to 3.7 GBq within prespecified margin
Trust score:5/5

negative whole-body scan rate at 1 year

1 evidences

Adding short-course oral lithium to 30 mCi 131I improved remnant ablation success at one year in low-risk thyroid cancer patients.

Trust comment: Randomized study with modest sample size showing a significant benefit of lithium as an adjuvant to 131I.

Study Details

PMID:22953991
Participants:61
Impact:30 mCi alone 68.75% vs 30 mCi + lithium 93.1% (P = 0.017)
Trust score:4/5

negative thyroglobulin conversion

1 evidences

Adding short-course oral lithium to 30 mCi 131I improved remnant ablation success at one year in low-risk thyroid cancer patients.

Trust comment: Randomized study with modest sample size showing a significant benefit of lithium as an adjuvant to 131I.

Study Details

PMID:22953991
Participants:61
Impact:73.7% (control) vs 100% (lithium adjuvant)
Trust score:4/5

Progression-free survival

1 evidences

Large phase III trial found no significant improvement in 2-year progression-free or overall survival from adding I-131 tositumomab consolidation to CHOP+rituximab.

Trust comment: Large, multicenter phase III randomized trial with long follow-up and robust design showing no significant benefit of I-131 RIT consolidation.

Study Details

PMID:23233710
Participants:554
Impact:2-year PFS: CHOP-RIT 80% vs CHOP-R 76% (+4 percentage points), P=0.11 (not significant)
Trust score:5/5

Objective response rate

1 evidences

125I radioactive seed implantation combined with EGFR-TKIs improved tumor response, disease control, PFS and 2-year survival versus EGFR-TKIs alone in advanced EGFR-mutant NSCLC.

Trust comment: Randomized clinical study with 108 patients showing significant clinical and immune-marker improvements with addition of 125I seeds.

Study Details

PMID:34761595
Participants:108
Impact:61.1% (combination) vs 51.9% (EGFR-TKIs alone)
Trust score:4/5

disease control rate

1 evidences

125I radioactive seed implantation combined with EGFR-TKIs improved tumor response, disease control, PFS and 2-year survival versus EGFR-TKIs alone in advanced EGFR-mutant NSCLC.

Trust comment: Randomized clinical study with 108 patients showing significant clinical and immune-marker improvements with addition of 125I seeds.

Study Details

PMID:34761595
Participants:108
Impact:88.9% vs 68.5% (combination vs EGFR-TKIs)
Trust score:4/5

Median progression-free survival

2 evidences

125I radioactive seed implantation combined with EGFR-TKIs improved tumor response, disease control, PFS and 2-year survival versus EGFR-TKIs alone in advanced EGFR-mutant NSCLC.

Trust comment: Randomized clinical study with 108 patients showing significant clinical and immune-marker improvements with addition of 125I seeds.

Study Details

PMID:34761595
Participants:108
Impact:14.5 months (combination) vs 9.8 months (EGFR-TKIs)
Trust score:4/5

Randomized prospective study found adding I-125 brachytherapy to chemotherapy improved local control, response rate, and progression-free survival vs chemotherapy alone in locally recurrent stage III NSCLC.

Trust comment: Prospective randomized single-center study (n=52) directly tests I-125 brachytherapy effects; sample size modest and follow-up limited, so moderate trust.

Study Details

PMID:26445227
Participants:52
Impact:8.0 months (combined) vs 5.5 months (chemo alone) (+2.5 months)
Trust score:3/5

5-year survival rate

2 evidences

Large randomized trial found no significant difference in overall mortality or melanoma-specific mortality between I-125 brachytherapy and enucleation for choroidal melanoma.

Trust comment: Large multicenter randomized trial with long follow-up and adequate power to detect clinically meaningful mortality differences.

Study Details

PMID:11448319
Participants:1317
Impact:no significant difference (81% enucleation vs 82% I-125 brachytherapy)
Trust score:5/5

Adding intrahepatic arterial 131I-labelled anti-HCC antibody to hepatic artery ligation increased long-term survival and made more tumors resectable.

Trust comment: Phase I/II clinical cohort (n=65) with significant outcomes but non-randomized design and moderate sample size limit causal strength.

Study Details

PMID:9645459
Participants:65
Impact:+19.0 percentage points (RIT 28.1% vs non-RIT 9.1%)
Trust score:3/5

Sequential resection rate (made resectable)

1 evidences

Adding intrahepatic arterial 131I-labelled anti-HCC antibody to hepatic artery ligation increased long-term survival and made more tumors resectable.

Trust comment: Phase I/II clinical cohort (n=65) with significant outcomes but non-randomized design and moderate sample size limit causal strength.

Study Details

PMID:9645459
Participants:65
Impact:+44.0 percentage points (RIT 53.1% vs non-RIT 9.1%)
Trust score:3/5

CD4+ T lymphocyte / HAMA effect

1 evidences

Adding intrahepatic arterial 131I-labelled anti-HCC antibody to hepatic artery ligation increased long-term survival and made more tumors resectable.

Trust comment: Phase I/II clinical cohort (n=65) with significant outcomes but non-randomized design and moderate sample size limit causal strength.

Study Details

PMID:9645459
Participants:65
Impact:Influenced short-term survival but not long-term survival (no numeric change reported)
Trust score:3/5

Ablation success

1 evidences

Using rhTSH before radioiodine ablation avoids hypothyroidism and greatly reduces sick-leave without reducing ablation efficacy.

Trust comment: Randomized small trial (n=25) with direct clinical endpoints showing non-inferior ablation efficacy and clear QoL/economic benefits; small sample limits generalizability.

Study Details

PMID:19687168
Participants:25
Impact:No significant difference (rhTSH equal efficacy to conventional hypothyroidism preparation)
Trust score:4/5

Sick leave duration

1 evidences

Using rhTSH before radioiodine ablation avoids hypothyroidism and greatly reduces sick-leave without reducing ablation efficacy.

Trust comment: Randomized small trial (n=25) with direct clinical endpoints showing non-inferior ablation efficacy and clear QoL/economic benefits; small sample limits generalizability.

Study Details

PMID:19687168
Participants:25
Impact:Reduced by ~23 days (from ~29 days to ~6 days)
Trust score:4/5

Avoidance of hypothyroidism

1 evidences

Using rhTSH before radioiodine ablation avoids hypothyroidism and greatly reduces sick-leave without reducing ablation efficacy.

Trust comment: Randomized small trial (n=25) with direct clinical endpoints showing non-inferior ablation efficacy and clear QoL/economic benefits; small sample limits generalizability.

Study Details

PMID:19687168
Participants:25
Impact:Complete avoidance in rhTSH group (qualitative)
Trust score:4/5

12-month total effective local control rate (CR+PR)

1 evidences

CT-guided permanent 125I seed implantation improved local tumor control and resulted in longer survival compared with radiochemotherapy for pelvic recurrence after cervical cancer surgery.

Trust comment: Randomized comparative study (n=62) showing improved local control and longer median survival with 125I implantation; moderate sample size and single/regional centers limit broad generalizability.

Study Details

PMID:34059692
Participants:62
Impact:+14.8 percentage points (125I 86.7% vs radiochemotherapy 71.9%; P < 0.05)
Trust score:4/5

1-year overall survival

1 evidences

CT-guided permanent 125I seed implantation improved local tumor control and resulted in longer survival compared with radiochemotherapy for pelvic recurrence after cervical cancer surgery.

Trust comment: Randomized comparative study (n=62) showing improved local control and longer median survival with 125I implantation; moderate sample size and single/regional centers limit broad generalizability.

Study Details

PMID:34059692
Participants:62
Impact:No significant difference (125I 96.7% vs radiochemotherapy 88.3%)
Trust score:4/5

Red-marrow absorbed dose per unit activity

1 evidences

In thyroid cancer patients, rhTSH stimulation before 131I ablation resulted in lower red-marrow absorbed dose and lower remnant uptake compared with L-T4 withdrawal (hypothyroidism).

Trust comment: Randomized trial (n=46) with measured dosimetric endpoints showing significant reduction in red-marrow dose and remnant uptake with rhTSH; subgroup sample sizes vary by endpoint.

Study Details

PMID:17264781
Participants:46
Impact:Lower with rhTSH: 0.06 ± 0.02 vs 0.09 ± 0.03 mGy/MBq (P = 0.003)
Trust score:4/5

Remnant cumulated activity per unit activity

1 evidences

In thyroid cancer patients, rhTSH stimulation before 131I ablation resulted in lower red-marrow absorbed dose and lower remnant uptake compared with L-T4 withdrawal (hypothyroidism).

Trust comment: Randomized trial (n=46) with measured dosimetric endpoints showing significant reduction in red-marrow dose and remnant uptake with rhTSH; subgroup sample sizes vary by endpoint.

Study Details

PMID:17264781
Participants:46
Impact:Trend lower with rhTSH: 0.9 ± 0.8 h vs 1.55 ± 1.05 h (P = 0.063, not statistically significant)
Trust score:4/5

Maximum thyroid remnant uptake (U)

1 evidences

In thyroid cancer patients, rhTSH stimulation before 131I ablation resulted in lower red-marrow absorbed dose and lower remnant uptake compared with L-T4 withdrawal (hypothyroidism).

Trust comment: Randomized trial (n=46) with measured dosimetric endpoints showing significant reduction in red-marrow dose and remnant uptake with rhTSH; subgroup sample sizes vary by endpoint.

Study Details

PMID:17264781
Participants:46
Impact:Lower with rhTSH: U = 0.01 ± 0.01 vs 0.03 ± 0.02 (P = 0.019)
Trust score:4/5

total response rate

1 evidences

Adding interstitial I-125 seed implantation to chemotherapy improved tumor response and local control with acceptable toxicity.

Trust comment: Moderate-quality comparative clinical study with a small sample and unclear randomization details.

Study Details

PMID:21122419
Participants:76
Impact:+26.0 percentage points (56.8% vs 30.8%)
Trust score:3/5

Local control rate

2 evidences

Prospective study of CT‑guided iodine‑125 brachytherapy for bilateral lung metastases from colorectal cancer showed high procedural success, acceptable safety, improved local control and significantly longer overall survival versus symptomatic care.

Trust comment: Prospective randomized single‑center study with modest sample size showing survival benefit, but limited by sample size and center-specific experience.

Study Details

PMID:26406550
Participants:72
Impact:Local control: 75.8% at 3 months, 51.5% at 6 months, 33.3% at 12 months
Trust score:3/5

Adding interstitial I-125 seed implantation to chemotherapy improved tumor response and local control with acceptable toxicity.

Trust comment: Moderate-quality comparative clinical study with a small sample and unclear randomization details.

Study Details

PMID:21122419
Participants:76
Impact:+22.0 percentage points (78.4% vs 56.4%)
Trust score:3/5

Nodular volume

1 evidences

PEI before radioiodine reduced nodule volume, allowed a lower radioiodine dose, and improved symptoms versus radioiodine alone.

Trust comment: Randomized trial but very small sample size limits precision.

Study Details

PMID:12571210
Participants:22
Impact:-44.8% (33.6 mL vs 60.8 mL after PEI; absolute change -27.2 mL)
Trust score:3/5

Administered radioiodine dose

1 evidences

PEI before radioiodine reduced nodule volume, allowed a lower radioiodine dose, and improved symptoms versus radioiodine alone.

Trust comment: Randomized trial but very small sample size limits precision.

Study Details

PMID:12571210
Participants:22
Impact:-30.3% (730 ± 245 MBq vs 1,048 ± 392 MBq)
Trust score:3/5

symptom score

1 evidences

PEI before radioiodine reduced nodule volume, allowed a lower radioiodine dose, and improved symptoms versus radioiodine alone.

Trust comment: Randomized trial but very small sample size limits precision.

Study Details

PMID:12571210
Participants:22
Impact:Lower symptom score at 12 months with PEI+RAI versus RAI alone (significant)
Trust score:3/5

total effective rate

1 evidences

Combining I-125 seed implantation with chemotherapy and Chinese medicine increased response rates, reduced tumor markers, and improved quality of life versus chemotherapy alone.

Trust comment: Randomized assignment reported but multi-component intervention and moderate sample size limit attribution to I-125 alone.

Study Details

PMID:22936319
Participants:90
Impact:83.33% (Group A) vs 46.67% (Group B) and 43.33% (Group C)
Trust score:3/5

Tumor marker levels

1 evidences

Combining I-125 seed implantation with chemotherapy and Chinese medicine increased response rates, reduced tumor markers, and improved quality of life versus chemotherapy alone.

Trust comment: Randomized assignment reported but multi-component intervention and moderate sample size limit attribution to I-125 alone.

Study Details

PMID:22936319
Participants:90
Impact:Decreased in I-125+chemotherapy+CM group (significant vs other groups)
Trust score:3/5

Mean spatial target point deviation

1 evidences

Stereotactically implanted I-125 seed catheters achieved high conformity, though spatial deviations (mean 2.0 mm) sometimes reduced delivered dose.

Trust comment: Small observational technical study on implantation accuracy in humans; useful for procedure quality but limited clinical outcome data.

Study Details

PMID:16209895
Participants:37
Impact:2.0 mm (maximum 4.1 mm; SD 0.9 mm)
Trust score:3/5

Planned dose reduction >5%

1 evidences

Stereotactically implanted I-125 seed catheters achieved high conformity, though spatial deviations (mean 2.0 mm) sometimes reduced delivered dose.

Trust comment: Small observational technical study on implantation accuracy in humans; useful for procedure quality but limited clinical outcome data.

Study Details

PMID:16209895
Participants:37
Impact:Observed in 54.1% of cases
Trust score:3/5

Dose conformity to target

1 evidences

Stereotactically implanted I-125 seed catheters achieved high conformity, though spatial deviations (mean 2.0 mm) sometimes reduced delivered dose.

Trust comment: Small observational technical study on implantation accuracy in humans; useful for procedure quality but limited clinical outcome data.

Study Details

PMID:16209895
Participants:37
Impact:Realized dose conformed in 89.2% of patients; 10.8% showed slight deviation
Trust score:3/5

I-131 treatment success rate at 12 months

1 evidences

Stopping methimazole 7 days before I-131 or giving no pretreatment resulted in high I-131 treatment success (~96%), whereas continuing methimazole until I-131 markedly reduced success to 63.8%.

Trust comment: Prospective randomized study with a moderate sample size and clear clinically meaningful outcomes.

Study Details

PMID:21512661
Participants:156
Impact:96.6% (no pretreatment) and 96.0% (MMI stopped 7 days before) vs 63.8% (MMI continued until I-131); ≈ -32 percentage points when MMI continued
Trust score:4/5

Absorbed dose of I-131

1 evidences

Stopping methimazole 7 days before I-131 or giving no pretreatment resulted in high I-131 treatment success (~96%), whereas continuing methimazole until I-131 markedly reduced success to 63.8%.

Trust comment: Prospective randomized study with a moderate sample size and clear clinically meaningful outcomes.

Study Details

PMID:21512661
Participants:156
Impact:Higher in groups without continuing MMI (144 ± 104 Gy and 164 ± 107 Gy) vs lower when MMI continued (105 ± 58 Gy)
Trust score:4/5

Limit of detection of 131I uptake (LoD)

1 evidences

In 60 thyroid cancer patients researchers defined a quantitative detection limit for iodine-131 uptake on neck scans; this LoD matched specialists' ratings and was lower after rhTSH than after thyroid hormone withdrawal.

Trust comment: Prospective study with blinded reader ratings and quantitative metrics in 60 patients; methods are appropriate though sample size is moderate.

Study Details

PMID:23403717
Participants:60
Impact:median 0.0094% (day 1), 0.0050% (day 2)
Trust score:4/5

Inter-observer agreement on visible cervical uptake

1 evidences

In 60 thyroid cancer patients researchers defined a quantitative detection limit for iodine-131 uptake on neck scans; this LoD matched specialists' ratings and was lower after rhTSH than after thyroid hormone withdrawal.

Trust comment: Prospective study with blinded reader ratings and quantitative metrics in 60 patients; methods are appropriate though sample size is moderate.

Study Details

PMID:23403717
Participants:60
Impact:≥4 readers concurred in 56/60 d1 scans (93.3%) and 54/60 d2 scans (90.0%)
Trust score:4/5

RIU exceeding LoD in positively rated scans

1 evidences

In 60 thyroid cancer patients researchers defined a quantitative detection limit for iodine-131 uptake on neck scans; this LoD matched specialists' ratings and was lower after rhTSH than after thyroid hormone withdrawal.

Trust comment: Prospective study with blinded reader ratings and quantitative metrics in 60 patients; methods are appropriate though sample size is moderate.

Study Details

PMID:23403717
Participants:60
Impact:15/17 scans (88.2%)
Trust score:4/5

LoD lower after rhTSH vs THW

1 evidences

In 60 thyroid cancer patients researchers defined a quantitative detection limit for iodine-131 uptake on neck scans; this LoD matched specialists' ratings and was lower after rhTSH than after thyroid hormone withdrawal.

Trust comment: Prospective study with blinded reader ratings and quantitative metrics in 60 patients; methods are appropriate though sample size is moderate.

Study Details

PMID:23403717
Participants:60
Impact:Significantly lower in rhTSH compared with THW (p < 0.01)
Trust score:4/5

Worsening or development of thyroid-associated ophthalmopathy (TAO)

1 evidences

Randomized trial of 313 Graves' patients found radioiodine treatment increased the risk of developing or worsening eye disease (TAO) compared with antithyroid drugs, with smokers at highest risk.

Trust comment: Large randomized trial with 4-year follow-up and clear, clinically relevant endpoints.

Study Details

PMID:19723755
Participants:313
Impact:38.7% (63/163) after radioiodine vs 21.3% (32/150) with medical treatment (P < 0.001)
Trust score:5/5

De novo development of TAO

1 evidences

Randomized trial of 313 Graves' patients found radioiodine treatment increased the risk of developing or worsening eye disease (TAO) compared with antithyroid drugs, with smokers at highest risk.

Trust comment: Large randomized trial with 4-year follow-up and clear, clinically relevant endpoints.

Study Details

PMID:19723755
Participants:313
Impact:53 patients in radioiodine group vs 23 in medical group
Trust score:5/5

Smoking effect on TAO risk

1 evidences

Randomized trial of 313 Graves' patients found radioiodine treatment increased the risk of developing or worsening eye disease (TAO) compared with antithyroid drugs, with smokers at highest risk.

Trust comment: Large randomized trial with 4-year follow-up and clear, clinically relevant endpoints.

Study Details

PMID:19723755
Participants:313
Impact:Smokers had highest overall risk; smoking modified risk but in smokers the association with treatment choice was not significant
Trust score:5/5

Thyroid-associated ophthalmopathy incidence

1 evidences

In 308 Graves' patients randomized to radioiodine or medical therapy, those who developed or worsened thyroid-associated ophthalmopathy had lower quality of life; TAO occurred more often in patients exposed to radioiodine.

Trust comment: Randomized multicenter trial with serial QoL measures; open design but robust sample and validated outcomes.

Study Details

PMID:20660002
Participants:308
Impact:75 patients with radioiodine at some time point vs 40 medically treated patients (P < 0.0009)
Trust score:4/5

Quality of life (SF-36) in patients with TAO

1 evidences

In 308 Graves' patients randomized to radioiodine or medical therapy, those who developed or worsened thyroid-associated ophthalmopathy had lower quality of life; TAO occurred more often in patients exposed to radioiodine.

Trust comment: Randomized multicenter trial with serial QoL measures; open design but robust sample and validated outcomes.

Study Details

PMID:20660002
Participants:308
Impact:Patients with TAO had significantly decreased QoL at several time points; physical recovery ~1 year, mental recovery ~2 years
Trust score:4/5

Mean therapeutic dose achieved

1 evidences

Among patients treated with radioiodide for Graves' disease or autonomous nodules, oral and intravenous administration produced similar achieved therapeutic doses and similar clinical outcomes at 6 months.

Trust comment: Prospective randomized study but modest sample size and some loss to follow-up; endpoints and methods are appropriate.

Study Details

PMID:15759147
Participants:87
Impact:Identical following intravenous or oral administration
Trust score:4/5

Treatment success at 6 months (unifocal autonomy and Graves' disease)

1 evidences

Among patients treated with radioiodide for Graves' disease or autonomous nodules, oral and intravenous administration produced similar achieved therapeutic doses and similar clinical outcomes at 6 months.

Trust comment: Prospective randomized study but modest sample size and some loss to follow-up; endpoints and methods are appropriate.

Study Details

PMID:15759147
Participants:87
Impact:UA: oral 94% vs IV 80%; GD: oral 68% vs IV 65% (87 patients attended 6-month follow-up)
Trust score:4/5

Dosimetry accuracy

1 evidences

Among patients treated with radioiodide for Graves' disease or autonomous nodules, oral and intravenous administration produced similar achieved therapeutic doses and similar clinical outcomes at 6 months.

Trust comment: Prospective randomized study but modest sample size and some loss to follow-up; endpoints and methods are appropriate.

Study Details

PMID:15759147
Participants:87
Impact:No improvement in dosimetry accuracy with IV administration
Trust score:4/5

5-year recurrence-free survival

2 evidences

In 504 low-risk thyroid cancer patients, omission of postoperative radioiodine ablation was non-inferior to ablation for 5-year recurrence-free survival; adverse events were similar.

Trust comment: Large multicentre randomized non-inferiority phase 3 trial with long follow-up and rigorous endpoints.

Study Details

PMID:40543520
Participants:504
Impact:No ablation 97.9% vs ablation 96.3% (ITT); absolute risk difference 0.5 percentage points; non-inferior
Trust score:5/5

A single postoperative intraarterial 131I-lipiodol dose reduced intrahepatic recurrence after curative HCC treatment but did not improve overall survival.

Trust comment: Prospective randomized trial with statistically significant reduction in recurrence though sample size was small and no overall survival benefit was seen.

Study Details

PMID:24722530
Participants:58
Impact:40% vs 0%; P=0.0184
Trust score:4/5

Successful thyroid remnant ablation

1 evidences

In 72 thyroid cancer patients prepared with rhTSH, 1850 MBq and 3700 MBq of iodine-131 achieved similar successful ablation rates.

Trust comment: Randomized multicenter comparison with clear clinical endpoints but relatively small sample size.

Study Details

PMID:17609306
Participants:72
Impact:88.9% in both 1850 MBq and 3700 MBq groups
Trust score:4/5

Undetectable basal and rhTSH-stimulated thyroglobulin

1 evidences

In 72 thyroid cancer patients prepared with rhTSH, 1850 MBq and 3700 MBq of iodine-131 achieved similar successful ablation rates.

Trust comment: Randomized multicenter comparison with clear clinical endpoints but relatively small sample size.

Study Details

PMID:17609306
Participants:72
Impact:78.9% in 1850 MBq group vs 66.6% in 3700 MBq group (P = 0.46)
Trust score:4/5

goiter-related complaints

1 evidences

In patients with very large multinodular goiters, giving 0.3 mg rhTSH before I-131 improved thyroid shrinkage but increased transient adverse effects.

Trust comment: Double-blind randomized trial directly testing radioiodine ± rhTSH with MRI follow-up but small sample (n=29).

Study Details

PMID:17566091
Participants:29
Impact:reduced in both groups at 12 months (no between-group difference)
Trust score:4/5

adverse effects after therapy

1 evidences

In patients with very large multinodular goiters, giving 0.3 mg rhTSH before I-131 improved thyroid shrinkage but increased transient adverse effects.

Trust comment: Double-blind randomized trial directly testing radioiodine ± rhTSH with MRI follow-up but small sample (n=29).

Study Details

PMID:17566091
Participants:29
Impact:more frequent in rhTSH group (mainly pain and compression)
Trust score:4/5

successful ablation after one administration

1 evidences

Long-term randomized study found no superiority of 3.7 GBq over 1.1 GBq I-131 for thyroid remnant ablation in low-risk differentiated thyroid cancer.

Trust comment: Prospective randomized phase III trial with long (median 13-year) follow-up, making results reliable for I-131 ablation dose comparison.

Study Details

PMID:32603613
Participants:160
Impact:1.1 GBq: 56% (45/81) vs 3.7 GBq: 57% (45/79)
Trust score:4/5

relapse proportion during follow-up

1 evidences

Long-term randomized study found no superiority of 3.7 GBq over 1.1 GBq I-131 for thyroid remnant ablation in low-risk differentiated thyroid cancer.

Trust comment: Prospective randomized phase III trial with long (median 13-year) follow-up, making results reliable for I-131 ablation dose comparison.

Study Details

PMID:32603613
Participants:160
Impact:no difference between groups (p=0.591)
Trust score:4/5

Graves' orbitopathy overall improvement

1 evidences

Patients with Graves' eye disease had either near-total thyroidectomy or thyroidectomy plus radioiodine ablation and were followed for eye improvement.

Trust comment: Prospective randomized single-blind trial with clear clinical endpoint and moderate sample size, though longer-term effects unclear.

Study Details

PMID:17299076
Participants:60
Impact:More favorable outcome at 9 months with total thyroid ablation vs thyroidectomy alone (P = 0.0014)
Trust score:4/5

GO outcome over time

1 evidences

Patients with Graves' eye disease had either near-total thyroidectomy or thyroidectomy plus radioiodine ablation and were followed for eye improvement.

Trust comment: Prospective randomized single-blind trial with clear clinical endpoint and moderate sample size, though longer-term effects unclear.

Study Details

PMID:17299076
Participants:60
Impact:Cumulative significant difference at 3 and 9 months favoring ablation (P = 0.0054)
Trust score:4/5

Radioiodine ablation completeness

1 evidences

Patients with Graves' eye disease had either near-total thyroidectomy or thyroidectomy plus radioiodine ablation and were followed for eye improvement.

Trust comment: Prospective randomized single-blind trial with clear clinical endpoint and moderate sample size, though longer-term effects unclear.

Study Details

PMID:17299076
Participants:60
Impact:Majority of TTA patients showed complete ablation by uptake and thyroglobulin assays
Trust score:4/5

Late intraocular recurrence incidence

1 evidences

Large series of eye melanoma patients showed that late tumor recurrences (>5 years) occurred after iodine-125 plaque radiation more often than after charged-particle therapy.

Trust comment: Large retrospective multicenter case series with long follow-up but non-randomized comparisons and potential selection biases.

Study Details

PMID:12359605
Participants:996
Impact:11 late recurrences among 996 patients; annualized regrowth 1.9% per year between 5 and 15 years after 125I brachytherapy
Trust score:3/5

Late recurrence risk vs charged particles

1 evidences

Large series of eye melanoma patients showed that late tumor recurrences (>5 years) occurred after iodine-125 plaque radiation more often than after charged-particle therapy.

Trust comment: Large retrospective multicenter case series with long follow-up but non-randomized comparisons and potential selection biases.

Study Details

PMID:12359605
Participants:996
Impact:Significantly higher late recurrence rate with 125I brachytherapy compared with charged-particle radiation
Trust score:3/5

Graves' orbitopathy improvement at 12 months

1 evidences

Patients with moderate-to-severe Graves' eye disease who had thyroidectomy plus postoperative radioiodine ablation showed greater and earlier eye disease improvement than surgery alone.

Trust comment: Prospective randomized single-blind trial with clear clinical outcomes but small sample size limits precision.

Study Details

PMID:24432992
Participants:40
Impact:Improved in 70% (Tx-RAI) vs 20% (Tx) at 12 months (+50 percentage points)
Trust score:4/5

GO inactivity at 12 months

1 evidences

Patients with moderate-to-severe Graves' eye disease who had thyroidectomy plus postoperative radioiodine ablation showed greater and earlier eye disease improvement than surgery alone.

Trust comment: Prospective randomized single-blind trial with clear clinical outcomes but small sample size limits precision.

Study Details

PMID:24432992
Participants:40
Impact:Inactive in 75% (Tx-RAI) vs 30% (Tx), P < .01
Trust score:4/5

Short-term improvement after IV glucocorticoids

1 evidences

Patients with moderate-to-severe Graves' eye disease who had thyroidectomy plus postoperative radioiodine ablation showed greater and earlier eye disease improvement than surgery alone.

Trust comment: Prospective randomized single-blind trial with clear clinical outcomes but small sample size limits precision.

Study Details

PMID:24432992
Participants:40
Impact:Initial improvement after IV GC seen in 65% (Tx-RAI) vs 60% (Tx) before further differences emerged
Trust score:4/5

Patients evaluated and eligible counts

1 evidences

Analysis of all patients evaluated for the COMS trial showed who was eligible and who enrolled, supporting that enrolled patients were similar to treated patients meeting trial criteria.

Trust comment: Large registry-style descriptive analysis with comprehensive data but focused on enrollment characteristics rather than treatment outcomes.

Study Details

PMID:11448318
Participants:8712
Impact:8712 patients evaluated; 5046 had tumors of eligible size
Trust score:3/5

Eligibility and enrollment numbers

1 evidences

Analysis of all patients evaluated for the COMS trial showed who was eligible and who enrolled, supporting that enrolled patients were similar to treated patients meeting trial criteria.

Trust comment: Large registry-style descriptive analysis with comprehensive data but focused on enrollment characteristics rather than treatment outcomes.

Study Details

PMID:11448318
Participants:8712
Impact:2882 were eligible and 1317 enrolled (46% of eligible; 26% of those with eligible-size tumors)
Trust score:3/5

Comparability of enrolled patients

1 evidences

Analysis of all patients evaluated for the COMS trial showed who was eligible and who enrolled, supporting that enrolled patients were similar to treated patients meeting trial criteria.

Trust comment: Large registry-style descriptive analysis with comprehensive data but focused on enrollment characteristics rather than treatment outcomes.

Study Details

PMID:11448318
Participants:8712
Impact:Enrolled patients were similar to other patients treated with 125I brachytherapy, supporting external validity
Trust score:3/5

Retention of 6/12 visual acuity at 3 years

1 evidences

Many irradiated eyes retained useful vision for years, but vision loss risk depended on tumor size/location and was highest soon after treatment.

Trust comment: Large retrospective series of patients treated with 125I or helium ion brachytherapy; solid follow-up but non-randomized retrospective design.

Study Details

PMID:8814740
Participants:426
Impact:36.0% of eyes
Trust score:3/5

Dependence of visual retention on tumor size/location

1 evidences

Many irradiated eyes retained useful vision for years, but vision loss risk depended on tumor size/location and was highest soon after treatment.

Trust comment: Large retrospective series of patients treated with 125I or helium ion brachytherapy; solid follow-up but non-randomized retrospective design.

Study Details

PMID:8814740
Participants:426
Impact:Greater tumor thickness and proximity to optic nerve/fovea associated with worse visual retention
Trust score:3/5

Five-year metastatic rate

1 evidences

Many irradiated eyes retained useful vision for years, but vision loss risk depended on tumor size/location and was highest soon after treatment.

Trust comment: Large retrospective series of patients treated with 125I or helium ion brachytherapy; solid follow-up but non-randomized retrospective design.

Study Details

PMID:8814740
Participants:426
Impact:Approximately 13% at 5 years
Trust score:3/5

Thyroid volume reduction at 6 months (0.03 mg MRrhTSH)

1 evidences

Low-dose modified-release rhTSH before I-131 increased short-term goiter shrinkage at one dose but did not show consistent long-term benefit and was associated with higher permanent hypothyroidism at higher dose.

Trust comment: Randomized, multicenter, placebo-controlled phase II trial with defined imaging endpoints but modest sample size.

Study Details

PMID:24341527
Participants:95
Impact:32.9% vs 23.1% (placebo); p=0.03
Trust score:4/5

Thyroid volume reduction at 36 months (0.03 mg MRrhTSH)

1 evidences

Low-dose modified-release rhTSH before I-131 increased short-term goiter shrinkage at one dose but did not show consistent long-term benefit and was associated with higher permanent hypothyroidism at higher dose.

Trust comment: Randomized, multicenter, placebo-controlled phase II trial with defined imaging endpoints but modest sample size.

Study Details

PMID:24341527
Participants:95
Impact:53% mean reduction (0.03 mg) vs 44% (placebo); no significant difference overall (p=0.105); subgroup with baseline uptake <20% had +24% greater reduction (p=0.01)
Trust score:4/5

Permanent hypothyroidism prevalence at 3 years

1 evidences

Low-dose modified-release rhTSH before I-131 increased short-term goiter shrinkage at one dose but did not show consistent long-term benefit and was associated with higher permanent hypothyroidism at higher dose.

Trust comment: Randomized, multicenter, placebo-controlled phase II trial with defined imaging endpoints but modest sample size.

Study Details

PMID:24341527
Participants:95
Impact:13% (placebo), 33% (0.01 mg), 45% (0.03 mg)
Trust score:4/5

Cure rate after first radioiodine dose

1 evidences

Adding lithium to radioiodine treatment did not change cure rates for hyperthyroidism but caused mild-moderate side effects in ~10% of patients.

Trust comment: Large randomized controlled trial with long follow-up and clear clinical endpoints.

Study Details

PMID:12097201
Participants:350
Impact:68.4% (control) vs 68.9% (lithium); no significant difference
Trust score:5/5

Overall cure rate at end of study

1 evidences

Adding lithium to radioiodine treatment did not change cure rates for hyperthyroidism but caused mild-moderate side effects in ~10% of patients.

Trust comment: Large randomized controlled trial with long follow-up and clear clinical endpoints.

Study Details

PMID:12097201
Participants:350
Impact:96.7% (control) vs 96.3% (lithium); no significant difference
Trust score:5/5

Lithium side effects

1 evidences

Adding lithium to radioiodine treatment did not change cure rates for hyperthyroidism but caused mild-moderate side effects in ~10% of patients.

Trust comment: Large randomized controlled trial with long follow-up and clear clinical endpoints.

Study Details

PMID:12097201
Participants:350
Impact:~10% reported mild to moderate side effects
Trust score:5/5

Tumor response rate (CR+PR)

1 evidences

Intraoperative I-125 brachytherapy plus chemotherapy increased tumor response, relieved pain, and improved short-term survival versus control in advanced pancreatic cancer.

Trust comment: Randomized but small trial reporting clinical benefit; modest sample limits generalizability.

Study Details

PMID:15355651
Participants:36
Impact:38.9% (brachy-chemotherapy) vs 0% (control)
Trust score:3/5

pain relief

1 evidences

Intraoperative I-125 brachytherapy plus chemotherapy increased tumor response, relieved pain, and improved short-term survival versus control in advanced pancreatic cancer.

Trust comment: Randomized but small trial reporting clinical benefit; modest sample limits generalizability.

Study Details

PMID:15355651
Participants:36
Impact:77.8% vs 22.2% (p<0.05)
Trust score:3/5

median survival

1 evidences

Intraoperative I-125 brachytherapy plus chemotherapy increased tumor response, relieved pain, and improved short-term survival versus control in advanced pancreatic cancer.

Trust comment: Randomized but small trial reporting clinical benefit; modest sample limits generalizability.

Study Details

PMID:15355651
Participants:36
Impact:10.6 months vs 5.2 months (p<0.05)
Trust score:3/5

total IPSS (1 month)

1 evidences

Randomized trial in men receiving 125I prostate implantation comparing three α1-blockers; silodosin produced the best short-term improvement in urinary symptoms.

Trust comment: Randomized controlled trial with clear participant numbers and objective outcomes; results are directly reported and credible.

Study Details

PMID:21664068
Participants:212
Impact:naftopidil +10.3; tamsulosin +8.9; silodosin +7.5 (mean change vs baseline)
Trust score:4/5

postvoid residual urine (PVR, 6 months)

1 evidences

Randomized trial in men receiving 125I prostate implantation comparing three α1-blockers; silodosin produced the best short-term improvement in urinary symptoms.

Trust comment: Randomized controlled trial with clear participant numbers and objective outcomes; results are directly reported and credible.

Study Details

PMID:21664068
Participants:212
Impact:naftopidil +14.6 mL; tamsulosin +23.7 mL; silodosin +5.7 mL (mean change)
Trust score:4/5

IPSS voiding score (1 month)

1 evidences

Randomized trial in men receiving 125I prostate implantation comparing three α1-blockers; silodosin produced the best short-term improvement in urinary symptoms.

Trust comment: Randomized controlled trial with clear participant numbers and objective outcomes; results are directly reported and credible.

Study Details

PMID:21664068
Participants:212
Impact:naftopidil +6.5; tamsulosin +5.6; silodosin +4.5 (mean change)
Trust score:4/5

5-year recurrence-free survival (RFS)

1 evidences

Randomised multicentre phase 2 trial showing adjuvant 131I‑metuximab after liver resection for CD147+ HCC improved 5-year recurrence-free survival versus no adjuvant treatment.

Trust comment: Randomised multicentre phase 2 trial with adequate follow-up and statistically significant primary outcome, but phase 2 size and open-label design limit certainty.

Study Details

PMID:32164877
Participants:156
Impact:131I-metuximab 43.4% vs control 21.7% (HR 0.49, 95% CI 0.34–0.72; p=0.0031)
Trust score:4/5

early treatment-related adverse events

1 evidences

Randomised multicentre phase 2 trial showing adjuvant 131I‑metuximab after liver resection for CD147+ HCC improved 5-year recurrence-free survival versus no adjuvant treatment.

Trust comment: Randomised multicentre phase 2 trial with adequate follow-up and statistically significant primary outcome, but phase 2 size and open-label design limit certainty.

Study Details

PMID:32164877
Participants:156
Impact:occurred in 34/76 (45%) within 4 weeks; 7/34 (21%) of these were grade 3–4 and resolved with treatment
Trust score:4/5

overall response rate (local tumor)

1 evidences

Phase II randomized study showing CT-guided 125I-seed implantation plus FOLFIRI markedly improved local tumor response and local control time versus FOLFIRI alone for locally recurrent rectal cancer.

Trust comment: Randomized phase II with small sample size; clear large effect sizes but limited power and single-phase design reduce certainty.

Study Details

PMID:26522058
Participants:57
Impact:CTII+FOLFIRI 100% vs FOLFIRI alone 29.6% (P<0.001)
Trust score:3/5

local control time (median LCT)

1 evidences

Phase II randomized study showing CT-guided 125I-seed implantation plus FOLFIRI markedly improved local tumor response and local control time versus FOLFIRI alone for locally recurrent rectal cancer.

Trust comment: Randomized phase II with small sample size; clear large effect sizes but limited power and single-phase design reduce certainty.

Study Details

PMID:26522058
Participants:57
Impact:CTII+FOLFIRI median 12 months vs FOLFIRI 4 months (P<0.001)
Trust score:3/5

overall survival (median OS)

1 evidences

Phase II randomized study showing CT-guided 125I-seed implantation plus FOLFIRI markedly improved local tumor response and local control time versus FOLFIRI alone for locally recurrent rectal cancer.

Trust comment: Randomized phase II with small sample size; clear large effect sizes but limited power and single-phase design reduce certainty.

Study Details

PMID:26522058
Participants:57
Impact:CTII+FOLFIRI median 25 months vs FOLFIRI 19 months (P=0.0464)
Trust score:3/5

serum T4

1 evidences

Randomized study showing stopping methimazole before 131I causes a transient rise in thyroid hormones pre- and early post‑radioiodine; hormone levels then stabilize or fall over 30 days.

Trust comment: Randomized clinical study with clear serial biochemical measurements and small sample size but internally consistent hormonal data.

Study Details

PMID:10566642
Participants:51
Impact:131I alone: no change post-therapy; with methimazole pretreatment: +38% after discontinuation pre-131I; peaked +70% vs baseline on day 7 after 131I
Trust score:4/5

serum FT4

1 evidences

Randomized study showing stopping methimazole before 131I causes a transient rise in thyroid hormones pre- and early post‑radioiodine; hormone levels then stabilize or fall over 30 days.

Trust comment: Randomized clinical study with clear serial biochemical measurements and small sample size but internally consistent hormonal data.

Study Details

PMID:10566642
Participants:51
Impact:with pretreatment: +39% after discontinuation pre-131I; peaked +53% vs treatment day and +107% vs baseline on day 14 after 131I
Trust score:4/5

serum T3

1 evidences

Randomized study showing stopping methimazole before 131I causes a transient rise in thyroid hormones pre- and early post‑radioiodine; hormone levels then stabilize or fall over 30 days.

Trust comment: Randomized clinical study with clear serial biochemical measurements and small sample size but internally consistent hormonal data.

Study Details

PMID:10566642
Participants:51
Impact:with pretreatment: +70% after discontinuation pre-131I; transient +9% on day 2 (85% vs baseline) then decreased to −21% by day 30 after 131I
Trust score:4/5

recurrence rate (long-term)

1 evidences

Long-term follow-up of the HiLo randomized trial showed low-dose (1.1 GBq) radioactive iodine ablation had similar recurrence rates to high-dose (3.7 GBq); preparation with rhTSH and withdrawal had similar recurrence risks.

Trust comment: Large multicentre randomized trial with long follow-up and robust outcome ascertainment; high-quality evidence for radioiodine dose and recurrence.

Study Details

PMID:30501974
Participants:434
Impact:1.1 GBq vs 3.7 GBq: cumulative recurrence 5.9% vs 7.3% at 7 years (HR 1.10, 95% CI 0.47–2.59; p=0.83); non-inferiority by proportion test significant (p=0.01) but not by HR (p=0.08)
Trust score:5/5

hyperthyroidism control

1 evidences

Adding rituximab to radioiodine improved thyroid control and several eye measures in patients with Graves' ophthalmopathy.

Trust comment: Randomized study with a reasonable sample size and clinically relevant endpoints but limited numeric effect sizes reported in the summary.

Study Details

PMID:28049190
Participants:217
Impact:improved (significant vs other groups, p<0.05)
Trust score:3/5

ophthalmic parameters (orbital volumetry)

1 evidences

Adding rituximab to radioiodine improved thyroid control and several eye measures in patients with Graves' ophthalmopathy.

Trust comment: Randomized study with a reasonable sample size and clinically relevant endpoints but limited numeric effect sizes reported in the summary.

Study Details

PMID:28049190
Participants:217
Impact:improved (significant vs other groups, p<0.05)
Trust score:3/5

serum miR-146a and cytokine levels

1 evidences

Adding rituximab to radioiodine improved thyroid control and several eye measures in patients with Graves' ophthalmopathy.

Trust comment: Randomized study with a reasonable sample size and clinically relevant endpoints but limited numeric effect sizes reported in the summary.

Study Details

PMID:28049190
Participants:217
Impact:changed (significant differences among groups from 24 weeks, p<0.05)
Trust score:3/5

ablation success rate (strict criteria, 3 tests)

1 evidences

Low-dose (800 MBq) I-131 was similarly effective as high-dose (3700 MBq) for remnant ablation in low-risk differentiated thyroid cancer.

Trust comment: Adequate sample size and objective, pre-specified ablation criteria with direct clinical outcome measures; differences were non-significant.

Study Details

PMID:22205241
Participants:108
Impact:60% (32/53) vs 64% (35/55); P=NS
Trust score:4/5

ablation success rate (lax criteria, 3 tests)

1 evidences

Low-dose (800 MBq) I-131 was similarly effective as high-dose (3700 MBq) for remnant ablation in low-risk differentiated thyroid cancer.

Trust comment: Adequate sample size and objective, pre-specified ablation criteria with direct clinical outcome measures; differences were non-significant.

Study Details

PMID:22205241
Participants:108
Impact:81% (43/53) vs 76% (42/55); P=NS
Trust score:4/5

ablation success rate (two-test lax)

1 evidences

Low-dose (800 MBq) I-131 was similarly effective as high-dose (3700 MBq) for remnant ablation in low-risk differentiated thyroid cancer.

Trust comment: Adequate sample size and objective, pre-specified ablation criteria with direct clinical outcome measures; differences were non-significant.

Study Details

PMID:22205241
Participants:108
Impact:89% vs 87%; P=NS
Trust score:4/5

24-hour thyroid radioiodine uptake (RAIU)

1 evidences

Thiamazole pretreatment roughly doubled thyroid radioiodine uptake and lowered the calculated therapeutic radioiodine dose needed for cure.

Trust comment: Randomized small trial with clear physiologic endpoints and significant effects but limited by small sample size.

Study Details

PMID:25867812
Participants:22
Impact:increased from 32 ±10% to 63 ±18% (P<0.001)
Trust score:3/5

calculated therapeutic 131I activity required

1 evidences

Thiamazole pretreatment roughly doubled thyroid radioiodine uptake and lowered the calculated therapeutic radioiodine dose needed for cure.

Trust comment: Randomized small trial with clear physiologic endpoints and significant effects but limited by small sample size.

Study Details

PMID:25867812
Participants:22
Impact:decreased median activity by 31% (P<0.05)
Trust score:3/5

thyroid hormones (free T4 and free T3)

1 evidences

Thiamazole pretreatment roughly doubled thyroid radioiodine uptake and lowered the calculated therapeutic radioiodine dose needed for cure.

Trust comment: Randomized small trial with clear physiologic endpoints and significant effects but limited by small sample size.

Study Details

PMID:25867812
Participants:22
Impact:free T4 decreased ~22%; free T3 decreased ~15%; TSH increased ~9%
Trust score:3/5

2-year intrahepatic recurrence rate

1 evidences

A single postoperative intraarterial 131I-lipiodol dose reduced intrahepatic recurrence after curative HCC treatment but did not improve overall survival.

Trust comment: Prospective randomized trial with statistically significant reduction in recurrence though sample size was small and no overall survival benefit was seen.

Study Details

PMID:24722530
Participants:58
Impact:28% (131I-lipiodol) vs 56% (control); P=0.0449
Trust score:4/5

2-year recurrence-free survival

1 evidences

A single postoperative intraarterial 131I-lipiodol dose reduced intrahepatic recurrence after curative HCC treatment but did not improve overall survival.

Trust comment: Prospective randomized trial with statistically significant reduction in recurrence though sample size was small and no overall survival benefit was seen.

Study Details

PMID:24722530
Participants:58
Impact:73% vs 45%; P=0.0259
Trust score:4/5

major complication rates

1 evidences

Stents loaded with 125I seeds prolonged median overall survival compared with conventional stents in unresectable oesophageal cancer.

Trust comment: Multicenter randomized phase 3 trial with a clear survival benefit and adequate sample size and follow-up.

Study Details

PMID:24742740
Participants:160
Impact:similar between groups (no clinically important increase with 125I)
Trust score:5/5

stent placement success

1 evidences

Stents loaded with 125I seeds prolonged median overall survival compared with conventional stents in unresectable oesophageal cancer.

Trust comment: Multicenter randomized phase 3 trial with a clear survival benefit and adequate sample size and follow-up.

Study Details

PMID:24742740
Participants:160
Impact:148 stents successfully placed in 148 participants (73 vs 75)
Trust score:5/5

12-year all-cause mortality

1 evidences

Iodine-125 brachytherapy showed no difference in long-term survival compared with enucleation for choroidal melanoma.

Trust comment: Large randomized multicenter trial with long-term follow-up and robust mortality ascertainment showing no survival difference between treatments.

Study Details

PMID:17159027
Participants:1317
Impact:43% (125I brachytherapy) vs 41% (enucleation); no significant difference
Trust score:5/5

12-year death with histopathologically confirmed melanoma metastasis

1 evidences

Iodine-125 brachytherapy showed no difference in long-term survival compared with enucleation for choroidal melanoma.

Trust comment: Large randomized multicenter trial with long-term follow-up and robust mortality ascertainment showing no survival difference between treatments.

Study Details

PMID:17159027
Participants:1317
Impact:21% vs 17%; no significant difference
Trust score:5/5

5- and 10-year all-cause mortality

1 evidences

Iodine-125 brachytherapy showed no difference in long-term survival compared with enucleation for choroidal melanoma.

Trust comment: Large randomized multicenter trial with long-term follow-up and robust mortality ascertainment showing no survival difference between treatments.

Study Details

PMID:17159027
Participants:1317
Impact:5-year 19%; 10-year 35% (both arms combined)
Trust score:5/5

median visual acuity decline

1 evidences

I-125 brachytherapy for medium choroidal melanoma resulted in substantial visual acuity decline for many treated eyes over 3 years; tumor size and proximity to fovea increased risk of poor vision outcomes.

Trust comment: Large randomized multicenter trial with prospectively collected visual-acuity outcomes and long follow-up, supporting moderate-high trust in results.

Study Details

PMID:11158813
Participants:623
Impact:Median visual acuity fell from 20/32 at baseline to 20/125 at 3 years
Trust score:4/5

loss of ≥6 lines of visual acuity

1 evidences

I-125 brachytherapy for medium choroidal melanoma resulted in substantial visual acuity decline for many treated eyes over 3 years; tumor size and proximity to fovea increased risk of poor vision outcomes.

Trust comment: Large randomized multicenter trial with prospectively collected visual-acuity outcomes and long follow-up, supporting moderate-high trust in results.

Study Details

PMID:11158813
Participants:623
Impact:Life-table estimate 49% by 3 years
Trust score:4/5

visual acuity 20/200 or worse

1 evidences

I-125 brachytherapy for medium choroidal melanoma resulted in substantial visual acuity decline for many treated eyes over 3 years; tumor size and proximity to fovea increased risk of poor vision outcomes.

Trust comment: Large randomized multicenter trial with prospectively collected visual-acuity outcomes and long follow-up, supporting moderate-high trust in results.

Study Details

PMID:11158813
Participants:623
Impact:Life-table estimate 43% by 3 years
Trust score:4/5

Complete response rate

1 evidences

Randomized comparison in relapsed/refractory NHL showed that conjugating 131I to tositumomab substantially increased response rates and durability but increased hematologic toxicity.

Trust comment: Randomized multicenter trial directly comparing I-131–labeled versus unlabeled antibody with clear efficacy differences, though sample size is modest.

Study Details

PMID:15585610
Participants:78
Impact:33% vs 8% (P=0.012)
Trust score:4/5

time to progression (median)

1 evidences

Randomized comparison in relapsed/refractory NHL showed that conjugating 131I to tositumomab substantially increased response rates and durability but increased hematologic toxicity.

Trust comment: Randomized multicenter trial directly comparing I-131–labeled versus unlabeled antibody with clear efficacy differences, though sample size is modest.

Study Details

PMID:15585610
Participants:78
Impact:6.3 vs 5.5 months (P=0.031)
Trust score:4/5

scan sensitivity (rTSH vs withdrawal)

1 evidences

Two randomized trials showed rTSH-stimulated radioiodine scanning plus thyroglobulin testing is at least as sensitive as thyroid-hormone withdrawal (in improved-tech trial) and causes less hypothyroid morbidity.

Trust comment: Two randomized clinical trials with moderate sample sizes directly comparing rTSH vs withdrawal for I-131 scanning and Tg testing, with both diagnostic and QoL outcomes.

Study Details

PMID:12053710
Participants:347
Impact:Trial1 (127 pts): among 62 positive scans rTSH equivalent in 41, superior in 3, inferior in 18; Trial2 (220 pts): no difference in superiority between methods among 108 positive scans
Trust score:4/5

rTSH-stimulated thyroglobulin sensitivity

1 evidences

Two randomized trials showed rTSH-stimulated radioiodine scanning plus thyroglobulin testing is at least as sensitive as thyroid-hormone withdrawal (in improved-tech trial) and causes less hypothyroid morbidity.

Trust comment: Two randomized clinical trials with moderate sample sizes directly comparing rTSH vs withdrawal for I-131 scanning and Tg testing, with both diagnostic and QoL outcomes.

Study Details

PMID:12053710
Participants:347
Impact:rTSH-stimulated Tg >2 ng/mL detected residual tissue in 74% of patients and detected all (100%) patients with tumor metastases
Trust score:4/5

TSH stimulation

1 evidences

rhTSH preserves quality of life compared with thyroid-hormone withdrawal while achieving comparable low-dose radioiodine remnant ablation success rates.

Trust comment: Large randomized human study directly addressing preparation for radioactive iodine ablation with clear endpoints and significant QoL result.

Study Details

PMID:20151824
Participants:291
Impact:robust stimulation in all groups (mean TSH ~82.24 mU/L), no between-group differences
Trust score:4/5

PSA spike incidence (overall)

1 evidences

PSA spikes after brachytherapy were common and were more frequent with iodine-125 than with palladium-103, especially in patients under 65.

Trust comment: Prospective randomized trial with median 5.4 yr follow-up and clear reported differences by isotope and age.

Study Details

PMID:17544597
Participants:164
Impact:26.9% (44/164) developed a PSA spike
Trust score:4/5

PSA spike incidence with I-125 (hormone‑naive)

1 evidences

PSA spikes after brachytherapy were common and were more frequent with iodine-125 than with palladium-103, especially in patients under 65.

Trust comment: Prospective randomized trial with median 5.4 yr follow-up and clear reported differences by isotope and age.

Study Details

PMID:17544597
Participants:164
Impact:45.7% (21/46) vs Pd-103 14.0% (8/57) in hormone‑naive patients
Trust score:4/5

age effect on PSA spike

1 evidences

PSA spikes after brachytherapy were common and were more frequent with iodine-125 than with palladium-103, especially in patients under 65.

Trust comment: Prospective randomized trial with median 5.4 yr follow-up and clear reported differences by isotope and age.

Study Details

PMID:17544597
Participants:164
Impact:higher in <65 yrs (38.5%) vs ≥65 yrs (16.3%); age significant predictor (p<0.001)
Trust score:4/5

thyroid remnant ablation success rate

1 evidences

Low-dose I-131 (1850 MBq) was as effective as high-dose (3700 MBq) for remnant ablation in Chinese patients with differentiated thyroid cancer.

Trust comment: Randomized allocation with adequate sample size and objective ablation endpoints; no significant efficacy difference between doses.

Study Details

PMID:28401794
Participants:278
Impact:overall 84.2%; low-dose 82.6% vs high-dose 86.2% (no significant difference, p=0.509)
Trust score:4/5

mean survival time

1 evidences

Adding an iodine-125 seed strand to TACE improved survival compared with TACE alone in patients with hepatocellular carcinoma and portal vein tumor thrombosis.

Trust comment: Randomized two-arm clinical trial showing statistically significant survival benefit with addition of I-125 seeds in a moderate sample.

Study Details

PMID:24374800
Participants:85
Impact:221.7±16.3 days vs 155.1±7.9 days (group A vs B)
Trust score:4/5

180-day cumulative survival rate

1 evidences

Adding an iodine-125 seed strand to TACE improved survival compared with TACE alone in patients with hepatocellular carcinoma and portal vein tumor thrombosis.

Trust comment: Randomized two-arm clinical trial showing statistically significant survival benefit with addition of I-125 seeds in a moderate sample.

Study Details

PMID:24374800
Participants:85
Impact:58.9% vs 30.7% (group A vs B)
Trust score:4/5

3-year biochemical freedom-from-failure

1 evidences

Three-year biochemical control rates were similar after iodine-125 and palladium-103 brachytherapy for low-risk prostate cancer.

Trust comment: Prospective randomized multicenter trial with clear outcome reporting and adequate follow-up for preliminary PSA outcomes.

Study Details

PMID:14630265
Participants:115
Impact:89% (I-125) vs 91% (Pd-103), no significant difference (p=0.76)
Trust score:4/5

dosimetry effect on control

1 evidences

Three-year biochemical control rates were similar after iodine-125 and palladium-103 brachytherapy for low-risk prostate cancer.

Trust comment: Prospective randomized multicenter trial with clear outcome reporting and adequate follow-up for preliminary PSA outcomes.

Study Details

PMID:14630265
Participants:115
Impact:better D90 or V100 associated with improved control; effect most pronounced for I-125 (p=0.01)
Trust score:4/5

cure rate (euthyroidism or hypothyroidism)

1 evidences

Randomized trial in Graves' disease comparing radioiodine alone versus methimazole pretreatment then radioiodine: cure rates and 1-year outcomes were similar between groups, so methimazole pretreatment did not affect 1-year success.

Trust comment: Prospective randomized study with 1-year follow-up and objective biochemical endpoints, moderate sample size and clear reporting.

Study Details

PMID:11502768
Participants:61
Impact:~80% cured by 3 months in both groups
Trust score:4/5

1-year outcome distribution

1 evidences

Randomized trial in Graves' disease comparing radioiodine alone versus methimazole pretreatment then radioiodine: cure rates and 1-year outcomes were similar between groups, so methimazole pretreatment did not affect 1-year success.

Trust comment: Prospective randomized study with 1-year follow-up and objective biochemical endpoints, moderate sample size and clear reporting.

Study Details

PMID:11502768
Participants:61
Impact:Persistent hyperthyroidism 15.6% vs 13.8%; euthyroidism 28.1% vs 31.0%; hypothyroidism 56.3% vs 55.2% (131I alone vs methimazole pretreated)
Trust score:4/5

predictors of relapse

1 evidences

Randomized trial in Graves' disease comparing radioiodine alone versus methimazole pretreatment then radioiodine: cure rates and 1-year outcomes were similar between groups, so methimazole pretreatment did not affect 1-year success.

Trust comment: Prospective randomized study with 1-year follow-up and objective biochemical endpoints, moderate sample size and clear reporting.

Study Details

PMID:11502768
Participants:61
Impact:Relapse associated with larger thyroid volume, higher 24-h radioiodine uptake and higher T3; T3 independently predicted failure
Trust score:4/5

overall treatment response (euthyroid + hypothyroid)

1 evidences

Randomized comparison of two fixed radioactive‑iodine doses in drug‑resistant Graves' disease showing the higher 370 MBq dose produced substantially greater overall treatment response but higher rates of hypothyroidism.

Trust comment: Randomized study with 2-year follow-up but modest sample size and limited multicenter validation; results show clear dose-related differences.

Study Details

PMID:16390021
Participants:59
Impact:185 MBq: 48.5% response; 370 MBq: 88.5% response
Trust score:3/5

persistent hyperthyroidism (treatment failure)

1 evidences

Randomized comparison of two fixed radioactive‑iodine doses in drug‑resistant Graves' disease showing the higher 370 MBq dose produced substantially greater overall treatment response but higher rates of hypothyroidism.

Trust comment: Randomized study with 2-year follow-up but modest sample size and limited multicenter validation; results show clear dose-related differences.

Study Details

PMID:16390021
Participants:59
Impact:185 MBq: 51.5% remained hyperthyroid; 370 MBq: 11.5% remained hyperthyroid
Trust score:3/5

procedural success rate

1 evidences

Prospective study of CT‑guided iodine‑125 brachytherapy for bilateral lung metastases from colorectal cancer showed high procedural success, acceptable safety, improved local control and significantly longer overall survival versus symptomatic care.

Trust comment: Prospective randomized single‑center study with modest sample size showing survival benefit, but limited by sample size and center-specific experience.

Study Details

PMID:26406550
Participants:72
Impact:Procedure success 87.9% (29/33 patients) by planning criteria at 1 month
Trust score:3/5

tumor response rate

1 evidences

Randomized trial comparing 131I-labeled Lipiodol versus chemoembolization for HCC: survival and tumor response were similar but 131I-Lipiodol had markedly better tolerance.

Trust comment: Randomized human trial with 129 patients analyzed directly testing 131I-labeled therapy; well-conducted though older single-study data.

Study Details

PMID:9362356
Participants:129
Impact:similar (CR 1 vs 0; PR 15 vs 16) between 131I-Lipiodol and chemoembolization
Trust score:4/5

tolerance / severe adverse events

1 evidences

Randomized trial comparing 131I-labeled Lipiodol versus chemoembolization for HCC: survival and tumor response were similar but 131I-Lipiodol had markedly better tolerance.

Trust comment: Randomized human trial with 129 patients analyzed directly testing 131I-labeled therapy; well-conducted though older single-study data.

Study Details

PMID:9362356
Participants:129
Impact:markedly better with 131I-Lipiodol (3 severe side effects vs 29; P<.001)
Trust score:4/5

median time of local control

1 evidences

Randomized prospective study found adding I-125 brachytherapy to chemotherapy improved local control, response rate, and progression-free survival vs chemotherapy alone in locally recurrent stage III NSCLC.

Trust comment: Prospective randomized single-center study (n=52) directly tests I-125 brachytherapy effects; sample size modest and follow-up limited, so moderate trust.

Study Details

PMID:26445227
Participants:52
Impact:10.0 months combined vs 6.2 months control (+3.8 months)
Trust score:3/5

driving ability / visual function

1 evidences

COMS ancillary QoL study comparing I-125 brachytherapy vs enucleation: brachytherapy patients had better driving and peripheral vision for up to 1–2 years but were more likely to have persistent anxiety; differences largely diminished by 3–5 years.

Trust comment: Large prospective randomized trial subgroup (n=209) with standardized QoL assessments and multi-year follow-up directly evaluating I-125 brachytherapy outcomes.

Study Details

PMID:16476893
Participants:209
Impact:brachytherapy favored for driving (first year) and peripheral vision (first 2 years)
Trust score:4/5

anxiety symptoms

1 evidences

COMS ancillary QoL study comparing I-125 brachytherapy vs enucleation: brachytherapy patients had better driving and peripheral vision for up to 1–2 years but were more likely to have persistent anxiety; differences largely diminished by 3–5 years.

Trust comment: Large prospective randomized trial subgroup (n=209) with standardized QoL assessments and multi-year follow-up directly evaluating I-125 brachytherapy outcomes.

Study Details

PMID:16476893
Participants:209
Impact:patients treated with brachytherapy more likely to have anxiety and less likely to have symptom resolution during follow-up
Trust score:4/5

long-term visual difference

1 evidences

COMS ancillary QoL study comparing I-125 brachytherapy vs enucleation: brachytherapy patients had better driving and peripheral vision for up to 1–2 years but were more likely to have persistent anxiety; differences largely diminished by 3–5 years.

Trust comment: Large prospective randomized trial subgroup (n=209) with standardized QoL assessments and multi-year follow-up directly evaluating I-125 brachytherapy outcomes.

Study Details

PMID:16476893
Participants:209
Impact:differences in visual function diminished by 3–5 years posttreatment
Trust score:4/5

Local tumor recurrence

1 evidences

Iodine-125 plaque radiotherapy controlled tumors with high eye preservation but caused some radiation-related eye problems and metastases.

Trust comment: Retrospective case series on humans with reasonable follow-up but non-randomized design limits causal inference.

Study Details

PMID:24008431
Participants:82
Impact:2.4% (2/82) local recurrence; globe preservation 97.6% (80/82)
Trust score:3/5

Metastasis

1 evidences

Iodine-125 plaque radiotherapy controlled tumors with high eye preservation but caused some radiation-related eye problems and metastases.

Trust comment: Retrospective case series on humans with reasonable follow-up but non-randomized design limits causal inference.

Study Details

PMID:24008431
Participants:82
Impact:11.0% (9/82) developed metastatic disease
Trust score:3/5

Late radiation adverse effects (eye)

1 evidences

Iodine-125 plaque radiotherapy controlled tumors with high eye preservation but caused some radiation-related eye problems and metastases.

Trust comment: Retrospective case series on humans with reasonable follow-up but non-randomized design limits causal inference.

Study Details

PMID:24008431
Participants:82
Impact:Retinopathy 37.8% (31/82); Optic neuropathy 14.6% (12/82); Cataract 31.7% (26/82); ≥6-line visual loss 25.6% (21/82)
Trust score:3/5

Aortic attenuation (HU)

1 evidences

Rapid injection of iodinated contrast (1.75 g iodine/s) produced higher aortic attenuation and better visualization of the Adamkiewicz artery on 64-row CT.

Trust comment: Prospective protocol comparison with adequate sample and objective imaging endpoints; results directly relevant to iodinated contrast use.

Study Details

PMID:18509656
Participants:80
Impact:Rapid injection A 473.4±82.6 HU, B 506.7±71.9 HU vs slow injection C 371.3±65.1 HU, D 391.5±60.8 HU
Trust score:4/5

Adamkiewicz artery visualization (assessable rate)

1 evidences

Rapid injection of iodinated contrast (1.75 g iodine/s) produced higher aortic attenuation and better visualization of the Adamkiewicz artery on 64-row CT.

Trust comment: Prospective protocol comparison with adequate sample and objective imaging endpoints; results directly relevant to iodinated contrast use.

Study Details

PMID:18509656
Participants:80
Impact:Assessable in A 75% (15/20), B 80% (16/20), C 45% (9/20), D 50% (10/20); best with 1.75 g I/s protocol
Trust score:4/5

Ablation success (Tg <1 ng/mL)

1 evidences

Preparation with rhTSH or L-thyroxine withdrawal resulted in similar ablation rates with low-activity I-131; rhTSH avoids hypothyroidism.

Trust comment: Small comparative study with clear clinical endpoints; limited sample size reduces precision.

Study Details

PMID:19074463
Participants:42
Impact:Group A (withdrawal) 90% vs Group B (rhTSH) 85% achieved Tg <1 ng/mL at follow-up
Trust score:3/5

No uptake on scan

1 evidences

Preparation with rhTSH or L-thyroxine withdrawal resulted in similar ablation rates with low-activity I-131; rhTSH avoids hypothyroidism.

Trust comment: Small comparative study with clear clinical endpoints; limited sample size reduces precision.

Study Details

PMID:19074463
Participants:42
Impact:Group A 95.2% vs Group B 90.5% no uptake; no statistical difference
Trust score:3/5

24 h 131I uptake rate

1 evidences

Randomized trial in postoperative thyroid cancer patients showing hydrochlorothiazide increased 24 h 131I uptake and augmented absorbed 131I dose of thyroid remnant.

Trust comment: Randomized controlled trial with clear numeric effects but small sample (n=30) limiting precision and generalizability.

Study Details

PMID:15291124
Participants:30
Impact:+36% vs baseline (mean ratio 1.36 ± 0.58); significantly higher vs control
Trust score:3/5

131I absorbed dose

1 evidences

Randomized trial in postoperative thyroid cancer patients showing hydrochlorothiazide increased 24 h 131I uptake and augmented absorbed 131I dose of thyroid remnant.

Trust comment: Randomized controlled trial with clear numeric effects but small sample (n=30) limiting precision and generalizability.

Study Details

PMID:15291124
Participants:30
Impact:+35% vs baseline (mean ratio 1.35 ± 0.54); significantly augmented vs control
Trust score:3/5

Death with histopathologically confirmed melanoma metastasis

1 evidences

Large randomized trial found no significant difference in overall mortality or melanoma-specific mortality between I-125 brachytherapy and enucleation for choroidal melanoma.

Trust comment: Large multicenter randomized trial with long follow-up and adequate power to detect clinically meaningful mortality differences.

Study Details

PMID:11448319
Participants:1317
Impact:no significant difference (11% enucleation vs 9% brachytherapy); adjusted RR ~0.91 (95% CI 0.66–1.24)
Trust score:5/5

therapeutic success rate (elimination of hyperthyroidism at ~6 months)

1 evidences

Randomized comparison of fixed versus calculated 131I activity for Graves' hyperthyroidism showed higher overall success with standard activity; success correlated strongly with absorbed thyroid dose and was influenced by thyroid size.

Trust comment: Prospective randomized multicentre trial with clear clinical endpoint and adequate sample size; good design though abstract truncated.

Study Details

PMID:7781666
Participants:205
Impact:Standard activity: 71% (70/98); Calculated activity: 58% (62/107)
Trust score:4/5

size dependence of success

1 evidences

Randomized comparison of fixed versus calculated 131I activity for Graves' hyperthyroidism showed higher overall success with standard activity; success correlated strongly with absorbed thyroid dose and was influenced by thyroid size.

Trust comment: Prospective randomized multicentre trial with clear clinical endpoint and adequate sample size; good design though abstract truncated.

Study Details

PMID:7781666
Participants:205
Impact:With standard activity success inversely related to thyroid size (100% for smallest volumes, lower for larger volumes); calculated activity largely compensated except in very small glands
Trust score:4/5

success vs absorbed dose

1 evidences

Randomized comparison of fixed versus calculated 131I activity for Graves' hyperthyroidism showed higher overall success with standard activity; success correlated strongly with absorbed thyroid dose and was influenced by thyroid size.

Trust comment: Prospective randomized multicentre trial with clear clinical endpoint and adequate sample size; good design though abstract truncated.

Study Details

PMID:7781666
Participants:205
Impact:Success rates by absorbed dose: 50 Gy: 11%; 100 Gy: 50%; 150 Gy: 67%; 200 Gy: 80%; 250 Gy: 84%; 300 Gy: 88%; 350 Gy: 90%; 400 Gy: 93%
Trust score:4/5

smallest cross-sectional tracheal area (SCAT)

1 evidences

rhTSH given before 131I therapy improved tracheal cross-sectional area and inspiratory flow at 12 months compared with placebo, indicating reduced tracheal compression after treatment.

Trust comment: Double-blind randomized design directly testing rhTSH augmentation of 131I therapy with objective imaging and pulmonary function endpoints, but sample size is small.

Study Details

PMID:18664541
Participants:29
Impact:In rhTSH group SCAT increased 10.5% at 1 week and 31.4% at 12 months (mean increase to 117±36 mm² from 92±38 mm²; p=0.005)
Trust score:4/5

forced inspiratory flow at 50% VC (FIF50%)

1 evidences

rhTSH given before 131I therapy improved tracheal cross-sectional area and inspiratory flow at 12 months compared with placebo, indicating reduced tracheal compression after treatment.

Trust comment: Double-blind randomized design directly testing rhTSH augmentation of 131I therapy with objective imaging and pulmonary function endpoints, but sample size is small.

Study Details

PMID:18664541
Participants:29
Impact:Increased from 3.34±1.33 to 4.23±1.88 L/s (median increase 24.6%; p=0.015) in rhTSH group
Trust score:4/5

forced vital capacity (FVC)

1 evidences

rhTSH given before 131I therapy improved tracheal cross-sectional area and inspiratory flow at 12 months compared with placebo, indicating reduced tracheal compression after treatment.

Trust comment: Double-blind randomized design directly testing rhTSH augmentation of 131I therapy with objective imaging and pulmonary function endpoints, but sample size is small.

Study Details

PMID:18664541
Participants:29
Impact:Slight decrease at 1 week in rhTSH group; no long-term deterioration reported
Trust score:4/5

disease-free survival

1 evidences

Randomized trial showing charged particle therapy produced better long-term local tumor control, higher eye preservation, and longer disease-free survival than iodine-125 plaque therapy for ocular melanoma.

Trust comment: Randomized, stratified trial with long follow-up and clear clinical endpoints, indicating reliable comparative effectiveness data between modalities including I-125 plaque.

Study Details

PMID:25841624
Participants:184
Impact:Prolonged with CPT (statistically significant, P=.001)
Trust score:4/5

CD3+ immunocytes

1 evidences

Intrahepatic iodine-125 implantation after HCC resection preserved T-cell levels and increased Th1 cytokines (IL-12, IFN-γ) compared with control.

Trust comment: Randomized clinical study with 68 patients and objective immune endpoints; moderate quality though further replication desirable.

Study Details

PMID:20159703
Participants:68
Impact:no significant postoperative decrease in treatment group (control fell from 62.58% preop to 39.38% postop)
Trust score:4/5

IL-12 (plasma)

1 evidences

Intrahepatic iodine-125 implantation after HCC resection preserved T-cell levels and increased Th1 cytokines (IL-12, IFN-γ) compared with control.

Trust comment: Randomized clinical study with 68 patients and objective immune endpoints; moderate quality though further replication desirable.

Study Details

PMID:20159703
Participants:68
Impact:increase from 36.13 to 89.46 ng/L (+≈148%, P<0.05)
Trust score:4/5

IFN-gamma (plasma)

1 evidences

Intrahepatic iodine-125 implantation after HCC resection preserved T-cell levels and increased Th1 cytokines (IL-12, IFN-γ) compared with control.

Trust comment: Randomized clinical study with 68 patients and objective immune endpoints; moderate quality though further replication desirable.

Study Details

PMID:20159703
Participants:68
Impact:increase from 7.14 to 47.78 ng/L (+≈569%, P<0.05)
Trust score:4/5

TSH target achievement (≥25 μU/ml)

1 evidences

Compared half-dose levothyroxine vs full withdrawal before I-131 scanning: full withdrawal reached target TSH far more often but caused greater biochemical disturbances, with no clinical score advantage.

Trust comment: Randomized study with clear primary outcomes and moderate sample size, providing reasonably reliable results for preparation strategies prior to I-131 scanning.

Study Details

PMID:26070652
Participants:55
Impact:TW 92.3% vs HD 48.3% (difference −44.0 percentage points; TW superior)
Trust score:4/5

biochemical disturbances (lipids, muscle/liver enzymes)

1 evidences

Compared half-dose levothyroxine vs full withdrawal before I-131 scanning: full withdrawal reached target TSH far more often but caused greater biochemical disturbances, with no clinical score advantage.

Trust comment: Randomized study with clear primary outcomes and moderate sample size, providing reasonably reliable results for preparation strategies prior to I-131 scanning.

Study Details

PMID:26070652
Participants:55
Impact:Greater increases in TW than HD (significant)
Trust score:4/5

clinical symptoms (Zulewski score)

1 evidences

Compared half-dose levothyroxine vs full withdrawal before I-131 scanning: full withdrawal reached target TSH far more often but caused greater biochemical disturbances, with no clinical score advantage.

Trust comment: Randomized study with clear primary outcomes and moderate sample size, providing reasonably reliable results for preparation strategies prior to I-131 scanning.

Study Details

PMID:26070652
Participants:55
Impact:No significant difference between groups
Trust score:4/5

full remission at 1 year

1 evidences

Randomized trial comparing 60 vs 100 mCi 131I for remnant ablation in low-risk DTC found no significant differences in early remission, thyroglobulin levels, or need for re-ablation.

Trust comment: Prospective randomized trial with a large sample size for early outcomes, supporting credible evidence that 60 mCi and 100 mCi had similar early efficacy in this population.

Study Details

PMID:17006839
Participants:224
Impact:60 mCi: 76/99 vs 100 mCi: 100/125; no statistically significant difference
Trust score:4/5

thyroglobulin levels at 12 and 24 months

1 evidences

Randomized trial comparing 60 vs 100 mCi 131I for remnant ablation in low-risk DTC found no significant differences in early remission, thyroglobulin levels, or need for re-ablation.

Trust comment: Prospective randomized trial with a large sample size for early outcomes, supporting credible evidence that 60 mCi and 100 mCi had similar early efficacy in this population.

Study Details

PMID:17006839
Participants:224
Impact:No significant differences between groups
Trust score:4/5

requirement for second ablation

1 evidences

Randomized trial comparing 60 vs 100 mCi 131I for remnant ablation in low-risk DTC found no significant differences in early remission, thyroglobulin levels, or need for re-ablation.

Trust comment: Prospective randomized trial with a large sample size for early outcomes, supporting credible evidence that 60 mCi and 100 mCi had similar early efficacy in this population.

Study Details

PMID:17006839
Participants:224
Impact:13.3% (60 mCi) vs 11.2% (100 mCi); no significant difference
Trust score:4/5

local tumor control (5 years)

1 evidences

Randomized trial showing charged particle therapy produced better long-term local tumor control, higher eye preservation, and longer disease-free survival than iodine-125 plaque therapy for ocular melanoma.

Trust comment: Randomized, stratified trial with long follow-up and clear clinical endpoints, indicating reliable comparative effectiveness data between modalities including I-125 plaque.

Study Details

PMID:25841624
Participants:184
Impact:CPT 100% vs I-125 plaque 84% (improved LC with CPT)
Trust score:4/5

enucleation rate (5 years)

1 evidences

Randomized trial showing charged particle therapy produced better long-term local tumor control, higher eye preservation, and longer disease-free survival than iodine-125 plaque therapy for ocular melanoma.

Trust comment: Randomized, stratified trial with long follow-up and clear clinical endpoints, indicating reliable comparative effectiveness data between modalities including I-125 plaque.

Study Details

PMID:25841624
Participants:184
Impact:CPT 11% vs I-125 plaque 22% (lower with CPT)
Trust score:4/5

PCNA index (proliferation)

1 evidences

Analysis of recurrent glioblastoma specimens showed that adjunctive iodine-125 brachytherapy markedly reduced tumor cell proliferation and adverse histological features compared with controls.

Trust comment: Small, selected sample of reoperated patients providing histopathological evidence of reduced proliferation after I-125 brachytherapy, but limited by sample size and selection.

Study Details

PMID:9149248
Participants:24
Impact:Reduced from 68.2% to 34.6% (mean decrease ≈33.6 percentage points) with I-125 brachytherapy
Trust score:3/5

mitotic figures (histological mitosis score)

1 evidences

Analysis of recurrent glioblastoma specimens showed that adjunctive iodine-125 brachytherapy markedly reduced tumor cell proliferation and adverse histological features compared with controls.

Trust comment: Small, selected sample of reoperated patients providing histopathological evidence of reduced proliferation after I-125 brachytherapy, but limited by sample size and selection.

Study Details

PMID:9149248
Participants:24
Impact:Reduced to 0.0 (mean score) in the I-125 brachytherapy group
Trust score:3/5

adverse histological features (cellularity, pleomorphism, vessel hyperplasia)

1 evidences

Analysis of recurrent glioblastoma specimens showed that adjunctive iodine-125 brachytherapy markedly reduced tumor cell proliferation and adverse histological features compared with controls.

Trust comment: Small, selected sample of reoperated patients providing histopathological evidence of reduced proliferation after I-125 brachytherapy, but limited by sample size and selection.

Study Details

PMID:9149248
Participants:24
Impact:Significantly reduced (P < 0.05) with I-125 brachytherapy
Trust score:3/5

enucleation (5-year cumulative risk)

1 evidences

Large randomized multicenter study of I-125 plaque brachytherapy showing low rates of local failure and enucleation at 5 years.

Trust comment: Large, prospective multicenter randomized trial with long follow-up directly assessing outcomes after I-125 brachytherapy; reliable data.

Study Details

PMID:12466159
Participants:638
Impact:12.5% (95% CI 10.0%–15.6%) by 5 years
Trust score:4/5

local treatment failure (5-year risk)

1 evidences

Large randomized multicenter study of I-125 plaque brachytherapy showing low rates of local failure and enucleation at 5 years.

Trust comment: Large, prospective multicenter randomized trial with long follow-up directly assessing outcomes after I-125 brachytherapy; reliable data.

Study Details

PMID:12466159
Participants:638
Impact:10.3% (95% CI 8.0%–13.2%) by 5 years
Trust score:4/5

effective dose (radiation)

1 evidences

Lower-iodine contrast plus 55 keV virtual monochromatic images provided equal-or-better CTA image quality while markedly lowering radiation and iodine exposure.

Trust comment: Large (n=280) prospective randomized study with objective and subjective imaging metrics; focused on imaging protocol rather than clinical harm outcomes.

Study Details

PMID:38135625
Participants:280
Impact:-44%
Trust score:4/5

iodine load

5 evidences

Randomized pediatric CT study found low-concentration contrast + low tube voltage (80 kVp) reduced iodine load (~37%) and radiation dose while maintaining comparable image quality.

Trust comment: Prospective randomized pediatric trial with n=48; small sample but appropriate measures and consistent findings for dose/iodine reduction.

Study Details

PMID:27577509
Participants:48
Impact:Group A (270 mg I/mL, 80 kVp): 5517.3 ± 3197.2 mg I vs Group B (370 mg I/mL, 100 kVp): 8772.1 ± 8474.6 mg I (~37% lower)
Trust score:4/5

Using 80 kVp low-iodine contrast protocol with IMR in CABG patients reduced radiation and iodine load and improved image quality for aorta, left ventricle and venous grafts.

Trust comment: Prospective randomized study in 71 CABG patients with objective imaging metrics and clear outcome measures.

Study Details

PMID:30606383
Participants:71
Impact:-31% (20±1.4 g vs 29±1.6 g)
Trust score:4/5

Randomized whole-body CTA trial showing that low tube voltage with low-concentration contrast reduces iodine load and radiation while preserving vascular enhancement and image quality.

Trust comment: Randomized study of 109 patients with quantitative imaging and dose metrics; methods appropriate though subgroup comparisons moderate in size.

Study Details

PMID:24370154
Participants:109
Impact:240-80 group: 21.6 g; 300-80: 26.8 g; 370-120: 34.0 g (240-80 lowest, p<0.05)
Trust score:4/5

Randomized pediatric CT study showing lower-concentration iodinated contrast plus lower tube settings reduces iodine load and radiation while keeping image quality.

Trust comment: Prospective randomized pediatric study with clear quantitative iodine and radiation outcomes and reasonable sample size; moderate-high trust.

Study Details

PMID:27925466
Participants:110
Impact:-30% (3976 ± 747 mgI vs 5763 ± 1018 mgI)
Trust score:4/5

Lower-iodine contrast plus 55 keV virtual monochromatic images provided equal-or-better CTA image quality while markedly lowering radiation and iodine exposure.

Trust comment: Large (n=280) prospective randomized study with objective and subjective imaging metrics; focused on imaging protocol rather than clinical harm outcomes.

Study Details

PMID:38135625
Participants:280
Impact:-59%
Trust score:4/5

iodine delivery rate (IDR)

1 evidences

Lower-iodine contrast plus 55 keV virtual monochromatic images provided equal-or-better CTA image quality while markedly lowering radiation and iodine exposure.

Trust comment: Large (n=280) prospective randomized study with objective and subjective imaging metrics; focused on imaging protocol rather than clinical harm outcomes.

Study Details

PMID:38135625
Participants:280
Impact:-19%
Trust score:4/5

image quality (SNR, CNR, subjective)

2 evidences

Room-temperature iodinated contrast was noninferior to prewarmed contrast for abdominal CT image quality and produced slightly higher liver attenuation and better comfort.

Trust comment: Double-blinded randomized noninferiority trial with objective and subjective outcomes and adequate sample size.

Study Details

PMID:34280944
Participants:218
Impact:no significant difference between room-temperature and prewarmed contrast
Trust score:5/5

Lower-iodine contrast plus 55 keV virtual monochromatic images provided equal-or-better CTA image quality while markedly lowering radiation and iodine exposure.

Trust comment: Large (n=280) prospective randomized study with objective and subjective imaging metrics; focused on imaging protocol rather than clinical harm outcomes.

Study Details

PMID:38135625
Participants:280
Impact:equal or better
Trust score:4/5

patient symptom VAS (pain/discharge/itching) at 3 weeks

1 evidences

In this small randomized pilot trial, ear packing with BIPP produced no clear benefit versus no packing for symptoms or hearing at follow-up.

Trust comment: Randomized pilot RCT but very small (n=32) with incomplete follow-up and limited power to detect differences.

Study Details

PMID:24337896
Participants:32
Impact:95 mm vs 98 mm; no significant difference (p=0.6)
Trust score:3/5

clinician symptom VAS at 3 weeks

1 evidences

In this small randomized pilot trial, ear packing with BIPP produced no clear benefit versus no packing for symptoms or hearing at follow-up.

Trust comment: Randomized pilot RCT but very small (n=32) with incomplete follow-up and limited power to detect differences.

Study Details

PMID:24337896
Participants:32
Impact:64 mm vs 81 mm; no significant difference (p=0.5)
Trust score:3/5

post-operative air–bone gap (hearing)

1 evidences

In this small randomized pilot trial, ear packing with BIPP produced no clear benefit versus no packing for symptoms or hearing at follow-up.

Trust comment: Randomized pilot RCT but very small (n=32) with incomplete follow-up and limited power to detect differences.

Study Details

PMID:24337896
Participants:32
Impact:13.0 dB vs 19.1 dB; no significant difference (p=0.2)
Trust score:3/5

pain on pack removal

1 evidences

In this small randomized pilot trial, ear packing with BIPP produced no clear benefit versus no packing for symptoms or hearing at follow-up.

Trust comment: Randomized pilot RCT but very small (n=32) with incomplete follow-up and limited power to detect differences.

Study Details

PMID:24337896
Participants:32
Impact:26 mm (no comparator)
Trust score:3/5

neonatal total thyroxine (T4)

1 evidences

Neonatal thyroid screening showed no increase in congenital hypothyroidism and comparable T4 levels after maternal HSG with oil- versus water-based iodinated contrast.

Trust comment: Retrospective neonatal-screening analysis nested in a large RCT with reliable newborn screening but moderate sample size and some attrition.

Study Details

PMID:32427280
Participants:140
Impact:no difference oil vs water (median 87.0 vs 90.0 nmol/L; p=0.13)
Trust score:4/5

positive congenital hypothyroidism screen

1 evidences

Neonatal thyroid screening showed no increase in congenital hypothyroidism and comparable T4 levels after maternal HSG with oil- versus water-based iodinated contrast.

Trust comment: Retrospective neonatal-screening analysis nested in a large RCT with reliable newborn screening but moderate sample size and some attrition.

Study Details

PMID:32427280
Participants:140
Impact:0 cases in both groups
Trust score:4/5

iodine dose to mother (per HSG)

1 evidences

Neonatal thyroid screening showed no increase in congenital hypothyroidism and comparable T4 levels after maternal HSG with oil- versus water-based iodinated contrast.

Trust comment: Retrospective neonatal-screening analysis nested in a large RCT with reliable newborn screening but moderate sample size and some attrition.

Study Details

PMID:32427280
Participants:140
Impact:oil vs water: 4.3 g vs 2.5 g (p=0.001)
Trust score:4/5

image quality (coronary MDCT)

1 evidences

A low-concentration/low-voltage iodinated-contrast protocol produced comparable coronary CT image quality and may improve safety without loss of diagnostic information.

Trust comment: Randomized, blinded single-center trial (n=60) assessing imaging protocols with iodinated contrast; limited sample size but randomized design.

Study Details

PMID:25775881
Participants:60
Impact:no difference (score 1.28 ±0.28 vs 1.34 ±0.29; p=0.4)
Trust score:3/5

proximal intra-arterial density (proximal LAD/RCA)

1 evidences

A low-concentration/low-voltage iodinated-contrast protocol produced comparable coronary CT image quality and may improve safety without loss of diagnostic information.

Trust comment: Randomized, blinded single-center trial (n=60) assessing imaging protocols with iodinated contrast; limited sample size but randomized design.

Study Details

PMID:25775881
Participants:60
Impact:higher in low-concentration/low-kV group vs high-concentration group (p<0.05)
Trust score:3/5

Radiation dose (effective)

1 evidences

Randomized pediatric CT study showing lower-concentration iodinated contrast plus lower tube settings reduces iodine load and radiation while keeping image quality.

Trust comment: Prospective randomized pediatric study with clear quantitative iodine and radiation outcomes and reasonable sample size; moderate-high trust.

Study Details

PMID:27925466
Participants:110
Impact:-22% (0.60 ± 0.08 mSv vs 0.77 ± 0.10 mSv)
Trust score:4/5

Percent diameter stenosis change

1 evidences

Analysis in STEMI patients showing that diagnostic iodinated contrast injections can mechanically reduce thrombotic stenosis, especially with prior eptifibatide.

Trust comment: Clinical randomized trial subgroup analysis with clear quantitative angiographic effect of contrast injections; moderate trust but secondary analysis limits strength.

Study Details

PMID:17599433
Participants:281
Impact:+1.3% absolute improvement (eptifibatide in ER group; p=0.02)
Trust score:3/5

diagnostic efficacy

3 evidences

Using a lower-iodine concentration contrast agent produced image quality similar to a higher-iodine agent and had slightly fewer adverse events.

Trust comment: Randomized, double-blind multicentre trial with clear endpoints and 98 patients supports moderate-to-high trust.

Study Details

PMID:20821930
Participants:98
Impact:no difference
Trust score:4/5

Randomized double-blind trial comparing two iodinated contrast agents for head CT found no difference in safety or diagnostic performance.

Trust comment: Randomized double-blind trial with reasonable sample (80) but single-center and limited detail.

Study Details

PMID:7556256
Participants:80
Impact:no significant difference between iobitridol and iohexol
Trust score:4/5

Iobitridol had comparable safety and diagnostic efficacy to reference iohexol in coronary angiography with few adverse events.

Trust comment: Randomized, double-blind phase-III trial with adequate reporting of safety and efficacy outcomes.

Study Details

PMID:8619358
Participants:90
Impact:good to excellent in 100% of patients
Trust score:4/5

adverse reactions / clinical safety

2 evidences

Randomized double-blind trial comparing two iodinated contrast agents for head CT found no difference in safety or diagnostic performance.

Trust comment: Randomized double-blind trial with reasonable sample (80) but single-center and limited detail.

Study Details

PMID:7556256
Participants:80
Impact:no significant reactions observed; no difference between groups
Trust score:4/5

Comparative study in children testing an iodinated contrast agent (iobitridol 350) versus iopamidol 370 for angiocardiography; no differences in image quality or safety.

Trust comment: Controlled comparative pediatric study with moderate sample size but limited methodological detail in abstract.

Study Details

PMID:8619360
Participants:80
Impact:No significant difference in nature, onset, intensity or outcome of adverse reactions between agents
Trust score:3/5

adverse reaction prevention

1 evidences

Compared two corticosteroid + H2 antagonist pretreatment schedules before iodinated contrast; no significant difference in preventing adverse reactions.

Trust comment: Randomized comparison but small sample (45) limiting power to detect differences.

Study Details

PMID:7552182
Participants:45
Impact:no statistically significant difference between protocols (p=0.451); protocol B 'excellent' 78.2% vs A 63.6%
Trust score:3/5

total T3 concentration

1 evidences

Assessed whether povidone-iodine skin prep affects infants' thyroid hormones after cardiac surgery; cardiopulmonary bypass had larger effects than antiseptic used.

Trust comment: Prospective randomized trial in infants but small N (37) and cardiopulmonary bypass is a strong confounder.

Study Details

PMID:9295836
Participants:37
Impact:T3 decreased by postoperative day 2 in both bypass groups (groups 1 and 2)
Trust score:3/5

total T4 concentration

1 evidences

Assessed whether povidone-iodine skin prep affects infants' thyroid hormones after cardiac surgery; cardiopulmonary bypass had larger effects than antiseptic used.

Trust comment: Prospective randomized trial in infants but small N (37) and cardiopulmonary bypass is a strong confounder.

Study Details

PMID:9295836
Participants:37
Impact:T4 decreased by postoperative day 2 in both bypass groups; all groups showed increases after day 2 with no significant differences by day 5–8
Trust score:3/5

lesion density (arterial phase)

1 evidences

Crossover trial showed higher iodinated contrast concentration (iomeprol 400 vs 300 mg I/mL) improved arterial-phase lesion enhancement and detection in liver CT.

Trust comment: Randomized double-blind crossover but small pilot single-center study (N=22), limiting generalizability.

Study Details

PMID:15654576
Participants:22
Impact:increased with iomeprol 400 vs 300 (p=0.0016)
Trust score:3/5

lesion-to-liver contrast (arterial phase)

1 evidences

Crossover trial showed higher iodinated contrast concentration (iomeprol 400 vs 300 mg I/mL) improved arterial-phase lesion enhancement and detection in liver CT.

Trust comment: Randomized double-blind crossover but small pilot single-center study (N=22), limiting generalizability.

Study Details

PMID:15654576
Participants:22
Impact:increased with iomeprol 400 vs 300 (p=0.0005)
Trust score:3/5

lesion detection count (arterial phase)

1 evidences

Crossover trial showed higher iodinated contrast concentration (iomeprol 400 vs 300 mg I/mL) improved arterial-phase lesion enhancement and detection in liver CT.

Trust comment: Randomized double-blind crossover but small pilot single-center study (N=22), limiting generalizability.

Study Details

PMID:15654576
Participants:22
Impact:increased from 37 (300 mg/mL) to 42 (400 mg/mL)
Trust score:3/5

rise in serum creatinine >10%

1 evidences

Randomized comparison in patients with renal impairment showed fewer creatinine rises after angiography with iodixanol than with iohexol.

Trust comment: Prospective randomized comparison in a moderate-risk population but limited detail on randomization/blinding and sample size.

Study Details

PMID:10624328
Participants:102
Impact:iodixanol 8/54 (15%) vs iohexol 15/48 (31%); p<0.05
Trust score:3/5

dose–response for creatinine rise

1 evidences

Randomized comparison in patients with renal impairment showed fewer creatinine rises after angiography with iodixanol than with iohexol.

Trust comment: Prospective randomized comparison in a moderate-risk population but limited detail on randomization/blinding and sample size.

Study Details

PMID:10624328
Participants:102
Impact:creatinine rise positively correlated with dose of both contrast agents
Trust score:3/5

Peak plasma iodine concentration (Cmax)

1 evidences

Single-dose phase‑1 study in healthy men showing rapid plasma peaks, renal excretion of the iodinated agent, and mostly mild transient adverse events.

Trust comment: Well-conducted randomized, double-blind, placebo-controlled Phase 1 in 24 healthy men with detailed PK and safety data but limited sample size.

Study Details

PMID:24895062
Participants:24
Impact:Dose-proportional increase: 1.80 → 9.63 mg iodine/mL across 0.2→1.0 gI/kg doses
Trust score:4/5

Renal excretion (urinary recovery)

1 evidences

Single-dose phase‑1 study in healthy men showing rapid plasma peaks, renal excretion of the iodinated agent, and mostly mild transient adverse events.

Trust comment: Well-conducted randomized, double-blind, placebo-controlled Phase 1 in 24 healthy men with detailed PK and safety data but limited sample size.

Study Details

PMID:24895062
Participants:24
Impact:76.7% ±10.4 at 6 h; 89.0% ±11.4 at 24 h; 90.5% ±11.4 at 96 h
Trust score:4/5

adverse event incidence

3 evidences

Iobitridol had comparable safety and diagnostic efficacy to reference iohexol in coronary angiography with few adverse events.

Trust comment: Randomized, double-blind phase-III trial with adequate reporting of safety and efficacy outcomes.

Study Details

PMID:8619358
Participants:90
Impact:4/90 (4.4%) total
Trust score:4/5

Prospective double-blind randomized multicenter trial comparing two low-osmolar iodinated contrast agents for abdominal CT focusing on adverse events and diagnostic efficacy.

Trust comment: Large randomized, double-blind multicenter trial with clear adverse event data and statistical testing.

Study Details

PMID:9204351
Participants:518
Impact:2.3% (iopentol) vs 8.9% (iopromide), p<0.001
Trust score:4/5

Single-dose phase‑1 study in healthy men showing rapid plasma peaks, renal excretion of the iodinated agent, and mostly mild transient adverse events.

Trust comment: Well-conducted randomized, double-blind, placebo-controlled Phase 1 in 24 healthy men with detailed PK and safety data but limited sample size.

Study Details

PMID:24895062
Participants:24
Impact:14/24 (58%) experienced AEs (mostly mild); feeling hot in 12, rash/pruritus in 5; no serious AEs
Trust score:4/5

Target-tract attenuation (HU)

1 evidences

Randomized comparison of contrast injection protocols found high-concentration/high-flow iodine produced higher vessel attenuation and better image quality but more artifacts.

Trust comment: Prospective randomized study with 120 patients, objective HU measures and blinded readers, though artifact assessment had moderate interreader agreement.

Study Details

PMID:23746688
Participants:120
Impact:Protocol A: 374 ± 98 HU (highest); B: 309 ± 80; C: 352 ± 119; D: 325 ± 74 (A > B,D statistically)
Trust score:4/5

CT image quality (subjective score)

1 evidences

Randomized comparison of contrast injection protocols found high-concentration/high-flow iodine produced higher vessel attenuation and better image quality but more artifacts.

Trust comment: Prospective randomized study with 120 patients, objective HU measures and blinded readers, though artifact assessment had moderate interreader agreement.

Study Details

PMID:23746688
Participants:120
Impact:Protocol A median score 5 vs 4 for others (P < 0.0001)
Trust score:4/5

Artifacts on iodine perfusion maps

1 evidences

Randomized comparison of contrast injection protocols found high-concentration/high-flow iodine produced higher vessel attenuation and better image quality but more artifacts.

Trust comment: Prospective randomized study with 120 patients, objective HU measures and blinded readers, though artifact assessment had moderate interreader agreement.

Study Details

PMID:23746688
Participants:120
Impact:Protocols A and B: 3 artifacts vs Protocols C and D: 2 artifacts
Trust score:4/5

Vascular enhancement (HU)

1 evidences

Randomized whole-body CTA trial showing that low tube voltage with low-concentration contrast reduces iodine load and radiation while preserving vascular enhancement and image quality.

Trust comment: Randomized study of 109 patients with quantitative imaging and dose metrics; methods appropriate though subgroup comparisons moderate in size.

Study Details

PMID:24370154
Participants:109
Impact:Mean enhancement ranges: 240-80: 508–521 HU; 300-80: 546–593 HU; 370-120: 435–442 HU (differences p<0.05)
Trust score:4/5

Arterial attenuation (HU)

1 evidences

Randomized trial showing that halving contrast volume and using low tube voltage (80 kV) yields higher arterial attenuation and substantially lower radiation dose with good image quality.

Trust comment: Randomized clinical study (n=101) with clear quantitative endpoints showing dose and contrast reductions with preserved image quality.

Study Details

PMID:27421672
Participants:101
Impact:Group B (0.5 mL/kg, 80 kV): 499.22 ± 97.25 HU vs Group A (1 mL/kg, 100 kV): 374.36 ± 73.79 HU (P < 0.05)
Trust score:4/5

Radiation dose (DLP)

2 evidences

A BMI-based dual-energy CT protocol reduced radiation dose and iodinated contrast volume without degrading image quality or diagnostic accuracy.

Trust comment: Prospective randomized study with objective imaging metrics but modest sample size (n=90).

Study Details

PMID:40403339
Participants:90
Impact:Reduced A 287.9±34.0 → B 177.2±39.2 and C 183.8±23.1 mGy·cm (p<0.001)
Trust score:4/5

Randomized trial showing that halving contrast volume and using low tube voltage (80 kV) yields higher arterial attenuation and substantially lower radiation dose with good image quality.

Trust comment: Randomized clinical study (n=101) with clear quantitative endpoints showing dose and contrast reductions with preserved image quality.

Study Details

PMID:27421672
Participants:101
Impact:Group B DLP 116.60 mGy·cm ±21.22 vs Group A 225.74 mGy·cm ±21.80 (P < 0.01)
Trust score:4/5

Radiation dose (DLP, CTDIvol)

1 evidences

Randomized pediatric CT study found low-concentration contrast + low tube voltage (80 kVp) reduced iodine load (~37%) and radiation dose while maintaining comparable image quality.

Trust comment: Prospective randomized pediatric trial with n=48; small sample but appropriate measures and consistent findings for dose/iodine reduction.

Study Details

PMID:27577509
Participants:48
Impact:DLP Group A 104 mGy-cm ±45.81 vs Group B 224.5 ±45.83 (lower but not statistically significant); CTDIvol 1.44 vs 2.08 mGy (NS)
Trust score:4/5

Image quality (enhancement/SNR/CNR)

1 evidences

Randomized pediatric CT study found low-concentration contrast + low tube voltage (80 kVp) reduced iodine load (~37%) and radiation dose while maintaining comparable image quality.

Trust comment: Prospective randomized pediatric trial with n=48; small sample but appropriate measures and consistent findings for dose/iodine reduction.

Study Details

PMID:27577509
Participants:48
Impact:No significant differences between groups (all P > .05); subjective scores similar
Trust score:4/5

Serum creatinine change

3 evidences

Prospective randomized study indicating that larger amounts of iodinated contrast correlate with greater short-term rises in serum creatinine; CO2 with small added ioxaglate associated with lower renal risk than larger ioxaglate doses alone.

Trust comment: Prospective randomized clinical study with 123 patients and clinically relevant renal endpoints; findings support dose–response relationship between iodine amount and kidney injury.

Study Details

PMID:15640411
Participants:123
Impact:Amount of injected iodine significantly correlated with increase in serum creatinine and decreased creatinine clearance at 2 days (P = 0.011)
Trust score:4/5

Use of iodinated contrast (iohexol) was associated with increases in creatinine and a measurable rate of contrast-induced nephropathy compared with gadodiamide mixed with a small amount of iohexol.

Trust comment: Randomized study in high-risk patients with clear clinical endpoints but small sample (42) limits precision.

Study Details

PMID:16715187
Participants:42
Impact:mean creatinine rose significantly in iodine group (from 2.0±0.4 to 2.3±0.5 mg/dL, P=0.001) but not in gadolinium group (P=0.06)
Trust score:3/5

In ICU patients receiving ≥100 mL iodinated contrast, theophylline reduced incidence of contrast-induced nephropathy more than acetylcysteine.

Trust comment: Randomized ICU trial with clear clinical endpoints directly related to injury from iodinated contrast; results reported with percentages and timepoint creatinine values.

Study Details

PMID:16714461
Participants:91
Impact:Group T: decreased to 1.19 mg/dL at 12h and 1.16 mg/dL at 48h (baseline 1.25 mg/dL); Group AT: decreased to 1.21 mg/dL at 24h and 1.17 mg/dL at 48h; Group A: no significant change
Trust score:4/5

Incidence of ≥25% creatinine increase

1 evidences

Prospective randomized study indicating that larger amounts of iodinated contrast correlate with greater short-term rises in serum creatinine; CO2 with small added ioxaglate associated with lower renal risk than larger ioxaglate doses alone.

Trust comment: Prospective randomized clinical study with 123 patients and clinically relevant renal endpoints; findings support dose–response relationship between iodine amount and kidney injury.

Study Details

PMID:15640411
Participants:123
Impact:Randomized groups: CO2+small ioxaglate 1/37 vs ioxaglate alone 3/45 experienced >25% creatinine increase within 2 days
Trust score:4/5

Renal impairment risk vs contrast volume

1 evidences

Prospective randomized study indicating that larger amounts of iodinated contrast correlate with greater short-term rises in serum creatinine; CO2 with small added ioxaglate associated with lower renal risk than larger ioxaglate doses alone.

Trust comment: Prospective randomized clinical study with 123 patients and clinically relevant renal endpoints; findings support dose–response relationship between iodine amount and kidney injury.

Study Details

PMID:15640411
Participants:123
Impact:Risk of renal function impairment increased with larger administered iodinated contrast volume
Trust score:4/5

anterior epidural spread

1 evidences

Compared two epidural injection approaches using iodinated contrast; the parasagittal interlaminar (PIL) approach produced more anterior contrast spread and shorter fluoroscopy time, pain relief was similar.

Trust comment: Randomized prospective study with clear outcomes and adequate reporting but modest sample size (n=60).

Study Details

PMID:18227326
Participants:60
Impact:+25 percentage points (100% vs 75% anterior spread; 29/29 vs 21/28)
Trust score:4/5

mean spread grade

1 evidences

Compared two epidural injection approaches using iodinated contrast; the parasagittal interlaminar (PIL) approach produced more anterior contrast spread and shorter fluoroscopy time, pain relief was similar.

Trust comment: Randomized prospective study with clear outcomes and adequate reporting but modest sample size (n=60).

Study Details

PMID:18227326
Participants:60
Impact:+0.47 (1.93 vs 1.46), P=0.003
Trust score:4/5

fluoroscopy time

1 evidences

Compared two epidural injection approaches using iodinated contrast; the parasagittal interlaminar (PIL) approach produced more anterior contrast spread and shorter fluoroscopy time, pain relief was similar.

Trust comment: Randomized prospective study with clear outcomes and adequate reporting but modest sample size (n=60).

Study Details

PMID:18227326
Participants:60
Impact:-17.3 s (28.96 s vs 46.25 s), P=0.003
Trust score:4/5

analgesia (VAS)

1 evidences

Compared two epidural injection approaches using iodinated contrast; the parasagittal interlaminar (PIL) approach produced more anterior contrast spread and shorter fluoroscopy time, pain relief was similar.

Trust comment: Randomized prospective study with clear outcomes and adequate reporting but modest sample size (n=60).

Study Details

PMID:18227326
Participants:60
Impact:no difference between groups
Trust score:4/5

patient-reported pain

1 evidences

Randomized trial comparing high (400 mg/ml) vs lower (300 mg/ml) iodinated contrast concentrations; overall patient-reported discomfort was very low with only a small difference in pain favoring lower concentration.

Trust comment: Large randomized prospective trial (n=253) with patient-reported outcomes and clear reporting; clinically small effect sizes.

Study Details

PMID:32215899
Participants:253
Impact:lower with 300 mg/ml (mean VAS 1.0 vs 1.3; P=0.005)
Trust score:4/5

taste sensation

1 evidences

Randomized trial comparing high (400 mg/ml) vs lower (300 mg/ml) iodinated contrast concentrations; overall patient-reported discomfort was very low with only a small difference in pain favoring lower concentration.

Trust comment: Large randomized prospective trial (n=253) with patient-reported outcomes and clear reporting; clinically small effect sizes.

Study Details

PMID:32215899
Participants:253
Impact:no significant difference (mean VAS 2.0 vs 2.4; P=0.08)
Trust score:4/5

diagnostic interpretability (image quality)

1 evidences

Randomized trial showing dual-energy CT allowed >50% reduction in iodinated contrast volume (35 mL vs 80 mL) with comparable diagnostic interpretability and similar CNR/SNR after adjustment.

Trust comment: Prospective randomized trial with objective image quality metrics but moderate sample size (n=102); methods well described.

Study Details

PMID:25151920
Participants:102
Impact:comparable (diagnostic interpretability ~91% vs 96%; no meaningful difference)
Trust score:4/5

SNR/CNR

1 evidences

Randomized trial showing dual-energy CT allowed >50% reduction in iodinated contrast volume (35 mL vs 80 mL) with comparable diagnostic interpretability and similar CNR/SNR after adjustment.

Trust comment: Prospective randomized trial with objective image quality metrics but moderate sample size (n=102); methods well described.

Study Details

PMID:25151920
Participants:102
Impact:no persistent clinically important difference after adjustment (CNR P=0.95; SNR difference lost significance when adjusted)
Trust score:4/5

diagnostic image quality (per-patient)

1 evidences

Prospective randomized study in normal-weight patients showing CCTA at 70 kVp with 28 mL iodinated contrast and low injection rate produced diagnostic image quality similar to standard protocol (40 mL).

Trust comment: Randomized trial with clear inclusion criteria and objective/subjective image quality metrics in 104 patients, but applicable mainly to normal-weight, low-HR patients.

Study Details

PMID:28860894
Participants:104
Impact:no significant difference (96.1% vs 94.2% diagnostic IQ; P=0.647)
Trust score:4/5

vessel CT attenuation / SNR / CNR

1 evidences

Prospective randomized study in normal-weight patients showing CCTA at 70 kVp with 28 mL iodinated contrast and low injection rate produced diagnostic image quality similar to standard protocol (40 mL).

Trust comment: Randomized trial with clear inclusion criteria and objective/subjective image quality metrics in 104 patients, but applicable mainly to normal-weight, low-HR patients.

Study Details

PMID:28860894
Participants:104
Impact:some vessel CT values and SNR/CNR differences between protocols but overall diagnostic metrics adequate for both
Trust score:4/5

incidence of pain

1 evidences

Double-blind randomized trial in diabetics with critical limb ischemia showing Iodixanol 270 caused substantially less intra-arterial pain and heat sensation than Ioversol 320.

Trust comment: Prospective double-blind randomized trial (n=148) with large, significant differences in patient-reported discomfort and appropriate blinding/randomization.

Study Details

PMID:24478190
Participants:148
Impact:lower with Iodixanol (25.7% vs 74.3%; P<0.0001)
Trust score:4/5

heat sensation incidence

1 evidences

Double-blind randomized trial in diabetics with critical limb ischemia showing Iodixanol 270 caused substantially less intra-arterial pain and heat sensation than Ioversol 320.

Trust comment: Prospective double-blind randomized trial (n=148) with large, significant differences in patient-reported discomfort and appropriate blinding/randomization.

Study Details

PMID:24478190
Participants:148
Impact:lower with Iodixanol (55.4% vs 85.1%; P<0.0001)
Trust score:4/5

discomfort severity (VAS)

1 evidences

Double-blind randomized trial in diabetics with critical limb ischemia showing Iodixanol 270 caused substantially less intra-arterial pain and heat sensation than Ioversol 320.

Trust comment: Prospective double-blind randomized trial (n=148) with large, significant differences in patient-reported discomfort and appropriate blinding/randomization.

Study Details

PMID:24478190
Participants:148
Impact:mean VAS much lower with Iodixanol (8.1 vs 36.0 after first injection; P<0.001)
Trust score:4/5

post-contrast acute kidney injury (PC-AKI) rate

1 evidences

Phase III randomized non-inferiority trial in CKD stage IIIb patients showed oral hydration was non-inferior to IV bicarbonate hydration to prevent post-contrast acute kidney injury after CT with iodinated contrast.

Trust comment: Prospective randomized phase III non-inferiority trial with clear endpoints and reasonable sample of evaluable patients (n=228); methods appropriate.

Study Details

PMID:33516141
Participants:228
Impact:oral 4.4% vs IV 5.3% (non-inferior)
Trust score:4/5

persistent PC-AKI

1 evidences

Phase III randomized non-inferiority trial in CKD stage IIIb patients showed oral hydration was non-inferior to IV bicarbonate hydration to prevent post-contrast acute kidney injury after CT with iodinated contrast.

Trust comment: Prospective randomized phase III non-inferiority trial with clear endpoints and reasonable sample of evaluable patients (n=228); methods appropriate.

Study Details

PMID:33516141
Participants:228
Impact:1.8% in both arms
Trust score:4/5

need for dialysis

1 evidences

Phase III randomized non-inferiority trial in CKD stage IIIb patients showed oral hydration was non-inferior to IV bicarbonate hydration to prevent post-contrast acute kidney injury after CT with iodinated contrast.

Trust comment: Prospective randomized phase III non-inferiority trial with clear endpoints and reasonable sample of evaluable patients (n=228); methods appropriate.

Study Details

PMID:33516141
Participants:228
Impact:none in either arm during first month
Trust score:4/5

Acetyl-cholinesterase activity

1 evidences

Small randomized study showing transient decreases in plasma acetyl- and butyrylcholinesterase activity after injection of iodinated contrast agents.

Trust comment: Randomized in vivo human study with clear biochemical endpoints but small sample size limits generalizability.

Study Details

PMID:11402958
Participants:48
Impact:Decrease up to −12.9% (G1) and −13.9% (G2); remained within normal range.
Trust score:3/5

Butyrylcholinesterase activity

1 evidences

Small randomized study showing transient decreases in plasma acetyl- and butyrylcholinesterase activity after injection of iodinated contrast agents.

Trust comment: Randomized in vivo human study with clear biochemical endpoints but small sample size limits generalizability.

Study Details

PMID:11402958
Participants:48
Impact:Decrease up to −8.2% (G1) and −18.4% (G2); remained within normal range.
Trust score:3/5

Contrast-induced nephropathy (serum creatinine increase ≥25%)

1 evidences

Multicenter randomized double-blind trial showing fenoldopam did not reduce contrast-induced nephropathy after iodinated contrast exposure.

Trust comment: Well-designed multicenter double-blind RCT with objective endpoints and adequate sample size for primary outcome.

Study Details

PMID:14600187
Participants:315
Impact:33.6% fenoldopam vs 30.1% placebo (relative risk 1.11; P=0.61) — no preventive effect.
Trust score:4/5

30-day clinical outcomes (death/dialysis/rehospitalization)

1 evidences

Multicenter randomized double-blind trial showing fenoldopam did not reduce contrast-induced nephropathy after iodinated contrast exposure.

Trust comment: Well-designed multicenter double-blind RCT with objective endpoints and adequate sample size for primary outcome.

Study Details

PMID:14600187
Participants:315
Impact:No significant differences (death 2.0% vs 3.8%; dialysis 2.6% vs 1.9%).
Trust score:4/5

Intraoperative contamination (CFU≥1)

1 evidences

Per-protocol analysis of a randomized trial showing iodinated antimicrobial drapes reduced intraoperative bacterial contamination in knee arthroplasty.

Trust comment: Large randomized multicenter trial with a per-protocol analysis and some missing samples; effect on contamination is statistically robust.

Study Details

PMID:32011378
Participants:1187
Impact:10% with iodinated drape vs 15% without (absolute −5%; relative risk reduction 35%; NNT 18; OR 0.61, p=0.005).
Trust score:4/5

Drape separation from skin (>10 mm)

1 evidences

Per-protocol analysis of a randomized trial showing iodinated antimicrobial drapes reduced intraoperative bacterial contamination in knee arthroplasty.

Trust comment: Large randomized multicenter trial with a per-protocol analysis and some missing samples; effect on contamination is statistically robust.

Study Details

PMID:32011378
Participants:1187
Impact:Increased contamination odds (OR 3.54; p=0.0013).
Trust score:4/5

Contrast-induced nephropathy (serum creatinine rise >25% or >44 μmol/L)

1 evidences

Randomized non-inferiority trial showing no prophylactic IV hydration was non-inferior and cost-saving versus hydration for preventing contrast-induced nephropathy.

Trust comment: Prospective randomized phase 3 non-inferiority trial with masked lab assessment and high follow-up rates; results appear reliable.

Study Details

PMID:29328007
Participants:660
Impact:2.6% no prophylaxis vs 2.7% hydration (absolute difference −0.1%; non-inferior within 2.1% margin).
Trust score:4/5

Complications of IV hydration

1 evidences

Randomized non-inferiority trial showing no prophylactic IV hydration was non-inferior and cost-saving versus hydration for preventing contrast-induced nephropathy.

Trust comment: Prospective randomized phase 3 non-inferiority trial with masked lab assessment and high follow-up rates; results appear reliable.

Study Details

PMID:29328007
Participants:660
Impact:Hydration-related complications in 5.5% of hydrated patients; no haemodialysis or related deaths within 35 days.
Trust score:4/5

Socket healing speed

1 evidences

Randomized trial in HIV-positive patients showing sockets treated with an iodoform-containing paste healed faster than sutured-only sockets.

Trust comment: Randomized controlled trial but small sample (n=40) and limited quantitative reporting in the abstract.

Study Details

PMID:16483699
Participants:40
Impact:Treated group healed more quickly than control (no numerical data reported in abstract).
Trust score:3/5

overall acute adverse reaction incidence

1 evidences

Rehydration before contrast CT did not change the incidence of acute adverse reactions to iodinated contrast compared with control.

Trust comment: Large prospective randomized trial with clear endpoints and adequate sample size, supporting high trustworthiness.

Study Details

PMID:27533472
Participants:5959
Impact:4.3% overall (254/5959); rehydration 4.4% vs adjusted control 4.5% (99/2244 vs 100/2244); no significant difference (p=0.9422)
Trust score:5/5

allergiclike reaction incidence

1 evidences

Rehydration before contrast CT did not change the incidence of acute adverse reactions to iodinated contrast compared with control.

Trust comment: Large prospective randomized trial with clear endpoints and adequate sample size, supporting high trustworthiness.

Study Details

PMID:27533472
Participants:5959
Impact:subclinically dehydrated 2.5% vs hydrated 2.2% (25/997 vs 111/4962); no significant difference (p=0.6062)
Trust score:5/5

physiologic reaction incidence

1 evidences

Rehydration before contrast CT did not change the incidence of acute adverse reactions to iodinated contrast compared with control.

Trust comment: Large prospective randomized trial with clear endpoints and adequate sample size, supporting high trustworthiness.

Study Details

PMID:27533472
Participants:5959
Impact:subclinically dehydrated 2.2% vs hydrated 1.9% (22/997 vs 96/4962); no significant difference (p=0.5793)
Trust score:5/5

contrast medium volume

2 evidences

A BMI-based dual-energy CT protocol reduced radiation dose and iodinated contrast volume without degrading image quality or diagnostic accuracy.

Trust comment: Prospective randomized study with objective imaging metrics but modest sample size (n=90).

Study Details

PMID:40403339
Participants:90
Impact:Reduced 50.0±0.0 mL → 22.1±3.0 mL (B) and 23.2±4.0 mL (C) (p<0.001)
Trust score:4/5

In 255 patients, deep learning image reconstruction plus high-concentration iodinated contrast enabled a double-low protocol (lower radiation and lower contrast volume) while maintaining or improving image quality.

Trust comment: Prospective single-center randomized assignment with clear quantitative imaging endpoints and 255 patients; vendor-specific DLIR limits generalizability.

Study Details

PMID:39299952
Participants:255
Impact:Group C 44.8 mL vs Group A 57.7 mL (≈ −22% C vs A); Group B 50.4 mL (intermediate)
Trust score:4/5

diagnostic accuracy / image quality

1 evidences

A BMI-based dual-energy CT protocol reduced radiation dose and iodinated contrast volume without degrading image quality or diagnostic accuracy.

Trust comment: Prospective randomized study with objective imaging metrics but modest sample size (n=90).

Study Details

PMID:40403339
Participants:90
Impact:No significant difference among protocols
Trust score:4/5

bacterial colonization (CFU/mL)

1 evidences

Iodoform+calendula-coated silk sutures showed significantly less bacterial colonization than uncoated sutures.

Trust comment: Small randomized trial with clear microbiological outcome but limited sample size, lowering generalizability.

Study Details

PMID:22841431
Participants:40
Impact:Significant reduction in CFU/mL with coated sutures versus control (P=0.002)
Trust score:3/5

epistaxis control efficacy

1 evidences

No difference in efficacy or patient tolerance between Merocel tampons and BIPP (iodoform-containing paste) for severe epistaxis.

Trust comment: Prospective randomized trial but relatively small sample (n=50), limiting precision of comparisons.

Study Details

PMID:8548959
Participants:50
Impact:No significant difference between Merocel and BIPP groups in bleeding control or patient tolerance
Trust score:3/5

treatment success rate

1 evidences

In children needing pulpectomy, an iodoform paste showed non-inferior 24‑month success versus a calcium hydroxide/iodoform paste.

Trust comment: Randomized non-inferiority trial in children with 24-month follow-up and low attrition, well reported.

Study Details

PMID:34856038
Participants:61
Impact:GP 86.8% vs CaOH/Iodof 78.4% (difference +8.4 percentage points); GP non-inferior
Trust score:4/5

interappointment emergency occurrence

1 evidences

Tinidazole-dexamethasone-iodoform intracanal paste reduced interappointment emergencies and showed good long-term results versus formocresol.

Trust comment: Large randomized allocation with two-year follow-up supports moderate-to-high trust in the reported clinical benefit.

Study Details

PMID:15269867
Participants:520
Impact:Significantly reduced occurrence in tinidazole-dexamethasone-iodoform group versus formocresol (P<0.05)
Trust score:4/5

clinical success

1 evidences

Randomized comparison in children of two root canal filling pastes (iodoform-based vs Calen®/ZO [calcium hydroxide/ZnO]); both had high clinical/radiographic success at 12 months.

Trust comment: Randomized trial with blinded radiographic assessment but small sample (23 children) and descriptive analyses limit precision.

Study Details

PMID:30758402
Participants:23
Impact:Both groups successful at 12 months; 1 tooth failure in iodoform group
Trust score:3/5

radiographic success

1 evidences

Randomized comparison in children of two root canal filling pastes (iodoform-based vs Calen®/ZO [calcium hydroxide/ZnO]); both had high clinical/radiographic success at 12 months.

Trust comment: Randomized trial with blinded radiographic assessment but small sample (23 children) and descriptive analyses limit precision.

Study Details

PMID:30758402
Participants:23
Impact:No difference between groups at 12 months
Trust score:3/5

root canal filling level

1 evidences

Randomized comparison in children of two root canal filling pastes (iodoform-based vs Calen®/ZO [calcium hydroxide/ZnO]); both had high clinical/radiographic success at 12 months.

Trust comment: Randomized trial with blinded radiographic assessment but small sample (23 children) and descriptive analyses limit precision.

Study Details

PMID:30758402
Participants:23
Impact:Better filling level with Calen®/ZO (iodoform inferior)
Trust score:3/5

postoperative pain

2 evidences

Chlorhexidine and hydrogen peroxide irrigation reduced postoperative pain and swelling after molar extraction; povidone‑iodine did not show those benefits compared with control.

Trust comment: Randomized single‑blind trial (n=112) with appropriate follow-up and statistical comparisons; conclusions limited to short‑term postoperative outcomes.

Study Details

PMID:39952838
Participants:112
Impact:povidone‑iodine showed no significant reduction in pain versus control; CHX and HP had significantly lower pain on days 3 and 7 (p≤0.033)
Trust score:4/5

Preoperative povidone-iodine vaginal cleansing reduced postoperative pain, inflammatory marker (CRP) and analgesic need after elective cesarean.

Trust comment: Prospective randomized controlled trial (n=120) with clinical and laboratory endpoints.

Study Details

PMID:27049354
Participants:120
Impact:Statistically significantly reduced in povidone-iodine group versus control
Trust score:4/5

treatment success

1 evidences

Randomized comparison of three root canal filling materials (Endoflas, zinc oxide eugenol, Metapex) in primary molars over 18 months; Metapex (a calcium hydroxide/iodoform product) showed 100% success while the other two showed 93.3% success; differences were not statistically significant.

Trust comment: Randomized tooth-level trial with moderate follow-up (up to 18 months); modest sample size and lack of extensive blinding limit certainty.

Study Details

PMID:22046693
Participants:45
Impact:Metapex 100% success vs Endoflas/ZOE 93.3% success
Trust score:3/5

overfilling/voids

1 evidences

Randomized comparison of three root canal filling materials (Endoflas, zinc oxide eugenol, Metapex) in primary molars over 18 months; Metapex (a calcium hydroxide/iodoform product) showed 100% success while the other two showed 93.3% success; differences were not statistically significant.

Trust comment: Randomized tooth-level trial with moderate follow-up (up to 18 months); modest sample size and lack of extensive blinding limit certainty.

Study Details

PMID:22046693
Participants:45
Impact:Overfilling and voids more common with Metapex
Trust score:3/5

canal filling quality

1 evidences

In children needing pulpectomy, an iodoform paste showed non-inferior 24‑month success versus a calcium hydroxide/iodoform paste.

Trust comment: Randomized non-inferiority trial in children with 24-month follow-up and low attrition, well reported.

Study Details

PMID:34856038
Participants:61
Impact:no clinically important difference reported between groups
Trust score:4/5

clinical and radiographic success

1 evidences

In children (5–9 y), Portland cement combined with radiopacifiers used for pulpotomy had 100% clinical and radiographic success over 24 months.

Trust comment: Small randomized study with clear outcomes but limited sample size (30 teeth) and no detailed subgroup data.

Study Details

PMID:25788172
Participants:30
Impact:100% success across groups at 6, 12, and 24 months; no significant differences
Trust score:3/5

diagnostic accuracy

1 evidences

Iso-osmolar (iodixanol) and low-osmolar (iopamidol) iodinated contrasts had similar diagnostic accuracy and image quality, but iodixanol caused less moderate-to-severe flushing.

Trust comment: Large, multicenter randomized trial with blinded core-lab reading and clinically relevant endpoints.

Study Details

PMID:27178781
Participants:266
Impact:Similar accuracy: iodixanol 91.7% vs iopamidol 90.2% (per-patient)
Trust score:5/5

patient-reported moderate-to-severe flushing

1 evidences

Iso-osmolar (iodixanol) and low-osmolar (iopamidol) iodinated contrasts had similar diagnostic accuracy and image quality, but iodixanol caused less moderate-to-severe flushing.

Trust comment: Large, multicenter randomized trial with blinded core-lab reading and clinically relevant endpoints.

Study Details

PMID:27178781
Participants:266
Impact:iodixanol 3.0% vs iopamidol 12.8% (−9.8 percentage points); for ≥55 years 8.5% vs 24.6% (−16.1 pp)
Trust score:5/5

iodinated contrast volume

1 evidences

Automated CYDAR fusion imaging reduced radiation metrics but used more iodinated contrast during aorto-iliac endovascular procedures.

Trust comment: Small single-center randomized pilot study with consistent signal but limited power.

Study Details

PMID:33823257
Participants:37
Impact:increased (41 mL vs 30 mL)
Trust score:3/5

pulmonary function

1 evidences

Sixteen weeks of iodinated glycerol did not improve pulmonary function, symptoms, or sputum properties compared with placebo in chronic bronchitis.

Trust comment: Double-blind randomized placebo-controlled cross-over trial with completed-subject reporting and clear negative results.

Study Details

PMID:8620704
Participants:26
Impact:no significant change with iodinated glycerol versus placebo
Trust score:4/5

symptom score / sputum properties

1 evidences

Sixteen weeks of iodinated glycerol did not improve pulmonary function, symptoms, or sputum properties compared with placebo in chronic bronchitis.

Trust comment: Double-blind randomized placebo-controlled cross-over trial with completed-subject reporting and clear negative results.

Study Details

PMID:8620704
Participants:26
Impact:no significant difference between iodinated glycerol and placebo; Global score improved in both periods but no treatment difference
Trust score:4/5

bone coverage speed

1 evidences

PRGF treated dry socket led to faster bone coverage and reduced inflammation and bad breath compared with Alvogyl.

Trust comment: Randomized, single-blind controlled trial with clear outcomes though sample size is modest.

Study Details

PMID:29382467
Participants:38
Impact:faster with PRGF (P<0.05)
Trust score:4/5

inflammation

1 evidences

PRGF treated dry socket led to faster bone coverage and reduced inflammation and bad breath compared with Alvogyl.

Trust comment: Randomized, single-blind controlled trial with clear outcomes though sample size is modest.

Study Details

PMID:29382467
Participants:38
Impact:decreased with PRGF (P<0.05)
Trust score:4/5

halitosis

1 evidences

PRGF treated dry socket led to faster bone coverage and reduced inflammation and bad breath compared with Alvogyl.

Trust comment: Randomized, single-blind controlled trial with clear outcomes though sample size is modest.

Study Details

PMID:29382467
Participants:38
Impact:decreased with PRGF (P<0.05)
Trust score:4/5

clinical success (MPRCF, 12 months)

1 evidences

In primary molar pulpectomies, ZOE and the modified zinc‑oxide/iodoform/calcium‑hydroxide compound showed high clinical/radiographic success at 6 and 12 months, with different resorption profiles among materials.

Trust comment: Randomized allocation with blinded radiographic/clinical assessment and adequate sample for dental study.

Study Details

PMID:26080888
Participants:155
Impact:100%
Trust score:4/5

radiographic success (MPRCF, 12 months)

1 evidences

In primary molar pulpectomies, ZOE and the modified zinc‑oxide/iodoform/calcium‑hydroxide compound showed high clinical/radiographic success at 6 and 12 months, with different resorption profiles among materials.

Trust comment: Randomized allocation with blinded radiographic/clinical assessment and adequate sample for dental study.

Study Details

PMID:26080888
Participants:155
Impact:100%
Trust score:4/5

resorption at same rate as root (MPRCF, 12 months)

1 evidences

In primary molar pulpectomies, ZOE and the modified zinc‑oxide/iodoform/calcium‑hydroxide compound showed high clinical/radiographic success at 6 and 12 months, with different resorption profiles among materials.

Trust comment: Randomized allocation with blinded radiographic/clinical assessment and adequate sample for dental study.

Study Details

PMID:26080888
Participants:155
Impact:40.9%
Trust score:4/5

contrast-induced nephropathy (CIN) incidence

5 evidences

In high-risk PCI patients given iodinated contrast, IV prostaglandin E1 reduced the incidence of contrast-induced nephropathy versus control hydration alone.

Trust comment: Randomized trial with clinically relevant endpoint but moderate sample size and limited detail on blinding and follow-up.

Study Details

PMID:24570327
Participants:163
Impact:-7.4 percentage points (3.7% vs 11.1%)
Trust score:3/5

In patients undergoing coronary angiography with iodinated contrast, nebivolol pretreatment showed a nonsignificant trend toward less creatinine rise and slightly lower CIN incidence versus controls.

Trust comment: - Checklist of steps performed: 1) Confirm human trial involving iodinated contrast and prophylactic interventions; 2) Extract main renal outcomes (CIN incidence, serum creatinine changes); 3) Verify participant count and group allocation; 4) Judge study quality and report observed changes. Randomized study in 120 patients; primary endpoint differences were not statistically significant, so conclusions about protection are tentative.

Study Details

PMID:22262230
Participants:120
Impact:NAC 22.5%, nebivolol 20.0%, hydration-only 27.5% (P = 0.72; no significant difference)
Trust score:3/5

Large randomized trial comparing two iodine-based contrast agents (low-osmolar vs iso-osmolar) in high-risk patients; measured contrast-induced nephropathy (CIN), dialysis, and 30-day outcomes.

Trust comment: Large randomized trial with clear clinical endpoints and adequate sample size, single-center but robust.

Study Details

PMID:37220640
Participants:2268
Impact:15% overall; iso-osmolar 15.2% vs low-osmolar 15.1% (no significant difference)
Trust score:4/5

CO2-guided angioplasty reduced iodinated contrast exposure and had a low incidence of contrast-induced nephropathy but notable CO2-related complications.

Trust comment: Prospective multicenter registry with clear endpoints; observational design but clinically relevant data on iodinated contrast exposure.

Study Details

PMID:25380326
Participants:98
Impact:5.1% (5/98)
Trust score:4/5

In children with normal renal function, iobitridol was noninferior to iodixanol for creatinine clearance change and rates of contrast-induced nephropathy were not significantly different.

Trust comment: Large, double-blind randomized multicenter pediatric RCT with predefined endpoints and appropriate analysis (high quality).

Study Details

PMID:21713440
Participants:128
Impact:4.8% vs 10.6% (iobitridol vs iodixanol); no significant difference (P=0.72)
Trust score:5/5

average iodinated contrast dose

1 evidences

CO2-guided angioplasty reduced iodinated contrast exposure and had a low incidence of contrast-induced nephropathy but notable CO2-related complications.

Trust comment: Prospective multicenter registry with clear endpoints; observational design but clinically relevant data on iodinated contrast exposure.

Study Details

PMID:25380326
Participants:98
Impact:15.0 ±18.1 mL
Trust score:4/5

CO2 angiography-related complications

1 evidences

CO2-guided angioplasty reduced iodinated contrast exposure and had a low incidence of contrast-induced nephropathy but notable CO2-related complications.

Trust comment: Prospective multicenter registry with clear endpoints; observational design but clinically relevant data on iodinated contrast exposure.

Study Details

PMID:25380326
Participants:98
Impact:17.3% (17/98)
Trust score:4/5

transient ECG excitability disorders

1 evidences

Iobitridol had comparable safety and diagnostic efficacy to reference iohexol in coronary angiography with few adverse events.

Trust comment: Randomized, double-blind phase-III trial with adequate reporting of safety and efficacy outcomes.

Study Details

PMID:8619358
Participants:90
Impact:10 patients (iobitridol) vs 6 patients (iohexol)
Trust score:4/5

polyp detection sensitivity (>=1 cm)

1 evidences

In 180 patients, prone imaging improved polyp detection but adding oral iodinated contrast did not significantly increase polyp detection.

Trust comment: Prospective, randomized assignments with colonoscopy gold standard and adequate sample size support moderate-high trustworthiness.

Study Details

PMID:10966698
Participants:180
Impact:prone vs supine: +15 percentage points (70% to 85%)
Trust score:4/5

polyp detection sensitivity (>=0.5 cm)

1 evidences

In 180 patients, prone imaging improved polyp detection but adding oral iodinated contrast did not significantly increase polyp detection.

Trust comment: Prospective, randomized assignments with colonoscopy gold standard and adequate sample size support moderate-high trustworthiness.

Study Details

PMID:10966698
Participants:180
Impact:prone vs supine: +13 percentage points (75% to 88%)
Trust score:4/5

effect of oral iodinated contrast on polyp detection

1 evidences

In 180 patients, prone imaging improved polyp detection but adding oral iodinated contrast did not significantly increase polyp detection.

Trust comment: Prospective, randomized assignments with colonoscopy gold standard and adequate sample size support moderate-high trustworthiness.

Study Details

PMID:10966698
Participants:180
Impact:no significant change reported
Trust score:4/5

PICC placement success rate

1 evidences

Randomized study in 74 patients comparing CO2 vs iodinated contrast for PICC placement: iodinated contrast had higher placement success, with similar procedure times and no adverse events reported for CO2.

Trust comment: Prospective randomized human trial with clear procedural endpoints; moderate-high quality.

Study Details

PMID:7648588
Participants:74
Impact:iodinated contrast 100% vs CO2 88% (+12 percentage points)
Trust score:4/5

procedure time

1 evidences

Randomized study in 74 patients comparing CO2 vs iodinated contrast for PICC placement: iodinated contrast had higher placement success, with similar procedure times and no adverse events reported for CO2.

Trust comment: Prospective randomized human trial with clear procedural endpoints; moderate-high quality.

Study Details

PMID:7648588
Participants:74
Impact:no significant difference (mean ~23 min both groups)
Trust score:4/5

adverse reactions

1 evidences

Randomized study in 74 patients comparing CO2 vs iodinated contrast for PICC placement: iodinated contrast had higher placement success, with similar procedure times and no adverse events reported for CO2.

Trust comment: Prospective randomized human trial with clear procedural endpoints; moderate-high quality.

Study Details

PMID:7648588
Participants:74
Impact:no adverse reactions reported with CO2; no notable adverse events reported with iodinated contrast
Trust score:4/5

functional outcome (mRS 0-2)

1 evidences

Review of 133 stroke patients found numerical outcome advantages favoring iso-osmolal iodixanol over low-osmolal contrast for several endpoints, but results were inconclusive.

Trust comment: Post-hoc subgroup comparison within a trial with modest sample size and imbalance in covariates, so results are suggestive but not definitive.

Study Details

PMID:26228892
Participants:133
Impact:risk estimates favored iodixanol (numerical improvement; not conclusive)
Trust score:3/5

reperfusion (modified TICI 2b-3)

1 evidences

Review of 133 stroke patients found numerical outcome advantages favoring iso-osmolal iodixanol over low-osmolal contrast for several endpoints, but results were inconclusive.

Trust comment: Post-hoc subgroup comparison within a trial with modest sample size and imbalance in covariates, so results are suggestive but not definitive.

Study Details

PMID:26228892
Participants:133
Impact:point estimates favored iodixanol (not conclusive)
Trust score:3/5

intracranial hemorrhage (symptomatic/asymptomatic)

1 evidences

Review of 133 stroke patients found numerical outcome advantages favoring iso-osmolal iodixanol over low-osmolal contrast for several endpoints, but results were inconclusive.

Trust comment: Post-hoc subgroup comparison within a trial with modest sample size and imbalance in covariates, so results are suggestive but not definitive.

Study Details

PMID:26228892
Participants:133
Impact:numerically less with iodixanol (not conclusive)
Trust score:3/5

nephrographic phase onset time

1 evidences

Bolus-tracking in 75 patients showed nephrographic phase onset varies with contrast volume and injection rate; onset times differed across groups (mean 75–103 s).

Trust comment: Prospective study with objective CT endpoints and multivariate analysis in a moderate sample size; credible.

Study Details

PMID:10189457
Participants:75
Impact:overall mean 89 s (group1 103 s; group2 91 s; group3 75 s; P<.001)
Trust score:4/5

renal enhancement degree

1 evidences

Bolus-tracking in 75 patients showed nephrographic phase onset varies with contrast volume and injection rate; onset times differed across groups (mean 75–103 s).

Trust comment: Prospective study with objective CT endpoints and multivariate analysis in a moderate sample size; credible.

Study Details

PMID:10189457
Participants:75
Impact:increased with contrast volume; contrast volume, age, and weight independent predictors
Trust score:4/5

injection rate effect

1 evidences

Bolus-tracking in 75 patients showed nephrographic phase onset varies with contrast volume and injection rate; onset times differed across groups (mean 75–103 s).

Trust comment: Prospective study with objective CT endpoints and multivariate analysis in a moderate sample size; credible.

Study Details

PMID:10189457
Participants:75
Impact:higher injection rate associated with earlier nephrographic phase onset
Trust score:4/5

small bowel distention

1 evidences

Compared dilute iodinated oral contrast with other low-attenuation agents for abdominal-pelvic CT; PEG performed best for bowel distention and transit.

Trust comment: Randomized trial with 98 subjects and objective imaging outcomes, but single-centre and some comparisons lacked statistical significance.

Study Details

PMID:16252139
Participants:98
Impact:inferior to PEG (trend; many comparisons not statistically significant)
Trust score:3/5

bowel wall visualization

1 evidences

Compared dilute iodinated oral contrast with other low-attenuation agents for abdominal-pelvic CT; PEG performed best for bowel distention and transit.

Trust comment: Randomized trial with 98 subjects and objective imaging outcomes, but single-centre and some comparisons lacked statistical significance.

Study Details

PMID:16252139
Participants:98
Impact:inferior to PEG (trend; many comparisons not statistically significant)
Trust score:3/5

colonic transit

1 evidences

Compared dilute iodinated oral contrast with other low-attenuation agents for abdominal-pelvic CT; PEG performed best for bowel distention and transit.

Trust comment: Randomized trial with 98 subjects and objective imaging outcomes, but single-centre and some comparisons lacked statistical significance.

Study Details

PMID:16252139
Participants:98
Impact:inferior to PEG (trend; many comparisons not statistically significant)
Trust score:3/5

right portal vein visualization

1 evidences

Compared two retrograde venography techniques using iodinated contrast during TIPS; balloon occlusion markedly improved portal vein visualization and portogram quality and reduced procedure time.

Trust comment: Prospective comparative study with clear, clinically relevant endpoints and statistically significant differences, though not randomized.

Study Details

PMID:25540929
Participants:58
Impact:71.3% with balloon vs 13.3% with wedged
Trust score:4/5

portogram quality score

1 evidences

Compared two retrograde venography techniques using iodinated contrast during TIPS; balloon occlusion markedly improved portal vein visualization and portogram quality and reduced procedure time.

Trust comment: Prospective comparative study with clear, clinically relevant endpoints and statistically significant differences, though not randomized.

Study Details

PMID:25540929
Participants:58
Impact:mean 2.21 (balloon) vs 1.07 (wedged)
Trust score:4/5

time to portal puncture

1 evidences

Compared two retrograde venography techniques using iodinated contrast during TIPS; balloon occlusion markedly improved portal vein visualization and portogram quality and reduced procedure time.

Trust comment: Prospective comparative study with clear, clinically relevant endpoints and statistically significant differences, though not randomized.

Study Details

PMID:25540929
Participants:58
Impact:shorter when right branch visualized: 21 min vs 33.5 min
Trust score:4/5

bone conduction hearing thresholds

1 evidences

Triple-blind RCT testing 5% povidone-iodine applied to the ear before tympanoplasty found no short-term hearing (bone conduction) impairment at one month.

Trust comment: Well-designed triple-blind randomized trial with objective audiometric outcomes, though single-centre and short (1 month) follow-up.

Study Details

PMID:34533542
Participants:66
Impact:no significant change at 1 month (mean 11.68 vs 12.68; P=0.754)
Trust score:4/5

time to pain resolution

1 evidences

Randomized trial comparing Alvogyl (contains iodoform) versus black seed mixture and saline for dry socket; black seed produced fastest pain relief and Alvogyl improved pain gradually.

Trust comment: Randomized double-blind trial with clear clinical outcomes, but small group sizes (≈20 per arm) and some baseline differences in age/gender noted.

Study Details

PMID:35685605
Participants:60
Impact:shorter with black seed (pain-free by day 2) vs Alvogyl (slower) vs saline (slowest)
Trust score:3/5

cessation of bleeding after socket irrigation

1 evidences

Clinical study found that irrigation of extraction sockets with 1% povidone-iodine stopped bleeding more often than saline.

Trust comment: Simple controlled clinical comparison with clear effect on bleeding cessation, but limited detail on randomization/blinding and small sample.

Study Details

PMID:16777382
Participants:50
Impact:19/25 with povidone-iodine vs 5/25 with saline (P<0.01)
Trust score:3/5

bacterial culture positivity

1 evidences

Timed intraoperative iodine irrigation (0.33% povidone-iodine equivalent) during cataract surgery greatly reduced cultivable bacteria and bacterial DNA on the ocular surface without adverse epithelial or endothelial effects.

Trust comment: Randomized eye-level study with microbiologic PCR and culture endpoints and adequate sample size (198 eyes), supporting antiseptic efficacy.

Study Details

PMID:27550429
Participants:99
Impact:post-iodine application: cultures negative; control eyes had positive cultures (5 before incision, 2 before IOL insertion)
Trust score:4/5

bacterial 16S DNA copy number

1 evidences

Timed intraoperative iodine irrigation (0.33% povidone-iodine equivalent) during cataract surgery greatly reduced cultivable bacteria and bacterial DNA on the ocular surface without adverse epithelial or endothelial effects.

Trust comment: Randomized eye-level study with microbiologic PCR and culture endpoints and adequate sample size (198 eyes), supporting antiseptic efficacy.

Study Details

PMID:27550429
Participants:99
Impact:reduced from ~1.7×10^4 (control) to ~1.7×10^3 after iodine before incision (~10-fold reduction)
Trust score:4/5

serum NGAL

1 evidences

In patients receiving iodinated contrast, NGAL rose early (8 h) and predicted contrast-induced nephropathy while serum creatinine rose later (24 h).

Trust comment: Prospective study of 120 patients with appropriate statistical analyses and clear biomarker results.

Study Details

PMID:23297321
Participants:120
Impact:+ early rise at 8 h; AUC 0.995 (strong predictor of CIN)
Trust score:4/5

urinary NGAL

1 evidences

In patients receiving iodinated contrast, NGAL rose early (8 h) and predicted contrast-induced nephropathy while serum creatinine rose later (24 h).

Trust comment: Prospective study of 120 patients with appropriate statistical analyses and clear biomarker results.

Study Details

PMID:23297321
Participants:120
Impact:+ early rise at 8 h; AUC 0.992 (strong predictor of CIN)
Trust score:4/5

serum creatinine

1 evidences

In patients receiving iodinated contrast, NGAL rose early (8 h) and predicted contrast-induced nephropathy while serum creatinine rose later (24 h).

Trust comment: Prospective study of 120 patients with appropriate statistical analyses and clear biomarker results.

Study Details

PMID:23297321
Participants:120
Impact:+ increase at 24 h (delayed vs NGAL)
Trust score:4/5

Fallopian tube diagnostic accuracy

1 evidences

In infertile women, a positive ultrasound contrast (Infoson) provided better tubal patency diagnoses than saline and matched iodinated HSG accuracy.

Trust comment: Small prospective randomized multicenter study (n=23) assessing diagnostic performance; limited sample size.

Study Details

PMID:11844177
Participants:23
Impact:Infoson: 20/22 tubes correctly diagnosed vs saline: 12/24; equal diagnostic yield to iodinated HSG
Trust score:3/5

pleurodesis complete response rate

2 evidences

Povidone-iodine pleurodesis had similar complete response rates to bleomycin and is a cost-effective option.

Trust comment: Randomized clinical trial but small sample (n=39), limiting precision of comparative efficacy estimates.

Study Details

PMID:22052141
Participants:39
Impact:bleomycin 79% vs povidone-iodine 75% (no statistically significant difference)
Trust score:3/5

Prospective randomized comparison of 5% povidone-iodine vs tetracycline for pleurodesis in malignant pleural effusion: similar high overall success rates with no significant difference.

Trust comment: Small randomized prospective study with clear clinical endpoints but limited sample size and power.

Study Details

PMID:33995776
Participants:30
Impact:Complete response: 66.7% povidone-iodine vs 73.3% tetracycline; overall success ≈93% for both (no significant difference, p=0.716)
Trust score:3/5

dyspnea score at 1 month

1 evidences

Povidone-iodine pleurodesis had similar complete response rates to bleomycin and is a cost-effective option.

Trust comment: Randomized clinical trial but small sample (n=39), limiting precision of comparative efficacy estimates.

Study Details

PMID:22052141
Participants:39
Impact:lower (better) with bleomycin at one month (statistically significant)
Trust score:3/5

conjunctival bacterial colony counts (blood agar)

1 evidences

Preoperative povidone-iodine 5% significantly reduced conjunctival bacterial counts; 1% was not effective; chloramphenicol also reduced counts.

Trust comment: Double-blind randomized clinical trial with a large sample (n=260) and microbiological endpoints.

Study Details

PMID:38504751
Participants:260
Impact:PVP-I 5%: mean CFU decreased significantly (from 6.98 to 0.24; p=0.032); PVP-I 1%: non-significant reduction
Trust score:4/5

conjunctival bacterial colony counts (chloramphenicol)

1 evidences

Preoperative povidone-iodine 5% significantly reduced conjunctival bacterial counts; 1% was not effective; chloramphenicol also reduced counts.

Trust comment: Double-blind randomized clinical trial with a large sample (n=260) and microbiological endpoints.

Study Details

PMID:38504751
Participants:260
Impact:mean CFU decreased from 20.02 to 6.02 (p=0.005); greater reduction than PVP-I 1%
Trust score:4/5

drainage period

1 evidences

Povidone-iodine pleurodesis reduced drainage time and hospital stay versus surveillance with acceptable complications.

Trust comment: Randomized prospective trial with registry design but small sample size (n=40) supports moderate confidence.

Study Details

PMID:34904450
Participants:40
Impact:-6.41 days (mean 9.21 vs 15.62 days; Group A vs B; p=0.001)
Trust score:4/5

hospitalization period

1 evidences

Povidone-iodine pleurodesis reduced drainage time and hospital stay versus surveillance with acceptable complications.

Trust comment: Randomized prospective trial with registry design but small sample size (n=40) supports moderate confidence.

Study Details

PMID:34904450
Participants:40
Impact:-7.85 days (mean 11.05 vs 18.90 days; Group A vs B; p<0.0001)
Trust score:4/5

groin wound infection rate

1 evidences

Use of povidone-iodine dressings showed fewer groin wound infections numerically but the difference was not statistically significant.

Trust comment: Randomized, blinded controlled trial but small sample and outcome difference was not statistically significant.

Study Details

PMID:23360528
Participants:49
Impact:-2 infections (1 vs 3 infections; Betadine vs saline; not significant, p=0.4)
Trust score:4/5

conjunctival colony forming units

1 evidences

Both Lavasept and 1.25% PVP-iodine reduced conjunctival bacterial counts, with Lavasept reducing colonies more than PVP-iodine.

Trust comment: Randomized double-blind human trial with moderate sample size and clear microbiological endpoints.

Study Details

PMID:16283191
Participants:67
Impact:Reduced after both agents; Lavasept > PVP-iodine (p=0.05)
Trust score:4/5

30-day surgical site infection (overall)

1 evidences

Irrigation with povidone-iodine did not reduce overall 30-day SSI and was associated with higher superficial incisional SSI compared to saline.

Trust comment: Large randomized blinded-endpoint single-center trial with robust sample but no overall benefit and some adverse superficial SSI findings.

Study Details

PMID:38825398
Participants:697
Impact:+3 percentage points (16% vs 13%; povidone-iodine vs control; P = 0.406; not significant)
Trust score:4/5

superficial incisional surgical site infection

1 evidences

Irrigation with povidone-iodine did not reduce overall 30-day SSI and was associated with higher superficial incisional SSI compared to saline.

Trust comment: Large randomized blinded-endpoint single-center trial with robust sample but no overall benefit and some adverse superficial SSI findings.

Study Details

PMID:38825398
Participants:697
Impact:+5 percentage points (9% vs 4%; OR 2.154; p=0.026) — higher with povidone-iodine
Trust score:4/5

infection rate

1 evidences

Irrigating spinal fusion wounds with diluted povidone-iodine reduced infections and did not harm wound healing, bone fusion, or clinical recovery.

Trust comment: Prospective randomized single-blind trial with 244 patients and clear clinical endpoints, though single-surgeon and specific exclusions limit broad generalizability.

Study Details

PMID:16133077
Participants:244
Impact:0% vs 4.8% (0/120 vs 6/124); absolute reduction ≈4.8 percentage points
Trust score:4/5

spinal bone fusion (union)

1 evidences

Irrigating spinal fusion wounds with diluted povidone-iodine reduced infections and did not harm wound healing, bone fusion, or clinical recovery.

Trust comment: Prospective randomized single-blind trial with 244 patients and clear clinical endpoints, though single-surgeon and specific exclusions limit broad generalizability.

Study Details

PMID:16133077
Participants:244
Impact:no significant change
Trust score:4/5

wound healing

1 evidences

Irrigating spinal fusion wounds with diluted povidone-iodine reduced infections and did not harm wound healing, bone fusion, or clinical recovery.

Trust comment: Prospective randomized single-blind trial with 244 patients and clear clinical endpoints, though single-surgeon and specific exclusions limit broad generalizability.

Study Details

PMID:16133077
Participants:244
Impact:no significant change
Trust score:4/5

respiratory pause / slowed respiration

1 evidences

Applying 5% povidone-iodine eye drops caused slowing and short pauses in breathing in many children under general anesthesia.

Trust comment: Randomized controlled trial with 100 paediatric patients showing a clear physiologic effect, though single-centre and single-blind.

Study Details

PMID:31743406
Participants:100
Impact:60% of treated children experienced slowing; among affected, median pause 18.5 seconds (range 4.36–96.2 s)
Trust score:4/5

trismus

2 evidences

Postoperative irrigation with povidone-iodine reduced jaw opening limitation (trismus); 3% concentration was most effective at reducing facial swelling.

Trust comment: Randomized, double-blind controlled trial (n=80) with clear clinical measures, but modest sample size per group.

Study Details

PMID:33475533
Participants:80
Impact:significant reduction versus saline control (all PVI concentrations)
Trust score:4/5

Low-concentration povidone-iodine irrigation during third molar extraction reduced postoperative swelling and trismus but did not significantly change pain; higher patient satisfaction reported for the PVI-treated side.

Trust comment: Randomized split-mouth pilot with objective measures but small sample size limits precision.

Study Details

PMID:25249172
Participants:30
Impact:decreased with povidone-iodine (significant)
Trust score:3/5

facial swelling

2 evidences

Using povidone-iodine as an irrigant after third-molar removal was associated with more pain, alveolar osteitis, swelling, and trismus compared with chlorhexidine.

Trust comment: Small cross-sectional study (48 patients) with multiple clinical outcomes but limited power and nonrandomized design.

Study Details

PMID:30287719
Participants:48
Impact:Higher swelling at 24 hours in povidone-iodine and saline groups vs chlorhexidine
Trust score:3/5

Postoperative irrigation with povidone-iodine reduced jaw opening limitation (trismus); 3% concentration was most effective at reducing facial swelling.

Trust comment: Randomized, double-blind controlled trial (n=80) with clear clinical measures, but modest sample size per group.

Study Details

PMID:33475533
Participants:80
Impact:reduced, with 3% PVI more effective than lower concentrations
Trust score:4/5

superficial incisional surgical site infection (SSI)

1 evidences

Irrigating subcutaneous tissue with 10% povidone-iodine reduced superficial incisional wound infections compared with saline irrigation.

Trust comment: Prospective randomized controlled trial with 300 patients and clinically relevant endpoints, though details on blinding are limited.

Study Details

PMID:31524943
Participants:300
Impact:significantly reduced with povidone-iodine (and rifampicin) versus saline; no significant difference between PVI and rifampicin
Trust score:4/5

wound infection rate

6 evidences

Use of povidone-iodine soaked wound wicks did not reduce post-appendectomy wound infections and had a numerically higher infection rate than subcuticular closure.

Trust comment: Randomized controlled surgical trial with adequate sample but nonsignificant differences and standard antibiotic prophylaxis for all patients.

Study Details

PMID:12098059
Participants:174
Impact:wick 11.6% (10/86) vs subcuticular closure 5.6% (5/88); overall 8.6% (15/174); difference not statistically significant
Trust score:3/5

Vaginal cleansing with 10% povidone-iodine before cesarean had higher wound infection rates than 4% chlorhexidine and similar rates of endometritis and fever.

Trust comment: Large randomized comparator trial (n=1,114) providing robust evidence, though the study was open-label.

Study Details

PMID:33319753
Participants:1114
Impact:2.0% (povidone-iodine) vs 0.6% (chlorhexidine); povidone-iodine associated with higher infection rate
Trust score:4/5

In ED patients with simple traumatic wounds, cleansing skin with povidone-iodine did not reduce subsequent wound infection rates compared with control.

Trust comment: Single-blind randomized controlled trial at two hospitals with adequate sample size (n=444); negative result for PVI effect.

Study Details

PMID:27269416
Participants:444
Impact:no significant difference between povidone-iodine and control groups (p=0.231)
Trust score:4/5

Applying povidone-iodine gel to subcutaneous tissue and sealing the wound markedly reduced postoperative wound infections compared with standard open treatment in high-risk hepatobiliary surgery patients.

Trust comment: Randomized prospective trial with a large, significant effect in a high-risk surgical population but small overall sample size.

Study Details

PMID:9921943
Participants:59
Impact:−30 percentage points (16% sealed vs 46% open; 5/31 vs 13/28)
Trust score:4/5

Compared shower+saline skin prep vs traditional scrub with povidone-iodine/chlorhexidine in outpatient plastic surgery; no wound infections occurred in either group.

Trust comment: Large prospective study with very large sample but likely non-randomized and limited detail on allocation, so moderate trust.

Study Details

PMID:16079686
Participants:1810
Impact:0% in both groups; no difference
Trust score:3/5

A single-application povidone-iodine applicator used much less solution and was non-inferior to conventional sterilization for wound infection after abdominal surgery.

Trust comment: Prospective randomized trial with adequate sample for non-inferiority and clear endpoints though single-center and not surgeon-blinded.

Study Details

PMID:31183443
Participants:486
Impact:applicator 6.7% vs conventional 6.5% — non-inferior (p=0.014)
Trust score:4/5

endometritis

1 evidences

Vaginal cleansing with 10% povidone-iodine before cesarean had higher wound infection rates than 4% chlorhexidine and similar rates of endometritis and fever.

Trust comment: Large randomized comparator trial (n=1,114) providing robust evidence, though the study was open-label.

Study Details

PMID:33319753
Participants:1114
Impact:no significant difference (0.5% vs 0.4%)
Trust score:4/5

postoperative fever

1 evidences

Vaginal cleansing with 10% povidone-iodine before cesarean had higher wound infection rates than 4% chlorhexidine and similar rates of endometritis and fever.

Trust comment: Large randomized comparator trial (n=1,114) providing robust evidence, though the study was open-label.

Study Details

PMID:33319753
Participants:1114
Impact:no significant difference (2.7% vs 2.5%)
Trust score:4/5

aqueous contamination (positive culture)

1 evidences

Mixing povidone-iodine 10% with levofloxacin 0.5% before cataract surgery reduced positive aqueous cultures compared with povidone-iodine alone.

Trust comment: Prospective double-blind randomized clinical trial with clear microbiological endpoints, moderate sample size.

Study Details

PMID:40102985
Participants:147
Impact:5.6% (4/72) positive in PVI+levo group vs 21.3% (16/75) in PVI-only; absolute reduction ≈15.7 percentage points (P=0.005)
Trust score:4/5

ventilator-associated pneumonia (VAP) prevalence

1 evidences

Regular oropharyngeal rinsing with povidone-iodine in ventilated head-trauma patients markedly reduced ventilator-associated pneumonia compared with saline or standard care.

Trust comment: Prospective randomized study in ICU patients (n=98) showing large absolute effects on VAP, though sample size is modest.

Study Details

PMID:16540962
Participants:98
Impact:8% (3/36) in PVI group vs 39% (12/31) saline and 42% (13/31) control; absolute reduction ≈31–34 percentage points
Trust score:4/5

length of ICU stay / mortality

1 evidences

Regular oropharyngeal rinsing with povidone-iodine in ventilated head-trauma patients markedly reduced ventilator-associated pneumonia compared with saline or standard care.

Trust comment: Prospective randomized study in ICU patients (n=98) showing large absolute effects on VAP, though sample size is modest.

Study Details

PMID:16540962
Participants:98
Impact:no significant change
Trust score:4/5

infectious complications (fever/UTI)

1 evidences

Randomized trial found no infectious events in either group and minimal differences in symptom scores; povidone-iodine suppository was safe.

Trust comment: Prospective randomized trial with adequate sample size but not double-blind and antibiotic prophylaxis likely masked any effect on infections.

Study Details

PMID:30896629
Participants:250
Impact:no events in either group (0%); no difference
Trust score:4/5

lower urinary tract symptoms (IPSS, nocturnal subscore)

1 evidences

Randomized trial found no infectious events in either group and minimal differences in symptom scores; povidone-iodine suppository was safe.

Trust comment: Prospective randomized trial with adequate sample size but not double-blind and antibiotic prophylaxis likely masked any effect on infections.

Study Details

PMID:30896629
Participants:250
Impact:no overall difference; nocturnal IPSS decreased in treatment vs control (P=0.036)
Trust score:4/5

adverse effects

1 evidences

Applying povidone-iodine to the incision after skin closure did not reduce surgical site infections compared with no application.

Trust comment: Well-powered randomized controlled trial, registered, with clear outcomes; directly applicable to humans.

Study Details

PMID:39056520
Participants:352
Impact:no significant difference between groups
Trust score:4/5

antibiotic timing (risk factor)

1 evidences

Applying povidone-iodine to the incision after skin closure did not reduce surgical site infections compared with no application.

Trust comment: Well-powered randomized controlled trial, registered, with clear outcomes; directly applicable to humans.

Study Details

PMID:39056520
Participants:352
Impact:long interval ≥60 min from antibiotic to incision associated with higher SSI risk (adjusted OR 4.06)
Trust score:4/5

pleurodesis response rate

1 evidences

In patients with malignant pleural effusion, povidone-iodine produced similar pleurodesis success and complications compared with bleomycin.

Trust comment: Prospective randomized trial but small sample size limits power to detect differences.

Study Details

PMID:29792037
Participants:60
Impact:povidone-iodine 83.3% vs bleomycin 66.7% (P=0.136; not statistically significant)
Trust score:3/5

complications (chest pain/fever/hypotension)

1 evidences

In patients with malignant pleural effusion, povidone-iodine produced similar pleurodesis success and complications compared with bleomycin.

Trust comment: Prospective randomized trial but small sample size limits power to detect differences.

Study Details

PMID:29792037
Participants:60
Impact:similar and low in both groups (minor events)
Trust score:3/5

Gingival index (GI)

2 evidences

Both PVP‑I 0.1% and boric acid 0.5% plus SRP improved periodontitis; boric acid produced greater reductions in gum inflammation and bleeding.

Trust comment: Single-blind randomized trial with small sample (36 completers) and short follow-up, limiting generalizability.

Study Details

PMID:33028054
Participants:36
Impact:greater reduction with boric acid vs PVP‑I at 4, 6, and 8 weeks (statistically significant, p<0.05)
Trust score:3/5

In peri-implant mucositis, 2% and 10% povidone-iodine adjunctive irrigation improved gingival and bleeding indices more than 0.1%.

Trust comment: Randomized double-blind trial but small group sizes (n=20 per arm) limit generalizability.

Study Details

PMID:38305374
Participants:60
Impact:improved with 2% and 10% vs 0.1% (P=0.000)
Trust score:3/5

bleeding index (BI)

1 evidences

In peri-implant mucositis, 2% and 10% povidone-iodine adjunctive irrigation improved gingival and bleeding indices more than 0.1%.

Trust comment: Randomized double-blind trial but small group sizes (n=20 per arm) limit generalizability.

Study Details

PMID:38305374
Participants:60
Impact:improved with 2% and 10% vs 0.1% (P=0.000)
Trust score:3/5

number of operations

1 evidences

Postoperative povidone-iodine soaks did not improve outcomes after operative drainage of hand abscesses.

Trust comment: Prospective randomized trial with clear clinical endpoints and reasonable sample size.

Study Details

PMID:24636027
Participants:100
Impact:no significant difference (mean 1.6 soaks vs 1.4 control)
Trust score:4/5

length of stay / readmissions / reoperations

1 evidences

Postoperative povidone-iodine soaks did not improve outcomes after operative drainage of hand abscesses.

Trust comment: Prospective randomized trial with clear clinical endpoints and reasonable sample size.

Study Details

PMID:24636027
Participants:100
Impact:no significant differences between groups
Trust score:4/5

30-day wound infection rate

1 evidences

Using a povidone-iodine paint alone for abdominal preoperative skin prep was equivalent to scrub-and-paint for preventing wound infections.

Trust comment: Randomized equivalence trial with adequate sample and clear outcome, directly relevant to clinical practice.

Study Details

PMID:16256917
Participants:234
Impact:equivalent (12/115 [10%] scrub-and-paint vs 12/119 [10%] paint-only)
Trust score:4/5

metal-skin interface infection rate

1 evidences

Sixty patients with external fixators had dressings with either diluted povidone-iodine or saline; infection rates were similar between groups.

Trust comment: Randomized trial with clear objective infection outcomes but modest sample size and event rates limit power slightly.

Study Details

PMID:19398787
Participants:60
Impact:19% (povidone-iodine) vs 17% (saline); no significant difference
Trust score:4/5

postpartum endometritis incidence

1 evidences

Vaginal irrigation with povidone-iodine before cesarean reduced postpartum endometritis, especially in women in labor or with ruptured membranes.

Trust comment: Large randomized controlled trial with clear clinical endpoint and subgroup analyses; applicable to cesarean patients though effect limited to specific subgroups.

Study Details

PMID:22590998
Participants:670
Impact:6.9% (povidone-iodine) vs 11.6% (control); absolute −4.7 percentage points; statistically significant
Trust score:4/5

incisional surgical site infection rate

2 evidences

Three hundred gynecologic oncology patients had subcutaneous irrigation with saline, saline + povidone-iodine, or saline + rifampicin; no difference in incisional SSI between groups.

Trust comment: Prospective randomized design with adequate sample size, but single-center and specific to subcutaneous irrigation limits generalizability.

Study Details

PMID:33030730
Participants:300
Impact:No significant difference between groups (p = 0.332)
Trust score:4/5

In 300 cesarean patients randomized to saline, rifampicin, or 10% povidone-iodine irrigation, povidone-iodine did not reduce incisional surgical site infections.

Trust comment: Prospective randomized controlled trial with adequate sample size and clear clinical outcome, though single study context limits wider inference.

Study Details

PMID:34689702
Participants:300
Impact:no difference (p = 0.202) between povidone-iodine and other groups
Trust score:4/5

post-procedural urinary tract infection incidence

1 evidences

Irrigating the distal urethra with 2% povidone-iodine before cystoscopy markedly reduced post-procedure urinary tract infections.

Trust comment: Well-powered, registered, double-blind randomized trial with clear clinical outcome and low loss to follow-up.

Study Details

PMID:32108161
Participants:192
Impact:7.2% (povidone-iodine) vs 22% (control); absolute −14.8 percentage points; ~67% relative reduction; p < 0.007
Trust score:5/5

post-antisepsis vaginal symptoms

1 evidences

Patients receiving preoperative vaginal antisepsis with povidone-iodine or chlorhexidine reported similar short-term vaginal symptoms.

Trust comment: Randomized trial but small sample and subjective self-reported symptom outcomes reduce strength of evidence for clinical harms/comfort differences.

Study Details

PMID:38536409
Participants:120
Impact:No significant difference between 10% povidone-iodine and 4% CHG with isopropyl alcohol (no numeric difference reported)
Trust score:3/5

skin flora presence at incision site

1 evidences

Sequential skin cleansing with chlorhexidine followed by two povidone-iodine washes eliminated detectable skin bacterial growth in neurosurgery patients.

Trust comment: Controlled sequential culture study showing strong microbiological effect, but non-randomized and sequential design limits attribution to povidone-iodine alone.

Study Details

PMID:18291465
Participants:100
Impact:Baseline frequent growth → marked reduction after chlorhexidine → no growth after subsequent povidone-iodine washes (third/fourth cultures: 0 growth)
Trust score:3/5

ulcer healing rate with local povidone-iodine + compression

1 evidences

In patients with venous leg ulcers, topical povidone-iodine with compression improved healing rates versus povidone-iodine without compression; systemic antibiotics had similar healing but higher relapse.

Trust comment: Small cohort with three equal treatment groups; useful clinical observations but unclear randomization and potential confounding by compression therapy.

Study Details

PMID:16490980
Participants:63
Impact:82% healed
Trust score:3/5

ulcer healing rate with local povidone-iodine without compression

1 evidences

In patients with venous leg ulcers, topical povidone-iodine with compression improved healing rates versus povidone-iodine without compression; systemic antibiotics had similar healing but higher relapse.

Trust comment: Small cohort with three equal treatment groups; useful clinical observations but unclear randomization and potential confounding by compression therapy.

Study Details

PMID:16490980
Participants:63
Impact:62% healed
Trust score:3/5

healing rate with systemic antibiotics

1 evidences

In patients with venous leg ulcers, topical povidone-iodine with compression improved healing rates versus povidone-iodine without compression; systemic antibiotics had similar healing but higher relapse.

Trust comment: Small cohort with three equal treatment groups; useful clinical observations but unclear randomization and potential confounding by compression therapy.

Study Details

PMID:16490980
Participants:63
Impact:85% healed (not significantly different from povidone-iodine)
Trust score:3/5

relapse rate of superficial infections

1 evidences

In patients with venous leg ulcers, topical povidone-iodine with compression improved healing rates versus povidone-iodine without compression; systemic antibiotics had similar healing but higher relapse.

Trust comment: Small cohort with three equal treatment groups; useful clinical observations but unclear randomization and potential confounding by compression therapy.

Study Details

PMID:16490980
Participants:63
Impact:32% (systemic antibiotics) vs 11% (local povidone-iodine)
Trust score:3/5

bacterial density

1 evidences

Healthy volunteers had antiseptics applied; chlorhexidine was removed by saline gauze while iodine film remained on skin and both reduced bacteria counts.

Trust comment: Randomized blinded human study but small sample (n=36) and surrogate seeded-organism model limits generalizability.

Study Details

PMID:17660006
Participants:36
Impact:statistically significant reduction
Trust score:3/5

antiseptic removal by saline

1 evidences

Healthy volunteers had antiseptics applied; chlorhexidine was removed by saline gauze while iodine film remained on skin and both reduced bacteria counts.

Trust comment: Randomized blinded human study but small sample (n=36) and surrogate seeded-organism model limits generalizability.

Study Details

PMID:17660006
Participants:36
Impact:iodine not detected on gauze (no removal); chlorhexidine detected on gauze (removed)
Trust score:3/5

ophthalmia neonatorum incidence

1 evidences

Among randomized full-term neonates, povidone-iodine prophylaxis was associated with higher rates of ophthalmia neonatorum and sterile conjunctivitis compared with tetracycline.

Trust comment: Randomized comparison with substantial sample and clear clinically relevant outcomes; results show significant differences.

Study Details

PMID:21439642
Participants:394
Impact:higher with povidone-iodine (15.4% vs 5.2%; P = 0.001)
Trust score:4/5

noninfective conjunctivitis (sterile)

1 evidences

Among randomized full-term neonates, povidone-iodine prophylaxis was associated with higher rates of ophthalmia neonatorum and sterile conjunctivitis compared with tetracycline.

Trust comment: Randomized comparison with substantial sample and clear clinically relevant outcomes; results show significant differences.

Study Details

PMID:21439642
Participants:394
Impact:occurred with povidone-iodine (5% vs 0%; P = 0.002)
Trust score:4/5

30-day surgical site infection rate

2 evidences

Large randomized trial found no significant difference in 30-day cesarean surgical site infection rates between chlorhexidine-alcohol and povidone-iodine skin preparations.

Trust comment: Large, pragmatic randomized trial with high follow-up rates and intent-to-treat analysis supports reliability of the null finding.

Study Details

PMID:28599898
Participants:932
Impact:no significant difference (6.3% vs 7.0%; P = 0.38)
Trust score:5/5

Large randomized equivalence trial found hand-rubbing with 75% aqueous alcohol was as effective as traditional hand-scrubbing with antiseptic soap containing 4% povidone iodine or 4% chlorhexidine in preventing 30-day surgical site infections, with better tolerance and compliance for hand-rubbing.

Trust comment: Large, multicenter randomized equivalence trial with robust sample size and clinically meaningful endpoints; high external validity for surgical settings.

Study Details

PMID:12169076
Participants:4387
Impact:Hand-rubbing: 55/2252 (2.44%) vs hand-scrubbing with povidone iodine/chlorhexidine: 53/2135 (2.48%); difference 0.04% (95% CI −0.88% to 0.96%) — equivalent outcomes
Trust score:5/5

time to full oral feeding

1 evidences

In 24 neonates with major omphalocoele, topical povidone-iodine and Acacia paste had similar clinical outcomes; no thyroid test changes were observed with povidone-iodine.

Trust comment: Randomized double-blind trial but very small sample (n=24), underpowered for mortality and other outcomes.

Study Details

PMID:26712288
Participants:24
Impact:non-significant shorter with Acacia (7.25 ±5.04 d) vs povidone-iodine (9.83 ±8.99 d); P=0.347
Trust score:3/5

Mortality

1 evidences

In 24 neonates with major omphalocoele, topical povidone-iodine and Acacia paste had similar clinical outcomes; no thyroid test changes were observed with povidone-iodine.

Trust comment: Randomized double-blind trial but very small sample (n=24), underpowered for mortality and other outcomes.

Study Details

PMID:26712288
Participants:24
Impact:overall 33.3% (3/12 Acacia vs 5/12 povidone-iodine); difference not significant (P=0.667)
Trust score:3/5

catheter bacterial colonisation

1 evidences

Randomized trial comparing 2% alcoholic chlorhexidine vs 5% povidone-iodine alcohol for skin antisepsis before perineural catheter placement; chlorhexidine reduced catheter colonisation.

Trust comment: Randomized controlled trial with clear primary endpoint, adequate sample and significant difference in colonisation.

Study Details

PMID:33285282
Participants:113
Impact:32.7% incidence with povidone-iodine vs 15.5% with chlorhexidine (absolute +17.2 percentage points); chlorhexidine OR 0.28 (p=0.01)
Trust score:4/5

catheter-related infection

1 evidences

Randomized trial comparing 2% alcoholic chlorhexidine vs 5% povidone-iodine alcohol for skin antisepsis before perineural catheter placement; chlorhexidine reduced catheter colonisation.

Trust comment: Randomized controlled trial with clear primary endpoint, adequate sample and significant difference in colonisation.

Study Details

PMID:33285282
Participants:113
Impact:No catheter-related infections observed in either group
Trust score:4/5

adverse effects of antiseptics

1 evidences

Randomized trial comparing 2% alcoholic chlorhexidine vs 5% povidone-iodine alcohol for skin antisepsis before perineural catheter placement; chlorhexidine reduced catheter colonisation.

Trust comment: Randomized controlled trial with clear primary endpoint, adequate sample and significant difference in colonisation.

Study Details

PMID:33285282
Participants:113
Impact:No adverse effects observed in either group
Trust score:4/5

image quality (diagnostic rate)

1 evidences

Comparative study in children testing an iodinated contrast agent (iobitridol 350) versus iopamidol 370 for angiocardiography; no differences in image quality or safety.

Trust comment: Controlled comparative pediatric study with moderate sample size but limited methodological detail in abstract.

Study Details

PMID:8619360
Participants:80
Impact:No significant difference between iobitridol and iopamidol
Trust score:3/5

postoperative pain (VAS)

1 evidences

Randomized trial of preoperative skin preparation before elective cesarean: chlorhexidine groups showed better wound outcomes and comfort than povidone-iodine.

Trust comment: Randomized controlled design with multiple clinically relevant wound-healing outcomes and significant differences reported.

Study Details

PMID:39692637
Participants:102
Impact:Povidone-iodine group had worse pain vs chlorhexidine groups (VAS difference significant, p<0.000)
Trust score:4/5

wound erythema and edema

1 evidences

Randomized trial of preoperative skin preparation before elective cesarean: chlorhexidine groups showed better wound outcomes and comfort than povidone-iodine.

Trust comment: Randomized controlled design with multiple clinically relevant wound-healing outcomes and significant differences reported.

Study Details

PMID:39692637
Participants:102
Impact:Greater erythema and edema in povidone-iodine group compared with chlorhexidine (erythema p<0.05, edema p<0.05)
Trust score:4/5

postpartum comfort (PPCQ)

1 evidences

Randomized trial of preoperative skin preparation before elective cesarean: chlorhexidine groups showed better wound outcomes and comfort than povidone-iodine.

Trust comment: Randomized controlled design with multiple clinically relevant wound-healing outcomes and significant differences reported.

Study Details

PMID:39692637
Participants:102
Impact:Lower PPCQ (worse comfort) in povidone-iodine group vs chlorhexidine groups (p<0.000)
Trust score:4/5

incidence of bacteraemia

1 evidences

Randomized trial in gingivitis patients showing that a 2-minute rinse with 7.5% povidone-iodine before ultrasonic scaling markedly reduced incidence and magnitude of oral bacteraemia.

Trust comment: Small randomized controlled trial with clear microbiological endpoints and statistically significant effects.

Study Details

PMID:17309589
Participants:60
Impact:10% with povidone-iodine vs 33.3% with saline (≈80% relative reduction); OR 0.189 (95% CI 0.043–0.827)
Trust score:4/5

magnitude of bacteraemia (CFU/ml)

1 evidences

Randomized trial in gingivitis patients showing that a 2-minute rinse with 7.5% povidone-iodine before ultrasonic scaling markedly reduced incidence and magnitude of oral bacteraemia.

Trust comment: Small randomized controlled trial with clear microbiological endpoints and statistically significant effects.

Study Details

PMID:17309589
Participants:60
Impact:Povidone-iodine subjects: 0.1 CFU/ml vs saline: 0.1–0.7 CFU/ml (lower magnitude with povidone-iodine)
Trust score:4/5

viridans streptococci in blood cultures

1 evidences

Randomized trial in gingivitis patients showing that a 2-minute rinse with 7.5% povidone-iodine before ultrasonic scaling markedly reduced incidence and magnitude of oral bacteraemia.

Trust comment: Small randomized controlled trial with clear microbiological endpoints and statistically significant effects.

Study Details

PMID:17309589
Participants:60
Impact:Eliminated in povidone-iodine group (0 isolates) vs 11 isolates in saline group
Trust score:4/5

postoperative swelling

3 evidences

Prospective randomized clinical trial in third-molar surgery showing low-concentration (0.5%) povidone-iodine used as irrigant reduced postoperative swelling.

Trust comment: Small randomized trial with a significant finding but limited detail and replication; mechanistic claims speculative.

Study Details

PMID:20970963
Participants:50
Impact:Significant reduction in swelling with 0.5% PVP-I vs control (P<0.01)
Trust score:3/5

Low-concentration povidone-iodine irrigation during third molar extraction reduced postoperative swelling and trismus but did not significantly change pain; higher patient satisfaction reported for the PVI-treated side.

Trust comment: Randomized split-mouth pilot with objective measures but small sample size limits precision.

Study Details

PMID:25249172
Participants:30
Impact:decreased with povidone-iodine (significant)
Trust score:3/5

Chlorhexidine and hydrogen peroxide irrigation reduced postoperative pain and swelling after molar extraction; povidone‑iodine did not show those benefits compared with control.

Trust comment: Randomized single‑blind trial (n=112) with appropriate follow-up and statistical comparisons; conclusions limited to short‑term postoperative outcomes.

Study Details

PMID:39952838
Participants:112
Impact:povidone‑iodine showed more swelling relative to CHX/HP (CHX vs PI day7 p=0.032; HP vs PI day1 p=0.037); CHX and HP < control on days 1–7
Trust score:4/5

possible anti-inflammatory mechanism

1 evidences

Prospective randomized clinical trial in third-molar surgery showing low-concentration (0.5%) povidone-iodine used as irrigant reduced postoperative swelling.

Trust comment: Small randomized trial with a significant finding but limited detail and replication; mechanistic claims speculative.

Study Details

PMID:20970963
Participants:50
Impact:Authors suggest inhibition of leukotriene B4 and leukocyte chemotaxis as explanatory mechanism (hypothesis from observations)
Trust score:3/5

post-procedure chest pain / complaints

1 evidences

Prospective randomized comparison of 5% povidone-iodine vs tetracycline for pleurodesis in malignant pleural effusion: similar high overall success rates with no significant difference.

Trust comment: Small randomized prospective study with clear clinical endpoints but limited sample size and power.

Study Details

PMID:33995776
Participants:30
Impact:20% of patients reported chest pain overall; distribution similar between agents (no significant difference)
Trust score:3/5

volume of pleural fluid drained post-pleurodesis

1 evidences

Prospective randomized comparison of 5% povidone-iodine vs tetracycline for pleurodesis in malignant pleural effusion: similar high overall success rates with no significant difference.

Trust comment: Small randomized prospective study with clear clinical endpoints but limited sample size and power.

Study Details

PMID:33995776
Participants:30
Impact:Mean drain volume: 70.7±24.6 ml (povidone) vs 80.7±45.4 ml (tetracycline); no significant difference (p=0.129)
Trust score:3/5

staphylococcal skin colonization

1 evidences

Randomized study showing a single preoperative 10% povidone-iodine shower 2 hours before elective plastic surgery significantly reduced staphylococcal skin colonization.

Trust comment: Randomized study with blinded culture assessment and clear, significant microbiological outcome.

Study Details

PMID:18176213
Participants:114
Impact:Significantly lower in povidone-iodine group (p<0.001); 33% of povidone-iodine cultures showed no growth vs 0% in control
Trust score:4/5

fungal and enterobacterial colonization

1 evidences

Randomized study showing a single preoperative 10% povidone-iodine shower 2 hours before elective plastic surgery significantly reduced staphylococcal skin colonization.

Trust comment: Randomized study with blinded culture assessment and clear, significant microbiological outcome.

Study Details

PMID:18176213
Participants:114
Impact:No significant reduction with povidone-iodine showers
Trust score:4/5

postoperative hemoglobin

1 evidences

Topical tranexamic acid applied with povidone-iodine in knee replacement increased postoperative hemoglobin and tended to reduce blood loss without more complications.

Trust comment: Prospective randomized controlled trial with adequate sample size and clear outcomes.

Study Details

PMID:25541338
Participants:125
Impact:higher (P=0.01)
Trust score:4/5

Postoperative blood loss

1 evidences

Topical tranexamic acid applied with povidone-iodine in knee replacement increased postoperative hemoglobin and tended to reduce blood loss without more complications.

Trust comment: Prospective randomized controlled trial with adequate sample size and clear outcomes.

Study Details

PMID:25541338
Participants:125
Impact:reduced (P=0.07–0.09; not statistically significant)
Trust score:4/5

radiation dose (DAP)

1 evidences

Automated CYDAR fusion imaging reduced radiation metrics but used more iodinated contrast during aorto-iliac endovascular procedures.

Trust comment: Small single-center randomized pilot study with consistent signal but limited power.

Study Details

PMID:33823257
Participants:37
Impact:reduced (18.5 vs 21.8 Gy·cm2)
Trust score:3/5

Air Kerma

1 evidences

Automated CYDAR fusion imaging reduced radiation metrics but used more iodinated contrast during aorto-iliac endovascular procedures.

Trust comment: Small single-center randomized pilot study with consistent signal but limited power.

Study Details

PMID:33823257
Participants:37
Impact:reduced (0.10 vs 0.12 Gy)
Trust score:3/5

acute kidney injury (AKI)

1 evidences

Contrast-enhanced CT was associated with higher AKI rates and worse clinical outcomes on unadjusted analysis, but after adjusting for disease severity there was no significant difference.

Trust comment: Randomized controlled trial with moderate sample size and appropriate post-hoc severity adjustment.

Study Details

PMID:37578599
Participants:105
Impact:increased unadjusted (45% CECT vs 20% NCCT; RR 2.25, p=0.014) but not significant after severity adjustment
Trust score:4/5

ICU admission

1 evidences

Contrast-enhanced CT was associated with higher AKI rates and worse clinical outcomes on unadjusted analysis, but after adjusting for disease severity there was no significant difference.

Trust comment: Randomized controlled trial with moderate sample size and appropriate post-hoc severity adjustment.

Study Details

PMID:37578599
Participants:105
Impact:increased (RR 2.1, p=0.0001)
Trust score:4/5

length of hospitalization

1 evidences

Contrast-enhanced CT was associated with higher AKI rates and worse clinical outcomes on unadjusted analysis, but after adjusting for disease severity there was no significant difference.

Trust comment: Randomized controlled trial with moderate sample size and appropriate post-hoc severity adjustment.

Study Details

PMID:37578599
Participants:105
Impact:longer in CECT group (p=0.001)
Trust score:4/5

microorganism isolation

1 evidences

Microbial sealant was equivalent to standard povidone-iodine cleaning plus plain adhesive drape for skin preparation in cardiac surgery; no postoperative wound infections occurred.

Trust comment: Prospective randomized study but relatively small and with no SSI events, limiting comparative conclusions.

Study Details

PMID:25022299
Participants:96
Impact:no significant difference between groups (p=0.974)
Trust score:3/5

unpleasant patient experience

1 evidences

Patients reported fewer unpleasant experiences and adverse events with povidone-iodine nasal decolonization compared with mupirocin.

Trust comment: Large randomized trial with high interview completion and significant patient-reported differences.

Study Details

PMID:24972440
Participants:1679
Impact:lower with povidone-iodine (3.4% PI vs 38.8% mupirocin)
Trust score:4/5

salivary SARS-CoV-2 viral load

3 evidences

Two double-blind RCTs tested multiple antiseptic rinses including povidone iodine; only the CPC-containing rinse significantly reduced salivary SARS-CoV-2 viral load at 30 min, while povidone iodine did not show a significant effect in these trials.

Trust comment: Well-powered, double-blind randomized controlled trials with standardized qPCR viral load outcomes and appropriate analyses; high internal validity for short-term effects.

Study Details

PMID:39651628
Participants:247
Impact:Povidone iodine: no significant reduction at 30 or 60 min postrinse versus baseline or placebo; CPC showed significant reduction at 30 min (PI non-significant)
Trust score:5/5

Randomized trial (n=40 COVID-19 patients) testing four mouthrinses including 0.5% povidone-iodine; primary outcome was reduction in salivary SARS-CoV-2 load at 15 minutes.

Trust comment: Randomized in vivo trial with blinded virology assessment but small sample size for mouthrinse arms (n≈10 per group) limiting precision.

Study Details

PMID:34561086
Participants:40
Impact:All mouthrinses produced median reductions of 61%–89% at 15 min and 70%–97% at 45 min; no significant differences between rinses
Trust score:3/5

Gargling with 0.25% povidone-iodine did not reduce salivary SARS-CoV-2 viral load compared with saline.

Trust comment: Pilot randomized clinical trial with modest sample size and short follow-up showing no effect.

Study Details

PMID:37203101
Participants:120
Impact:no reduction after gargling (P>0.05)
Trust score:3/5

Propionibacterium acnes suture contamination

1 evidences

Povidone-iodine skin prep had higher Propionibacterium acnes suture contamination than chlorhexidine-alcohol with an adhesive drape.

Trust comment: Prospective randomized Level I trial with objective culture endpoints and 126 patients.

Study Details

PMID:29373294
Participants:126
Impact:47% positive cultures in povidone-iodine group (vs 9.3% in chlorhexidine-alcohol with drape)
Trust score:4/5

Coagulase-negative Staphylococcus presence

1 evidences

Povidone-iodine skin prep had higher Propionibacterium acnes suture contamination than chlorhexidine-alcohol with an adhesive drape.

Trust comment: Prospective randomized Level I trial with objective culture endpoints and 126 patients.

Study Details

PMID:29373294
Participants:126
Impact:Isolated in 1 case (povidone-iodine with drape) and 2 cases (chlorhexidine-alcohol with drape)
Trust score:4/5

C-reactive protein (CRP) at 24 h

1 evidences

Preoperative povidone-iodine vaginal cleansing reduced postoperative pain, inflammatory marker (CRP) and analgesic need after elective cesarean.

Trust comment: Prospective randomized controlled trial (n=120) with clinical and laboratory endpoints.

Study Details

PMID:27049354
Participants:120
Impact:CRP significantly lower in povidone-iodine group at 24 hours
Trust score:4/5

analgesic requirement

1 evidences

Preoperative povidone-iodine vaginal cleansing reduced postoperative pain, inflammatory marker (CRP) and analgesic need after elective cesarean.

Trust comment: Prospective randomized controlled trial (n=120) with clinical and laboratory endpoints.

Study Details

PMID:27049354
Participants:120
Impact:Analgesic need reduced in povidone-iodine group
Trust score:4/5

SARS-CoV-2 cycle threshold (CT) value

1 evidences

Mouth rinsing/gargling with 0.5%–1% povidone-iodine increased SARS-CoV-2 RT-PCR CT values (indicating lower viral RNA) over 5 days.

Trust comment: Single-blind randomized trial with objective PCR outcomes but small and uneven group sizes limiting between-group comparisons.

Study Details

PMID:38988895
Participants:69
Impact:1% PI: mean CT increased from 23.97 (baseline) to 36.88 (day 5); 0.5% PI: 24.15 to 37.78 (day 5)
Trust score:3/5

Salivary SARS-CoV-2 cycle threshold (Ct) value

1 evidences

A 1% povidone-iodine mouthwash significantly increased salivary SARS-CoV-2 Ct values (reduced salivary viral load) compared with water.

Trust comment: Randomized, blinded, placebo-controlled clinical trial (n=61) with PCR-based primary outcome.

Study Details

PMID:34479668
Participants:61
Impact:Mean delta Ct 4.72 after 1% povidone-iodine mouthwash (corresponding to ~4.45 mean Ct increase pre→post)
Trust score:4/5

Conjunctival bacterial culture positivity

1 evidences

Irrigating the conjunctival sac with 0.5% or 5% povidone-iodine reduced conjunctival bacteria similarly to gentamycin with no safety concerns reported.

Trust comment: Randomized comparative study with 300 patients showing similar antimicrobial effects across agents.

Study Details

PMID:19187664
Participants:300
Impact:End-of-surgery positive rates: 8.3% (0.5% PVI) and 6.3% (5.0% PVI); no significant difference vs gentamycin (11.7%)
Trust score:3/5

Anterior chamber contamination

2 evidences

Topical ofloxacin reduced conjunctival bacteria and adding preoperative 5% povidone-iodine further reduced conjunctival flora to very low levels; anterior chamber contamination was rare.

Trust comment: Large prospective surgical study with clear microbiological endpoints directly assessing povidone-iodine antisepsis; robust sample and objective measures.

Study Details

PMID:22218245
Participants:300
Impact:0.66% (2/300)
Trust score:4/5

Irrigating the conjunctival sac with 0.5% or 5% povidone-iodine reduced conjunctival bacteria similarly to gentamycin with no safety concerns reported.

Trust comment: Randomized comparative study with 300 patients showing similar antimicrobial effects across agents.

Study Details

PMID:19187664
Participants:300
Impact:Average aqueous contamination 4.9% with no significant differences among groups
Trust score:3/5

Post-biopsy infectious complications rate

1 evidences

Washing the biopsy needle with povidone-iodine did not change infection rates after transrectal prostate biopsy.

Trust comment: Comparative clinical study with 180 patients showing no infection-rate benefit from povidone-iodine needle washing.

Study Details

PMID:20453481
Participants:180
Impact:Overall 6.1% complications (4 cases in needle-wash group of 84 vs 7 cases in no-wash group of 96); no significant difference
Trust score:3/5

wound healing time

3 evidences

In children after circumcision, application of wound induction gel resulted in fewer glans scabs and slightly faster wound healing than povidone-iodine application.

Trust comment: Small randomized pediatric trial that used povidone iodine as the control; outcomes are clear but sample size is limited.

Study Details

PMID:27172664
Participants:48
Impact:Gel 10.7 ± 1.7 days vs povidone iodine 11.9 ± 2.1 days, P<0.05
Trust score:3/5

In this small pilot RCT povidone‑iodine showed similar wound healing time to honey and paraffin gauze with no statistically significant differences.

Trust comment: Single‑blind pilot RCT with very small sample (n=35), limiting statistical power and precision.

Study Details

PMID:39137253
Participants:35
Impact:mean 9.45 ± 5.31 days for povidone‑iodine; no significant difference vs other groups (p>0.05)
Trust score:3/5

Wet silver dressings healed skin wounds faster, reduced dressing changes and pain compared with povidone-iodine dressings.

Trust comment: Randomized controlled trial but small sample (58) and described as preliminary, so moderate confidence.

Study Details

PMID:33611826
Participants:58
Impact:- significant decrease
Trust score:3/5

superficial infection incidence

1 evidences

Sequential intraoperative irrigation including hydrogen peroxide + povidone‑iodine + saline markedly reduced superficial and periprosthetic joint infections versus saline alone after TKA.

Trust comment: Large prospective randomized controlled study (n=4743) with statistically robust reductions, but the intervention combined multiple agents so attribution to iodine alone is limited.

Study Details

PMID:38244239
Participants:4743
Impact:0.22% vs 1.17% (Group A vs B); -0.95 percentage points; p=0.007
Trust score:5/5

periprosthetic joint infection (PJI) incidence

1 evidences

Sequential intraoperative irrigation including hydrogen peroxide + povidone‑iodine + saline markedly reduced superficial and periprosthetic joint infections versus saline alone after TKA.

Trust comment: Large prospective randomized controlled study (n=4743) with statistically robust reductions, but the intervention combined multiple agents so attribution to iodine alone is limited.

Study Details

PMID:38244239
Participants:4743
Impact:0.17% vs 1.26% (Group A vs B); -1.09 percentage points; p=0.0121
Trust score:5/5

probing depth reduction

1 evidences

Adding 0.5% povidone‑iodine irrigation to one‑stage periodontal debridement did not improve probing depth reduction at 3 months compared with controls.

Trust comment: Randomized clinical study (n=45) with objective measures but limited sample size and short follow-up for biochemical effects.

Study Details

PMID:16512765
Participants:45
Impact:mean PD reduction ~2.5 mm in all groups at 3 months; no significant differences (P>0.05)
Trust score:3/5

trypsin activity (BAPNA)

1 evidences

Adding 0.5% povidone‑iodine irrigation to one‑stage periodontal debridement did not improve probing depth reduction at 3 months compared with controls.

Trust comment: Randomized clinical study (n=45) with objective measures but limited sample size and short follow-up for biochemical effects.

Study Details

PMID:16512765
Participants:45
Impact:trypsin activity reduced at 1 month only (significant) but returned to baseline by 3 months
Trust score:3/5

CFU reduction after NaOCl preparation (S2 vs S1)

1 evidences

In patients needing root canal retreatment, using 5% iodine-potassium iodide as a final rinse reduced bacteria more than 2% IKI.

Trust comment: Randomised double-blind clinical trial with predefined sample size and clear microbiological outcomes; small sample (n=30) but appropriate methods.

Study Details

PMID:40145486
Participants:30
Impact:-23.98% (mean)
Trust score:4/5

CFU reduction after 2% IKI final irrigation (S3 vs S2)

1 evidences

In patients needing root canal retreatment, using 5% iodine-potassium iodide as a final rinse reduced bacteria more than 2% IKI.

Trust comment: Randomised double-blind clinical trial with predefined sample size and clear microbiological outcomes; small sample (n=30) but appropriate methods.

Study Details

PMID:40145486
Participants:30
Impact:-87.44% (mean)
Trust score:4/5

CFU reduction after 5% IKI final irrigation (S3 vs S2)

1 evidences

In patients needing root canal retreatment, using 5% iodine-potassium iodide as a final rinse reduced bacteria more than 2% IKI.

Trust comment: Randomised double-blind clinical trial with predefined sample size and clear microbiological outcomes; small sample (n=30) but appropriate methods.

Study Details

PMID:40145486
Participants:30
Impact:-97.65% (mean; greater reduction than 2% IKI)
Trust score:4/5

Tongue dorsum bacterial count — povidone-iodine (PV-I)

1 evidences

Brushing the tongue with povidone-iodine or hydrogen peroxide significantly lowered tongue bacterial counts, while benzethonium chloride and water did not.

Trust comment: Randomised controlled trial with objective bacterial measurement but small sample (n=32) and open-label design.

Study Details

PMID:34259433
Participants:32
Impact:Significant decrease after brushing (p=0.012)
Trust score:3/5

Tongue dorsum bacterial count — hydrogen peroxide (HP)

1 evidences

Brushing the tongue with povidone-iodine or hydrogen peroxide significantly lowered tongue bacterial counts, while benzethonium chloride and water did not.

Trust comment: Randomised controlled trial with objective bacterial measurement but small sample (n=32) and open-label design.

Study Details

PMID:34259433
Participants:32
Impact:Significant decrease after brushing (p=0.012)
Trust score:3/5

Tongue dorsum bacterial count — benzethonium chloride (BC) / tap water

1 evidences

Brushing the tongue with povidone-iodine or hydrogen peroxide significantly lowered tongue bacterial counts, while benzethonium chloride and water did not.

Trust comment: Randomised controlled trial with objective bacterial measurement but small sample (n=32) and open-label design.

Study Details

PMID:34259433
Participants:32
Impact:No significant change
Trust score:3/5

Aerobic aerosol CFU reduction (mask position) — chlorhexidine (CHX)

1 evidences

Preprocedural rinses/irrigation with chlorhexidine, povidone-iodine, or ozone all reduced aerobic and anaerobic microbial counts in dental aerosols, with varying percent reductions by location.

Trust comment: Randomized double-blind trial with 60 patients and culture-based aerosol outcomes; reported location-specific percent reductions.

Study Details

PMID:24992844
Participants:60
Impact:-57% (highest at mask position)
Trust score:4/5

Aerobic aerosol CFU reduction (chest and 9 ft) — povidone-iodine (PI)

1 evidences

Preprocedural rinses/irrigation with chlorhexidine, povidone-iodine, or ozone all reduced aerobic and anaerobic microbial counts in dental aerosols, with varying percent reductions by location.

Trust comment: Randomized double-blind trial with 60 patients and culture-based aerosol outcomes; reported location-specific percent reductions.

Study Details

PMID:24992844
Participants:60
Impact:-37% (chest), -47% (9 ft)
Trust score:4/5

Anaerobic aerosol CFU reduction — chlorhexidine (CHX)

1 evidences

Preprocedural rinses/irrigation with chlorhexidine, povidone-iodine, or ozone all reduced aerobic and anaerobic microbial counts in dental aerosols, with varying percent reductions by location.

Trust comment: Randomized double-blind trial with 60 patients and culture-based aerosol outcomes; reported location-specific percent reductions.

Study Details

PMID:24992844
Participants:60
Impact:-43% (chest), -44% (9 ft)
Trust score:4/5

Total oropharyngeal bacterial count

1 evidences

Applying 10% povidone-iodine in the mouth of ventilated patients reduced oral bacterial counts for at least 3 hours and lowered several tested pathogens without disrupting microbiota balance.

Trust comment: Randomized phase II trial with objective bacterial quantification and PCR for specific pathogens but small final sample (n≈22) and short follow-up (3 h).

Study Details

PMID:32093667
Participants:22
Impact:Reduced for at least 1–3 hours after application (significant vs control at 1,2,3 h)
Trust score:3/5

Counts of specific pathogens (streptococci, MRSA, S. pneumoniae, P. aeruginosa, P. gingivalis, C. albicans)

1 evidences

Applying 10% povidone-iodine in the mouth of ventilated patients reduced oral bacterial counts for at least 3 hours and lowered several tested pathogens without disrupting microbiota balance.

Trust comment: Randomized phase II trial with objective bacterial quantification and PCR for specific pathogens but small final sample (n≈22) and short follow-up (3 h).

Study Details

PMID:32093667
Participants:22
Impact:Decreased at 1–3 hours after application
Trust score:3/5

Oral microbiota balance / resistant organisms

1 evidences

Applying 10% povidone-iodine in the mouth of ventilated patients reduced oral bacterial counts for at least 3 hours and lowered several tested pathogens without disrupting microbiota balance.

Trust comment: Randomized phase II trial with objective bacterial quantification and PCR for specific pathogens but small final sample (n≈22) and short follow-up (3 h).

Study Details

PMID:32093667
Participants:22
Impact:No disturbance or promotion of resistant bacteria/fungi detected
Trust score:3/5

Vaginal/cervical culture positivity prior to colpotomy

1 evidences

Preoperative vaginal preparation with 4% chlorhexidine resulted in lower vaginal/cervical culture growth before colpotomy than 2% chlorhexidine or 10% povidone-iodine in patients undergoing laparoscopic hysterectomy.

Trust comment: Prospective randomized trial with culture outcomes; moderate sample size but some ambiguity in reporting and single-center design.

Study Details

PMID:37663434
Participants:50
Impact:Povidone-iodine 93.8% positive vs 2% CHX 47.4% vs 4% CHX 20% (lowest growth with 4% CHX)
Trust score:3/5

Growth on uterine manipulator surfaces

1 evidences

Preoperative vaginal preparation with 4% chlorhexidine resulted in lower vaginal/cervical culture growth before colpotomy than 2% chlorhexidine or 10% povidone-iodine in patients undergoing laparoscopic hysterectomy.

Trust comment: Prospective randomized trial with culture outcomes; moderate sample size but some ambiguity in reporting and single-center design.

Study Details

PMID:37663434
Participants:50
Impact:No significant difference among groups
Trust score:3/5

Postoperative vaginal itching/burning

1 evidences

Preoperative vaginal preparation with 4% chlorhexidine resulted in lower vaginal/cervical culture growth before colpotomy than 2% chlorhexidine or 10% povidone-iodine in patients undergoing laparoscopic hysterectomy.

Trust comment: Prospective randomized trial with culture outcomes; moderate sample size but some ambiguity in reporting and single-center design.

Study Details

PMID:37663434
Participants:50
Impact:No difference among groups
Trust score:3/5

Catheter-associated urinary tract infection (CAUTI) rate — povidone-iodine

1 evidences

Periurethral cleansing with povidone-iodine, chlorhexidine, or sterile water showed no statistically significant differences in catheter-associated urinary tract infection rates in this pediatric ICU trial.

Trust comment: Randomized controlled trial with adequate sample for pediatric ICU setting; differences were not statistically significant and authors note need for larger studies.

Study Details

PMID:27824737
Participants:122
Impact:15% (6 patients) — higher numerically but not statistically significant
Trust score:4/5

CAUTI rate — 0.05% chlorhexidine gluconate

1 evidences

Periurethral cleansing with povidone-iodine, chlorhexidine, or sterile water showed no statistically significant differences in catheter-associated urinary tract infection rates in this pediatric ICU trial.

Trust comment: Randomized controlled trial with adequate sample for pediatric ICU setting; differences were not statistically significant and authors note need for larger studies.

Study Details

PMID:27824737
Participants:122
Impact:4.8% (2 patients) — lower numerically but not statistically significant
Trust score:4/5

CAUTI rate — sterile water

1 evidences

Periurethral cleansing with povidone-iodine, chlorhexidine, or sterile water showed no statistically significant differences in catheter-associated urinary tract infection rates in this pediatric ICU trial.

Trust comment: Randomized controlled trial with adequate sample for pediatric ICU setting; differences were not statistically significant and authors note need for larger studies.

Study Details

PMID:27824737
Participants:122
Impact:7.5% (3 patients) — not statistically different
Trust score:4/5

S. aureus nasal colonization

1 evidences

Tested mupirocin vs povidone-iodine for clearing nasal Staphylococcus aureus in healthcare workers; mupirocin worked better.

Trust comment: Single-blinded randomized controlled trial in humans with clear participant count but small sample size (n=54).

Study Details

PMID:39313892
Participants:54
Impact:37.0% positive cultures with povidone-iodine vs 11.1% with mupirocin (p=0.026); povidone-iodine had +25.9 percentage points more residual colonization vs mupirocin
Trust score:4/5

wound contamination rate

2 evidences

DuraPrep plus drape was equivalent to povidone-iodine scrub/paint plus drape for wound contamination prevention, with less drape lift and lower cost for DuraPrep.

Trust comment: Randomized single-center trial with adequate sample size and objective measures, but single-center limits generalizability.

Study Details

PMID:16205134
Participants:176
Impact:DuraPrep 28.0% vs povidone-iodine 36.4% (no meaningful superiority)
Trust score:4/5

Compared PVI twice versus PVI once then chlorhexidine; sequential PVI+CHG reduced bacterial wound contamination more than PVI alone.

Trust comment: Large single-centre randomized trial with clear microbiologic outcome and statistically significant result favoring sequential antisepsis.

Study Details

PMID:28963158
Participants:407
Impact:PVI twice: 41.7% culture-positive vs PVI then CHG: 29.1% (difference +12.6 percentage points; p=0.009; OR 0.574)
Trust score:4/5

conjunctival bacterial flora eradication

1 evidences

Compared 5% povidone-iodine to topical ciprofloxacin and ofloxacin for conjunctival bacterial sterilization; antibiotics (ciprofloxacin) performed better than povidone-iodine.

Trust comment: Prospective clinical study with moderate sample size but limited detail on blinding and some imbalance between groups; outcome reported as significance rather than detailed effect sizes for PVI.

Study Details

PMID:21834670
Participants:164
Impact:Povidone-iodine was less effective than ciprofloxacin (statistically significant) and inferior to ofloxacin in reducing conjunctival flora (no exact %s reported for PVI here)
Trust score:3/5

non-sterile conjunctival swab rate

1 evidences

Tested topical antibiotics versus no drops prior to intravitreal injection, with povidone-iodine applied before injection; povidone-iodine alone produced large reduction in conjunctival bacterial positivity and was as effective as pre-applied antibiotics.

Trust comment: Randomized, triple-blind pilot trial in humans showing consistent antiseptic effect of povidone-iodine, but small sample size limits precision.

Study Details

PMID:37199800
Participants:98
Impact:After povidone-iodine application all groups showed significant and comparable reduction in non-sterile swabs (PVI alone sufficient; exact post-PVI %s not provided)
Trust score:4/5

conjunctival bacterial presence

1 evidences

Measured conjunctival and anterior chamber bacterial contamination during cataract surgery; povidone-iodine markedly reduced conjunctival bacterial presence.

Trust comment: Prospective randomized clinical study with direct microbiologic measurements showing large reduction in conjunctival bacteria after povidone-iodine; moderate sample size.

Study Details

PMID:17010869
Participants:97
Impact:Conjunctival cultures positive in 21.65% before povidone-iodine vs 4.12% after disinfection (reduction of ~17.5 percentage points)
Trust score:4/5

sensitivity (detection of dysplasia)

1 evidences

In patients with tobacco-associated oral lesions, chemiluminescence plus toluidine blue detected dysplasia with higher sensitivity than chemiluminescence plus Lugol's iodine.

Trust comment: Randomized diagnostic study with moderate sample (n=84); useful estimates but single-study diagnostic setting limits generalizability.

Study Details

PMID:35645072
Participants:84
Impact:Lugol's iodine 91.7% vs toluidine blue 100%
Trust score:3/5

specificity (detection of dysplasia)

1 evidences

In patients with tobacco-associated oral lesions, chemiluminescence plus toluidine blue detected dysplasia with higher sensitivity than chemiluminescence plus Lugol's iodine.

Trust comment: Randomized diagnostic study with moderate sample (n=84); useful estimates but single-study diagnostic setting limits generalizability.

Study Details

PMID:35645072
Participants:84
Impact:Lugol's iodine 66.7% vs toluidine blue 60%
Trust score:3/5

skin bacterial colony counts (CFU)

1 evidences

Randomized study showed both 5- and 10-minute povidone-iodine scrubs greatly reduced skin CFUs compared to painting alone, with no significant difference between 5 and 10 minutes.

Trust comment: Prospective randomized study with quantified CFU outcomes in 101 patients; small single-specialty sample but clear results.

Study Details

PMID:30801820
Participants:101
Impact:No significant difference between 5-min and 10-min scrub after scrub (means ~1.5 vs 2.0 CFU; P = 0.28); scrub reduced CFU fourfold vs painting
Trust score:4/5

colony-forming units (CFU) reduction

1 evidences

Both povidone-iodine with isopropyl alcohol and chlorhexidine gluconate with isopropyl alcohol significantly reduced bacterial counts before forefoot surgery with no difference between methods.

Trust comment: Randomized study of 50 patients showing clear microbiologic endpoints but limited to a specific surgical area.

Study Details

PMID:19796594
Participants:50
Impact:All prep methods significantly decreased CFU (p < 0.001); no significant difference between povidone-iodine+isopropyl alcohol and chlorhexidine+isopropyl alcohol
Trust score:3/5

effect of bristled brush prep

1 evidences

Both povidone-iodine with isopropyl alcohol and chlorhexidine gluconate with isopropyl alcohol significantly reduced bacterial counts before forefoot surgery with no difference between methods.

Trust comment: Randomized study of 50 patients showing clear microbiologic endpoints but limited to a specific surgical area.

Study Details

PMID:19796594
Participants:50
Impact:No additional reduction in bacterial load from bristle scrubbing prior to painting
Trust score:3/5

S. aureus nasal colonization at 4 hours

1 evidences

A specifically manufactured 5% povidone-iodine nasal antiseptic (SNA) decreased nasal S. aureus carriage at 4 hours more than off-the-shelf 10% PI or saline, but differences were not sustained at 24 hours.

Trust comment: Large randomized, placebo-controlled study with clear microbiologic endpoints; single-center but robust sample (n=429).

Study Details

PMID:28578841
Participants:429
Impact:Positive cultures: SNA 21% vs off-the-shelf PI 52% vs saline 59% (SNA significantly better, P = .003)
Trust score:4/5

S. aureus nasal colonization at 24 hours

1 evidences

A specifically manufactured 5% povidone-iodine nasal antiseptic (SNA) decreased nasal S. aureus carriage at 4 hours more than off-the-shelf 10% PI or saline, but differences were not sustained at 24 hours.

Trust comment: Large randomized, placebo-controlled study with clear microbiologic endpoints; single-center but robust sample (n=429).

Study Details

PMID:28578841
Participants:429
Impact:Positive cultures: SNA 59% vs off-the-shelf PI 72% vs saline 69% (no significant differences between groups)
Trust score:4/5

pain during skin preparation (NPASS at T1)

1 evidences

Warming povidone-iodine before skin disinfection reduced preparation pain and shortened procedure time and needle attempts during PICC insertion in preterm infants compared with room-temperature PI.

Trust comment: Randomized controlled neonatal trial with objective pain and process measures; modest sample size but clinically relevant.

Study Details

PMID:37303207
Participants:52
Impact:Median NPASS at T1 significantly lower in warm-PI vs room-temp PI (p = .019)
Trust score:4/5

procedure duration

1 evidences

Warming povidone-iodine before skin disinfection reduced preparation pain and shortened procedure time and needle attempts during PICC insertion in preterm infants compared with room-temperature PI.

Trust comment: Randomized controlled neonatal trial with objective pain and process measures; modest sample size but clinically relevant.

Study Details

PMID:37303207
Participants:52
Impact:Shorter in warm-PI group (significant)
Trust score:4/5

number of needle insertions

1 evidences

Warming povidone-iodine before skin disinfection reduced preparation pain and shortened procedure time and needle attempts during PICC insertion in preterm infants compared with room-temperature PI.

Trust comment: Randomized controlled neonatal trial with objective pain and process measures; modest sample size but clinically relevant.

Study Details

PMID:37303207
Participants:52
Impact:Fewer attempts in warm-PI group (significant)
Trust score:4/5

skin contamination (culture)

1 evidences

Applying povidone-iodine to skin before wound closure removed surface contamination but did not demonstrably reduce wound infection or SSI rates in this randomized surgical sample.

Trust comment: Randomized surgical study showing microbiologic clearance but no SSI benefit; sample may be too small to detect clinical differences.

Study Details

PMID:16490976
Participants:107
Impact:Cultures became negative after PVP-I application (eliminated skin contamination)
Trust score:3/5

wound infection / surgical site infection (SSI) rates

1 evidences

Applying povidone-iodine to skin before wound closure removed surface contamination but did not demonstrably reduce wound infection or SSI rates in this randomized surgical sample.

Trust comment: Randomized surgical study showing microbiologic clearance but no SSI benefit; sample may be too small to detect clinical differences.

Study Details

PMID:16490976
Participants:107
Impact:No reduction in wound infection or SSI demonstrated (study likely underpowered)
Trust score:3/5

analgesic use

1 evidences

Compared a new topical dressing to Alvogyl (which contains iodoform); new dressing gave faster short-term pain relief (30–60 min) but Alvogyl provided better pain control at 24–72 hours; no complications.

Trust comment: Double-blind randomized trial with complete follow-up but small sample size (n=36).

Study Details

PMID:39582403
Participants:36
Impact:no significant difference between groups (p=0.097)
Trust score:4/5

dressing application frequency

1 evidences

Compared a new topical dressing to Alvogyl (which contains iodoform); new dressing gave faster short-term pain relief (30–60 min) but Alvogyl provided better pain control at 24–72 hours; no complications.

Trust comment: Double-blind randomized trial with complete follow-up but small sample size (n=36).

Study Details

PMID:39582403
Participants:36
Impact:no significant difference between groups (p=0.839)
Trust score:4/5

clinical BV improvement

1 evidences

Povidone-iodine suppositories and lactobacilli both improved BV; povidone-iodine reduced pathogenic bacteria more and showed significant benefit in acute BV at day 15.

Trust comment: Prospective randomized clinical trial with clear microbiological outcomes but moderate sample size.

Study Details

PMID:12011527
Participants:70
Impact:both treatments improved; povidone-iodine showed trend to better efficacy at day 15 and was significantly better in acute BV subgroup at day 15
Trust score:4/5

pathogenic bacterial counts (e.g., Gardnerella, Bacteroides)

1 evidences

Povidone-iodine suppositories and lactobacilli both improved BV; povidone-iodine reduced pathogenic bacteria more and showed significant benefit in acute BV at day 15.

Trust comment: Prospective randomized clinical trial with clear microbiological outcomes but moderate sample size.

Study Details

PMID:12011527
Participants:70
Impact:greater and longer-lasting reduction with povidone-iodine vs lactobacilli
Trust score:4/5

lactobacilli counts

1 evidences

Povidone-iodine suppositories and lactobacilli both improved BV; povidone-iodine reduced pathogenic bacteria more and showed significant benefit in acute BV at day 15.

Trust comment: Prospective randomized clinical trial with clear microbiological outcomes but moderate sample size.

Study Details

PMID:12011527
Participants:70
Impact:lactobacilli arm: increase at day 8 then decrease at day 15; povidone-iodine arm: decrease at week 1 then increase in week 2
Trust score:4/5

conjunctival bacterial colony count

1 evidences

In neonates, 2.5% povidone-iodine and 1% chloramphenicol both significantly reduced conjunctival bacterial colonies with no difference between them and no adverse effects.

Trust comment: Double-blind randomized controlled trial with clear microbiological endpoints but modest sample size (n=60).

Study Details

PMID:26065506
Participants:60
Impact:both agents significantly reduced CFU (P=0.00); no significant difference between groups (P=0.748)
Trust score:4/5

adverse ocular effects

1 evidences

In neonates, 2.5% povidone-iodine and 1% chloramphenicol both significantly reduced conjunctival bacterial colonies with no difference between them and no adverse effects.

Trust comment: Double-blind randomized controlled trial with clear microbiological endpoints but modest sample size (n=60).

Study Details

PMID:26065506
Participants:60
Impact:no toxic conjunctivitis or corneal haziness observed in either group
Trust score:4/5

drape lift

1 evidences

DuraPrep plus drape was equivalent to povidone-iodine scrub/paint plus drape for wound contamination prevention, with less drape lift and lower cost for DuraPrep.

Trust comment: Randomized single-center trial with adequate sample size and objective measures, but single-center limits generalizability.

Study Details

PMID:16205134
Participants:176
Impact:mean drape lift lower with DuraPrep (1.5 cm) vs povidone-iodine (9.9 cm)
Trust score:4/5

preparation cost

1 evidences

DuraPrep plus drape was equivalent to povidone-iodine scrub/paint plus drape for wound contamination prevention, with less drape lift and lower cost for DuraPrep.

Trust comment: Randomized single-center trial with adequate sample size and objective measures, but single-center limits generalizability.

Study Details

PMID:16205134
Participants:176
Impact:mean cost lower for DuraPrep ($93.36) vs povidone-iodine ($248.91)
Trust score:4/5

endophthalmitis rate with povidone-iodine

1 evidences

Across >28,000 intravitreal injections, povidone-iodine use was associated with very low endophthalmitis rates; lack of povidone-iodine was associated with infections in the very small group not treated with it.

Trust comment: Large multicenter clinical trial dataset; strong evidence though very few injections lacked povidone-iodine.

Study Details

PMID:27533136
Participants:3123
Impact:9 cases among 28,773 injections with povidone-iodine (approx. 0.03%); 6 cases in eyes receiving topical antibiotics (0.05%), 3 cases in eyes not receiving topical antibiotics (0.02%)
Trust score:5/5

endophthalmitis without povidone-iodine

1 evidences

Across >28,000 intravitreal injections, povidone-iodine use was associated with very low endophthalmitis rates; lack of povidone-iodine was associated with infections in the very small group not treated with it.

Trust comment: Large multicenter clinical trial dataset; strong evidence though very few injections lacked povidone-iodine.

Study Details

PMID:27533136
Participants:3123
Impact:3 injections in 2 participants (13 injections without povidone-iodine) resulted in endophthalmitis in both participants (small numbers but higher apparent risk)
Trust score:5/5

infection risk by wound location

1 evidences

In ED patients with simple traumatic wounds, cleansing skin with povidone-iodine did not reduce subsequent wound infection rates compared with control.

Trust comment: Single-blind randomized controlled trial at two hospitals with adequate sample size (n=444); negative result for PVI effect.

Study Details

PMID:27269416
Participants:444
Impact:higher infection odds for lower limbs (OR=9.23) and upper limbs (OR=5.47)
Trust score:4/5

thyroid autoimmunity and dysfunction incidence

1 evidences

Low-dose iodine intake in endemic-goitre patients markedly increased urinary iodine and induced autoimmune thyroid changes in a subset (antibody rise, lymphocytic infiltration) with some developing hypo- or hyperthyroidism that mostly remitted after withdrawal.

Trust comment: Randomized double-blind trial with objective hormone/antibody measures but modest sample size and specific population (endemic goitre).

Study Details

PMID:9758438
Participants:62
Impact:6/31 (19%) on iodine developed high autoantibody titres with lymphocytic infiltration; iodine-induced hypothyroidism in 4 and hyperthyroidism in 2 (some reversible after withdrawal)
Trust score:4/5

time to presumed cure

1 evidences

Povidone-iodine 1.25% performed similarly to commonly available topical antibiotics for treating bacterial keratitis.

Trust comment: Randomized, investigator-masked clinical trial with 172 participants and clear outcome definitions showing no significant differences.

Study Details

PMID:27984024
Participants:172
Impact:no significant difference (Philippines median 7 days PVP‑I vs 7 days antibiotics; India 12 vs 17 days; P>0.05)
Trust score:4/5

time to recovering

1 evidences

Povidone-iodine 1.25% performed similarly to commonly available topical antibiotics for treating bacterial keratitis.

Trust comment: Randomized, investigator-masked clinical trial with 172 participants and clear outcome definitions showing no significant differences.

Study Details

PMID:27984024
Participants:172
Impact:no significant difference between povidone‑iodine and antibiotics
Trust score:4/5

bleeding on probing (BOP)

2 evidences

Both PVP‑I 0.1% and boric acid 0.5% plus SRP improved periodontitis; boric acid produced greater reductions in gum inflammation and bleeding.

Trust comment: Single-blind randomized trial with small sample (36 completers) and short follow-up, limiting generalizability.

Study Details

PMID:33028054
Participants:36
Impact:greater percentage reduction with boric acid vs PVP‑I at 4, 6, and 8 weeks (p<0.05)
Trust score:3/5

Randomized trial (n=36) comparing single-visit full-mouth ultrasonic debridement (one arm used povidone iodine) versus quadrant-wise therapy for chronic periodontitis; clinical and microbiological outcomes assessed up to 6 months.

Trust comment: Small randomized clinical trial showing clinical improvements across groups; limited power to detect small differences and microbiologic changes were minimal.

Study Details

PMID:15966880
Participants:36
Impact:Greater reduction in BOP% in full-mouth treatment groups (including povidone-iodine arm) versus quadrant-wise
Trust score:3/5

pocket depth / clinical attachment loss (PD/CAL)

1 evidences

Both PVP‑I 0.1% and boric acid 0.5% plus SRP improved periodontitis; boric acid produced greater reductions in gum inflammation and bleeding.

Trust comment: Single-blind randomized trial with small sample (36 completers) and short follow-up, limiting generalizability.

Study Details

PMID:33028054
Participants:36
Impact:both groups improved; greater PD and CAL reduction in moderately deep pockets with boric acid (p<0.05)
Trust score:3/5

injected iodine dose

1 evidences

An optimized bolus-tracking threshold for DECT allowed maintenance of vascular image quality with about half the usual iodine contrast dose.

Trust comment: Prospective randomized study with 96 participants showing clear, clinically relevant reductions in injected iodine while preserving image quality.

Study Details

PMID:34128721
Participants:96
Impact:median dose lower in optimized DECTA group (13 g) vs conventional DECTA (19 g) and SECTA (26 g)
Trust score:4/5

aortic enhancement (CT number)

1 evidences

An optimized bolus-tracking threshold for DECT allowed maintenance of vascular image quality with about half the usual iodine contrast dose.

Trust comment: Prospective randomized study with 96 participants showing clear, clinically relevant reductions in injected iodine while preserving image quality.

Study Details

PMID:34128721
Participants:96
Impact:comparable aortic enhancement maintained with optimized threshold at 40 keV despite reduced iodine dose
Trust score:4/5

febrile morbidity

1 evidences

Preoperative vaginal douching with 1% povidone-iodine reduced postoperative infectious morbidity after total abdominal hysterectomy compared with no douching.

Trust comment: Multicenter randomized controlled trial with 300 patients and blinded external outcome assessment; credible reduction in infectious morbidity.

Study Details

PMID:14971530
Participants:300
Impact:25% (douching) vs 35% (no douching); difference -9.6 percentage points (not statistically significant)
Trust score:4/5

iodine dose per kg

1 evidences

Iodine dosing based on lean body weight achieved equivalent aortic and hepatic CT enhancement while reducing iodine exposure in patients with normal/high BMI.

Trust comment: Large randomized study (529 patients) with clear methodology showing equivalent imaging and reduced iodine dosing using LBW-based protocol.

Study Details

PMID:31609293
Participants:529
Impact:LBW protocol delivered a lower median iodine dose in normal/high BMI patients compared with TBW protocol (significant, P<0.001)
Trust score:4/5

aortic and hepatic enhancement

1 evidences

Iodine dosing based on lean body weight achieved equivalent aortic and hepatic CT enhancement while reducing iodine exposure in patients with normal/high BMI.

Trust comment: Large randomized study (529 patients) with clear methodology showing equivalent imaging and reduced iodine dosing using LBW-based protocol.

Study Details

PMID:31609293
Participants:529
Impact:equivalent enhancement between LBW and TBW protocols within predefined margins
Trust score:4/5

body fat percentage

1 evidences

8-week randomized double-blind trial of boiled (iodine-reduced) kelp tablets in overweight Japanese adults: reduced body fat in men and lowered LDL in some subgroups; no thyroid hormone changes.

Trust comment: Randomized double-blind RCT with objective measures but small sample and subgroup findings; per-protocol n=48 limits generalizability.

Study Details

PMID:34206160
Participants:48
Impact:decrease in males (significantly greater vs placebo)
Trust score:4/5

body weight / BMI

1 evidences

8-week randomized double-blind trial of boiled (iodine-reduced) kelp tablets in overweight Japanese adults: reduced body fat in men and lowered LDL in some subgroups; no thyroid hormone changes.

Trust comment: Randomized double-blind RCT with objective measures but small sample and subgroup findings; per-protocol n=48 limits generalizability.

Study Details

PMID:34206160
Participants:48
Impact:no significant change overall; trend to decrease in males (weight p=0.065, BMI p=0.072)
Trust score:4/5

LDL cholesterol (non-hyperlipidemic subjects)

1 evidences

8-week randomized double-blind trial of boiled (iodine-reduced) kelp tablets in overweight Japanese adults: reduced body fat in men and lowered LDL in some subgroups; no thyroid hormone changes.

Trust comment: Randomized double-blind RCT with objective measures but small sample and subgroup findings; per-protocol n=48 limits generalizability.

Study Details

PMID:34206160
Participants:48
Impact:−0.17 mmol/L in test vs +0.19 mmol/L in placebo at 8 weeks
Trust score:4/5

incision-site bacterial culture positivity (18 h)

1 evidences

Randomized trial at cesarean delivery: povidone-iodine had higher incision-site bacterial culture positivity at 18 hours compared with chlorhexidine.

Trust comment: Randomized design but small sample (n=60) limits precision; effect on cultures clear but clinical infection outcomes not reported.

Study Details

PMID:24849000
Participants:60
Impact:48.5% (PI) vs 11.1% (CG); OR 7.53, p=0.0023
Trust score:3/5

conjunctival bacterial colonization

3 evidences

Adults undergoing intraocular surgery: povidone-iodine 5% effectively reduced conjunctival bacterial colonization; adding topical moxifloxacin provided no additional reduction.

Trust comment: Moderately-sized randomized study with clear microbiological endpoints and no additional benefit from antibiotic drops.

Study Details

PMID:19969216
Participants:464
Impact:4% vs 3% just before surgery (moxifloxacin+PI vs saline+PI); no significant difference; PI alone effective
Trust score:4/5

In 28 patients, a 10 ml flush of 5% povidone-iodine reduced conjunctival bacterial organisms more than 2–3 drops (50% vs 18.7% reduction in broth media), though P=0.07.

Trust comment: Small randomized study with objective microbiological endpoints but limited sample size and marginal statistical significance.

Study Details

PMID:17440685
Participants:28
Impact:greater reduction with 10 ml flush (50% reduction) vs drops (18.7% reduction) in broth media; P=0.07
Trust score:3/5

Applying periocular 10% and conjunctival 5% povidone-iodine the day before and one hour before cataract surgery greatly reduced positive conjunctival cultures.

Trust comment: Randomized prospective clinical trial (82 patients) with a statistically significant reduction in positive cultures.

Study Details

PMID:11340513
Participants:82
Impact:-12.2 percentage points (14.6% -> 2.4%)
Trust score:4/5

catheter-related bloodstream infection (CRBSI)

4 evidences

In neonates requiring central venous catheters, skin disinfection with 10% povidone-iodine was as effective as a chlorhexidine-impregnated dressing for preventing bloodstream infections, but had higher catheter-tip colonization and no contact dermatitis.

Trust comment: Large multicenter randomized trial with clear randomization and clinically relevant outcomes.

Study Details

PMID:11389271
Participants:705
Impact:PI 3.2% vs chlorhexidine 3.8% (difference -0.6 pp; no significant difference)
Trust score:5/5

Alcohol-based chlorhexidine (0.5% and 1.0%) reduced catheter-tip colonization compared with 10% aqueous povidone-iodine; no significant difference in bloodstream infection rates.

Trust comment: Large multicenter randomized trial with blinded microbiologic assessment and robust statistical analyses.

Study Details

PMID:29268759
Participants:796
Impact:no significant difference (3.0 vs 2.0 vs 4.9 per 1000 catheter-days; p=0.41)
Trust score:5/5

Study comparing skin antisepsis methods for central venous catheter insertion: chlorhexidine-based prep reduced catheter colonization and catheter-related bloodstream infections compared with povidone-iodine.

Trust comment: Small randomized allocation by operating room; significant findings but limited by sample size and potential operational confounders.

Study Details

PMID:22979911
Participants:50
Impact:reduced with chlorhexidine vs povidone-iodine (p=0.022)
Trust score:3/5

Using 2% chlorhexidine in alcohol for skin disinfection was associated with a lower risk of catheter-related infection compared with alcoholic povidone-iodine in ICU patients.

Trust comment: Large multicenter cohort with propensity adjustment and quasi-experimental component, though not a fully randomized comparison for all antiseptics.

Study Details

PMID:27311311
Participants:3362
Impact:no significant difference between antiseptics in analyses
Trust score:4/5

catheter colonization

4 evidences

Chlorhexidine-based skin antisepsis halved catheter colonization rates compared with alcohol-based povidone-iodine and showed a trend toward fewer bloodstream infections.

Trust comment: Large randomized trial of 538 catheters with significant reduction in colonization and robust methodology.

Study Details

PMID:17954800
Participants:538
Impact:11.6% (chlorhexidine) vs 22.2% (povidone-iodine); incidence density 9.7 vs 18.3 per 1,000 catheter-days; P = .002 (≈50% relative reduction)
Trust score:5/5

Aqueous povidone-iodine had higher catheter colonization (24.7%) than chlorhexidine solutions (~14–16%); bacteremia rates were similar across groups.

Trust comment: Prospective randomized trial with clear catheter-level outcomes; single-center design and catheter-based counts limit generalizability.

Study Details

PMID:18665819
Participants:631
Impact:24.7% (aqueous PVI) vs 14.2% (alcoholic chlorhexidine) and 16.1% (aqueous chlorhexidine)
Trust score:4/5

In this small neonatal pilot RCT, catheter colonization rates were similar between povidone-iodine and chlorhexidine groups; no dermatitis observed at chlorhexidine sites and chlorhexidine was detectable in some infants' blood.

Trust comment: Small pilot randomized trial in neonates with limited power; useful for safety signals but underpowered for efficacy conclusions.

Study Details

PMID:19812587
Participants:48
Impact:no significant difference (P<0.6)
Trust score:3/5

Study comparing skin antisepsis methods for central venous catheter insertion: chlorhexidine-based prep reduced catheter colonization and catheter-related bloodstream infections compared with povidone-iodine.

Trust comment: Small randomized allocation by operating room; significant findings but limited by sample size and potential operational confounders.

Study Details

PMID:22979911
Participants:50
Impact:reduced with chlorhexidine vs povidone-iodine (p=0.047)
Trust score:3/5

antibacterial efficacy

1 evidences

Randomized trial in hospitalized men comparing povidone-iodine and octenidine for urethral antisepsis: similar antimicrobial efficacy but better local tolerability with povidone-iodine.

Trust comment: Randomized clinical trial but small sample; outcomes are short-term microbiological and tolerability measures.

Study Details

PMID:10219640
Participants:61
Impact:no significant difference between agents (P=0.3)
Trust score:3/5

local tolerability

1 evidences

Randomized trial in hospitalized men comparing povidone-iodine and octenidine for urethral antisepsis: similar antimicrobial efficacy but better local tolerability with povidone-iodine.

Trust comment: Randomized clinical trial but small sample; outcomes are short-term microbiological and tolerability measures.

Study Details

PMID:10219640
Participants:61
Impact:better tolerability score for povidone-iodine vs octenidine
Trust score:3/5

skin bacterial colonization (hallux nailfold)

1 evidences

Adding a 3-minute dilute povidone-iodine soak/scrub to standard alcohol+chlorhexidine skin prep did not reduce bacterial growth from the hallux nailfold.

Trust comment: Large, prospective randomized controlled trial with 242 completers and clear outcome measurement (Level I evidence).

Study Details

PMID:34282647
Participants:242
Impact:no difference (26.8% intervention vs 26.9% control; P=0.991)
Trust score:4/5

thyroid function tests

1 evidences

In 24 neonates with major omphalocoele, topical povidone-iodine and Acacia paste had similar clinical outcomes; no thyroid test changes were observed with povidone-iodine.

Trust comment: Randomized double-blind trial but very small sample (n=24), underpowered for mortality and other outcomes.

Study Details

PMID:26712288
Participants:24
Impact:no change detected during treatment or follow-up
Trust score:3/5

Streptococcus mutans counts

1 evidences

In 30 children after full mouth rehab, periodic topical 10% povidone-iodine reduced Streptococcus mutans levels and was associated with fewer caries relapses over 12 months.

Trust comment: Randomized small trial (n=30) with 12-month follow-up showing microbiological and clinical effects, but limited sample size.

Study Details

PMID:20578661
Participants:30
Impact:significant reduction in rise from baseline at 12 months with 10% povidone-iodine
Trust score:3/5

caries relapse (new/secondary caries)

1 evidences

In 30 children after full mouth rehab, periodic topical 10% povidone-iodine reduced Streptococcus mutans levels and was associated with fewer caries relapses over 12 months.

Trust comment: Randomized small trial (n=30) with 12-month follow-up showing microbiological and clinical effects, but limited sample size.

Study Details

PMID:20578661
Participants:30
Impact:reduced relapse/incidence with regular 10% povidone-iodine application
Trust score:3/5

skin insertion-site colonization

1 evidences

In patients undergoing regional anesthesia, alcohol-based chlorhexidine produced fewer positive skin cultures after antisepsis than povidone-iodine (10% vs 35%).

Trust comment: Randomized study with ~100 patients and clear, clinically relevant microbiological outcome and reported effect sizes.

Study Details

PMID:21774287
Participants:98
Impact:absolute reduction 25% (35% with povidone-iodine vs 10% with alcohol-based chlorhexidine); ARR=0.25, RRR=71%, NNT=4
Trust score:4/5

post-operative bacteremia incidence

1 evidences

In 26 patients undergoing tooth extraction, povidone-iodine gingival irrigation significantly reduced post-extraction bacteremia compared with placebo.

Trust comment: Small randomized placebo-controlled study showing significant reduction in bacteremia, but limited sample size and details.

Study Details

PMID:10202506
Participants:26
Impact:significant reduction with povidone-iodine versus placebo (P=0.01558)
Trust score:3/5

gingival culture growth

1 evidences

In 26 patients undergoing tooth extraction, povidone-iodine gingival irrigation significantly reduced post-extraction bacteremia compared with placebo.

Trust comment: Small randomized placebo-controlled study showing significant reduction in bacteremia, but limited sample size and details.

Study Details

PMID:10202506
Participants:26
Impact:reduction in gingival cultures with povidone-iodine (reported, significance unclear in excerpt)
Trust score:3/5

Ventilator-associated pneumonia (VAP)

1 evidences

Multicenter randomized double-blind trial: oral povidone-iodine vs placebo in high-risk ventilated patients showed no reduction in ventilator-associated pneumonia and a possible increase in ARDS.

Trust comment: Large multicenter double-blind RCT with modified ITT (150 evaluable); well-conducted but limited by event counts for some outcomes.

Study Details

PMID:24105456
Participants:150
Impact:+3 percentage points (31% PI vs 28% placebo; RR 1.11; p=0.69, NS)
Trust score:4/5

ventilator-associated tracheobronchitis

1 evidences

Multicenter randomized double-blind trial: oral povidone-iodine vs placebo in high-risk ventilated patients showed no reduction in ventilator-associated pneumonia and a possible increase in ARDS.

Trust comment: Large multicenter double-blind RCT with modified ITT (150 evaluable); well-conducted but limited by event counts for some outcomes.

Study Details

PMID:24105456
Participants:150
Impact:+3 percentage points (10% PI vs 7% placebo; RR 1.48; p=0.47, NS)
Trust score:4/5

acute respiratory distress syndrome (ARDS)

1 evidences

Multicenter randomized double-blind trial: oral povidone-iodine vs placebo in high-risk ventilated patients showed no reduction in ventilator-associated pneumonia and a possible increase in ARDS.

Trust comment: Large multicenter double-blind RCT with modified ITT (150 evaluable); well-conducted but limited by event counts for some outcomes.

Study Details

PMID:24105456
Participants:150
Impact:increase in PI group (5 cases in PI vs 0 in placebo; p=0.06)
Trust score:4/5

dyspnea (MRC dyspnea scale)

1 evidences

Randomized trial in metastatic breast cancer patients found povidone-iodine pleurodesis provided similar symptom relief and recurrence rates to talc but shorter hospital stay.

Trust comment: Prospective randomized trial but small sample (n=42) limits precision and generalizability.

Study Details

PMID:20961772
Participants:42
Impact:improvement in both groups (improvement range 1–3 points)
Trust score:3/5

recurrence of pleural effusion requiring intervention

1 evidences

Randomized trial in metastatic breast cancer patients found povidone-iodine pleurodesis provided similar symptom relief and recurrence rates to talc but shorter hospital stay.

Trust comment: Prospective randomized trial but small sample (n=42) limits precision and generalizability.

Study Details

PMID:20961772
Participants:42
Impact:no significant difference (talc 2 recurrences vs povidone-iodine 3; p=NS)
Trust score:3/5

post-procedure hospital stay

1 evidences

Randomized trial in metastatic breast cancer patients found povidone-iodine pleurodesis provided similar symptom relief and recurrence rates to talc but shorter hospital stay.

Trust comment: Prospective randomized trial but small sample (n=42) limits precision and generalizability.

Study Details

PMID:20961772
Participants:42
Impact:shorter with povidone-iodine (p=0.009)
Trust score:3/5

suture colonization rate

1 evidences

Randomized clinical trial in 65 adults found applying povidone-iodine at surgery end did not reduce suture colonization rates.

Trust comment: Randomized clinical trial with masked observers and clear microbiologic outcome but moderate sample size and surrogate endpoint.

Study Details

PMID:27561000
Participants:65
Impact:no reduction with povidone-iodine (57% PI vs 47% no PI; control 44%; differences NS)
Trust score:4/5

time from end of surgery to adjustment

1 evidences

Randomized clinical trial in 65 adults found applying povidone-iodine at surgery end did not reduce suture colonization rates.

Trust comment: Randomized clinical trial with masked observers and clear microbiologic outcome but moderate sample size and surrogate endpoint.

Study Details

PMID:27561000
Participants:65
Impact:longer interval associated with higher culture positivity (6.3 vs 4.4 hours; p=0.001)
Trust score:4/5

adverse effects of povidone-iodine

1 evidences

Randomized clinical trial in 65 adults found applying povidone-iodine at surgery end did not reduce suture colonization rates.

Trust comment: Randomized clinical trial with masked observers and clear microbiologic outcome but moderate sample size and surrogate endpoint.

Study Details

PMID:27561000
Participants:65
Impact:no adverse effects observed
Trust score:4/5

surgical site infection (SSI)

2 evidences

Large multicentre RCT in LMICs comparing 2% alcoholic chlorhexidine versus 10% povidone‑iodine (and triclosan vs non‑coated sutures): no evidence that povidone‑iodine was inferior or superior to chlorhexidine for preventing surgical site infection.

Trust comment: Large, multicentre, randomized, masked outcome‑assessor trial with high external validity and robust methodology; directly compares povidone‑iodine to chlorhexidine.

Study Details

PMID:34710362
Participants:5788
Impact:No significant difference: overall SSI 22.0%; clean‑contaminated 15.3% (chlorhexidine) vs 15.7% (povidone‑iodine) (RR 0.97, p=0.71); contaminated/dirty 28.3% vs 31.8% (RR 0.91, p=0.11)
Trust score:5/5

Randomized trial in 220 gynecologic surgery patients found warming povidone-iodine reduced SSI compared with room-temperature povidone-iodine; overall PI and chlorhexidine had similar SSI rates.

Trust comment: Randomized controlled trial with adequate sample size and clear primary outcome; subgroup temperature effect demonstrated.

Study Details

PMID:31739120
Participants:220
Impact:warm povidone-iodine reduced SSI vs room-temp PI (p=0.032)
Trust score:4/5

PI vs chlorhexidine alcohol (overall)

1 evidences

Randomized trial in 220 gynecologic surgery patients found warming povidone-iodine reduced SSI compared with room-temperature povidone-iodine; overall PI and chlorhexidine had similar SSI rates.

Trust comment: Randomized controlled trial with adequate sample size and clear primary outcome; subgroup temperature effect demonstrated.

Study Details

PMID:31739120
Participants:220
Impact:no difference (10.9% PI vs 11% chlorhexidine; p=1.00)
Trust score:4/5

causative organisms

1 evidences

Randomized trial in 220 gynecologic surgery patients found warming povidone-iodine reduced SSI compared with room-temperature povidone-iodine; overall PI and chlorhexidine had similar SSI rates.

Trust comment: Randomized controlled trial with adequate sample size and clear primary outcome; subgroup temperature effect demonstrated.

Study Details

PMID:31739120
Participants:220
Impact:Enterococcus faecalis was most common in wound cultures
Trust score:4/5

intravascular attenuation (HU)

1 evidences

Prospective randomized imaging study showed that virtual monochromatic low-energy images with ~50% reduced iodine contrast provided diagnostic aortoiliac CTA with higher intravascular attenuation and lower radiation dose-length product.

Trust comment: Prospective randomized study with objective quantitative imaging endpoints and moderate sample size, suitable for technical conclusions.

Study Details

PMID:30476460
Participants:52
Impact:40 keV: 720±125 HU and 50 keV: 482±82 HU vs SECTA 303±65 HU (p<0.01)
Trust score:4/5

dose-length product (radiation)

1 evidences

Prospective randomized imaging study showed that virtual monochromatic low-energy images with ~50% reduced iodine contrast provided diagnostic aortoiliac CTA with higher intravascular attenuation and lower radiation dose-length product.

Trust comment: Prospective randomized study with objective quantitative imaging endpoints and moderate sample size, suitable for technical conclusions.

Study Details

PMID:30476460
Participants:52
Impact:lower for DECTA (788±166 mGy·cm) vs SECTA (1114±468 mGy·cm)
Trust score:4/5

hospitalization or death

1 evidences

Randomized high-risk COVID-19 outpatients to nasal irrigation with povidone-iodine vs alkalinization; few hospitalizations occurred and twice-daily irrigation was associated with better symptom resolution regardless of additive.

Trust comment: Randomized to additives but compared to external CDC dataset for effectiveness; small sample and low event counts limit causal inference.

Study Details

PMID:36007135
Participants:79
Impact:very low events: 1 hospitalization in povidone-iodine group (1 of 37); no deaths; overall irrigation group had much lower hospitalization than national rate (P=0.006)
Trust score:3/5

symptom resolution

1 evidences

Randomized high-risk COVID-19 outpatients to nasal irrigation with povidone-iodine vs alkalinization; few hospitalizations occurred and twice-daily irrigation was associated with better symptom resolution regardless of additive.

Trust comment: Randomized to additives but compared to external CDC dataset for effectiveness; small sample and low event counts limit causal inference.

Study Details

PMID:36007135
Participants:79
Impact:more likely with twice-daily irrigation (χ2=8.728; p=0.0031), independent of additive
Trust score:3/5

adherence and tolerability

1 evidences

Randomized high-risk COVID-19 outpatients to nasal irrigation with povidone-iodine vs alkalinization; few hospitalizations occurred and twice-daily irrigation was associated with better symptom resolution regardless of additive.

Trust comment: Randomized to additives but compared to external CDC dataset for effectiveness; small sample and low event counts limit causal inference.

Study Details

PMID:36007135
Participants:79
Impact:62/79 (78%) completed daily surveys; 11 reported complaints and 4 discontinued
Trust score:3/5

wound leak detection (Siep's test)

1 evidences

Povidone-iodine was used intraoperatively to reveal wound leaks during cataract surgery; leaks were sutured and re-operations decreased.

Trust comment: Observational cross-sectional study with clear methods and outcomes but no randomized control.

Study Details

PMID:36308138
Participants:300
Impact:110/300 positive (36.7%); all 110 immediately sutured
Trust score:3/5

re-surgery rate

1 evidences

Povidone-iodine was used intraoperatively to reveal wound leaks during cataract surgery; leaks were sutured and re-operations decreased.

Trust comment: Observational cross-sectional study with clear methods and outcomes but no randomized control.

Study Details

PMID:36308138
Participants:300
Impact:re-surgeries reduced from 12 (2018) to 3 (2019) (-75%)
Trust score:3/5

conjunctival bacterial growth

1 evidences

Compared topical antibiotics and 5% povidone-iodine for conjunctival flora; moxifloxacin was more effective and combination with povidone-iodine showed synergy.

Trust comment: Randomized study with adequate sample and microbiologic endpoints supporting the conclusions.

Study Details

PMID:30652764
Participants:132
Impact:moxifloxacin reduced growth vs control (p=0.049) and had higher eradication rate (p=0.001); 5% povidone-iodine less effective alone; combination with moxifloxacin showed synergistic effect
Trust score:4/5

salivary mutans streptococci

1 evidences

Povidone-iodine/fluoride foam did not outperform fluoride foam alone for reducing cariogenic bacteria or caries indicators over one year.

Trust comment: Randomized controlled trial in children with defined endpoints but small sample size.

Study Details

PMID:19417885
Participants:61
Impact:decreased in both groups over 6 months; no significant difference between treatments
Trust score:4/5

laser fluorescence (cariostatic measure)

1 evidences

Povidone-iodine/fluoride foam did not outperform fluoride foam alone for reducing cariogenic bacteria or caries indicators over one year.

Trust comment: Randomized controlled trial in children with defined endpoints but small sample size.

Study Details

PMID:19417885
Participants:61
Impact:lower readings at 6 months in both groups but no significant difference between groups at 12 months
Trust score:4/5

post-cesarean infectious morbidity

1 evidences

Preoperative vaginal cleansing with 10% povidone-iodine reduced overall post-cesarean infectious morbidity, mainly by lowering endometritis rates.

Trust comment: Prospective randomized trial with adequate sample size and clinically relevant outcomes.

Study Details

PMID:30447348
Participants:226
Impact:reduced from 20.7% (control) to 7.5% (povidone-iodine)
Trust score:4/5

endometritis incidence

1 evidences

Preoperative vaginal cleansing with 10% povidone-iodine reduced overall post-cesarean infectious morbidity, mainly by lowering endometritis rates.

Trust comment: Prospective randomized trial with adequate sample size and clinically relevant outcomes.

Study Details

PMID:30447348
Participants:226
Impact:reduced from 11.8% to 2.8% with povidone-iodine
Trust score:4/5

maternal fever and wound infection

1 evidences

Preoperative vaginal cleansing with 10% povidone-iodine reduced overall post-cesarean infectious morbidity, mainly by lowering endometritis rates.

Trust comment: Prospective randomized trial with adequate sample size and clinically relevant outcomes.

Study Details

PMID:30447348
Participants:226
Impact:no significant difference between groups
Trust score:4/5

post-treatment culture negativity

1 evidences

In post-surgery CRS exacerbations, 1% povidone-iodine irrigations were well tolerated but had lower culture-negative rates than mupirocin.

Trust comment: Randomized single-blind trial with small sample and microbiologic plus patient-centered outcomes.

Study Details

PMID:32563787
Participants:62
Impact:povidone-iodine 43% vs mupirocin 70% and saline 47% (differences not statistically significant, p=0.29)
Trust score:4/5

tolerability

2 evidences

Povidone-iodine and chlorhexidine procedures had comparable rapid in vivo bactericidal activity on skin flora up to 2 hours after application.

Trust comment: Randomized volunteer study with objective microbiological endpoints but small sample and surrogate (skin flora) outcomes.

Study Details

PMID:10662566
Participants:44
Impact:well tolerated (no significant differences reported)
Trust score:3/5

In post-surgery CRS exacerbations, 1% povidone-iodine irrigations were well tolerated but had lower culture-negative rates than mupirocin.

Trust comment: Randomized single-blind trial with small sample and microbiologic plus patient-centered outcomes.

Study Details

PMID:32563787
Participants:62
Impact:1% povidone-iodine well tolerated, similar to saline
Trust score:4/5

clinical symptom and endoscopy scores

1 evidences

In post-surgery CRS exacerbations, 1% povidone-iodine irrigations were well tolerated but had lower culture-negative rates than mupirocin.

Trust comment: Randomized single-blind trial with small sample and microbiologic plus patient-centered outcomes.

Study Details

PMID:32563787
Participants:62
Impact:no significant differences between groups
Trust score:4/5

post-preparation bacterial culture positive rate

1 evidences

Povidone-iodine scrub-and-paint alone was less effective at sterilizing incision-site bacteria than protocols combining chlorhexidine.

Trust comment: Randomized controlled trial with 150 patients and clear microbiologic endpoints.

Study Details

PMID:36932681
Participants:150
Impact:overall 5.3% (8/150); povidone-iodine scrub-and-paint 12% (6/50) vs other methods 2% (1/50 each) (p=0.037)
Trust score:4/5

sterilization effectiveness

1 evidences

Povidone-iodine scrub-and-paint alone was less effective at sterilizing incision-site bacteria than protocols combining chlorhexidine.

Trust comment: Randomized controlled trial with 150 patients and clear microbiologic endpoints.

Study Details

PMID:36932681
Participants:150
Impact:chlorhexidine+povidone combinations superior to povidone-iodine scrub-and-paint
Trust score:4/5

ocular symptom frequency

1 evidences

Contact lens wearers using a povidone-iodine disinfecting solution had no increase in ocular symptoms; some conjunctival signs decreased after lens wear.

Trust comment: Checklist: 1)Confirm Iodine effect; 2)Outcomes: ocular symptoms, follicles, injection; 3)Participants: 68; 4)Quality: randomized groups, prospective; 5)Report changes. Prospective randomized assignment across cleaning regimes with 68 completers; moderate-high quality for clinical outcomes.

Study Details

PMID:35931598
Participants:68
Impact:no significant change (frequency/severity unchanged, p>0.10)
Trust score:4/5

conjunctival follicles

1 evidences

Contact lens wearers using a povidone-iodine disinfecting solution had no increase in ocular symptoms; some conjunctival signs decreased after lens wear.

Trust comment: Checklist: 1)Confirm Iodine effect; 2)Outcomes: ocular symptoms, follicles, injection; 3)Participants: 68; 4)Quality: randomized groups, prospective; 5)Report changes. Prospective randomized assignment across cleaning regimes with 68 completers; moderate-high quality for clinical outcomes.

Study Details

PMID:35931598
Participants:68
Impact:decreased (significant, p<0.01)
Trust score:4/5

conjunctival injection

1 evidences

Contact lens wearers using a povidone-iodine disinfecting solution had no increase in ocular symptoms; some conjunctival signs decreased after lens wear.

Trust comment: Checklist: 1)Confirm Iodine effect; 2)Outcomes: ocular symptoms, follicles, injection; 3)Participants: 68; 4)Quality: randomized groups, prospective; 5)Report changes. Prospective randomized assignment across cleaning regimes with 68 completers; moderate-high quality for clinical outcomes.

Study Details

PMID:35931598
Participants:68
Impact:decreased (significant, p<0.01)
Trust score:4/5

preoperative skin prep time

1 evidences

Betadine (povidone-iodine) skin prep took longer and cost more than Chloraprep in a small prospective comparison.

Trust comment: Checklist: 1)Confirm Iodine effect; 2)Outcomes: prep time, cost; 3)Participants: 30; 4)Quality: small prospective cohort with surgeon-level allocation; 5)Report changes. Small, prospective study with limited sample and surgeon-level assignment; results on time/cost are likely reliable but limited generalizability.

Study Details

PMID:35716984
Participants:30
Impact:+10.0 min (13.5 ± 0.9 min vs 3.5 ± 0.3 min)
Trust score:3/5

perioperative antisepsis cost

1 evidences

Betadine (povidone-iodine) skin prep took longer and cost more than Chloraprep in a small prospective comparison.

Trust comment: Checklist: 1)Confirm Iodine effect; 2)Outcomes: prep time, cost; 3)Participants: 30; 4)Quality: small prospective cohort with surgeon-level allocation; 5)Report changes. Small, prospective study with limited sample and surgeon-level assignment; results on time/cost are likely reliable but limited generalizability.

Study Details

PMID:35716984
Participants:30
Impact:+€108.2 (€155 ± 10.9 vs €46.8 ± 4.2; p<0.0001)
Trust score:3/5

3-month periprosthetic joint infection (PJI) rate

1 evidences

In high-risk joint arthroplasty patients, dilute povidone-iodine (alone or with vancomycin) did not change 3‑month infection or wound complication rates compared with control.

Trust comment: Checklist: 1)Confirm Iodine effect; 2)Outcomes: PJI, wound complications, readmissions; 3)Participants: 1901; 4)Quality: large multicenter RCT; 5)Report changes. Large, multicenter randomized trial with balanced groups and clear clinical endpoints; high trust.

Study Details

PMID:40349869
Participants:1901
Impact:no significant difference (THA p=0.14, TKA p=0.13)
Trust score:5/5

wound complications (drainage, dehiscence)

1 evidences

In high-risk joint arthroplasty patients, dilute povidone-iodine (alone or with vancomycin) did not change 3‑month infection or wound complication rates compared with control.

Trust comment: Checklist: 1)Confirm Iodine effect; 2)Outcomes: PJI, wound complications, readmissions; 3)Participants: 1901; 4)Quality: large multicenter RCT; 5)Report changes. Large, multicenter randomized trial with balanced groups and clear clinical endpoints; high trust.

Study Details

PMID:40349869
Participants:1901
Impact:no significant difference (THA p=0.98, TKA p=0.95)
Trust score:5/5

readmissions / ED visits

1 evidences

In high-risk joint arthroplasty patients, dilute povidone-iodine (alone or with vancomycin) did not change 3‑month infection or wound complication rates compared with control.

Trust comment: Checklist: 1)Confirm Iodine effect; 2)Outcomes: PJI, wound complications, readmissions; 3)Participants: 1901; 4)Quality: large multicenter RCT; 5)Report changes. Large, multicenter randomized trial with balanced groups and clear clinical endpoints; high trust.

Study Details

PMID:40349869
Participants:1901
Impact:no significant difference (ED visits p≥0.46, readmissions p≥0.78)
Trust score:5/5

CT image quality (attenuation in pulmonary arteries)

1 evidences

Higher iodine concentration combined with a higher iodine delivery rate produced the best CT pulmonary angiography image quality and fewer beam-hardening artifacts.

Trust comment: Checklist: 1)Confirm Iodine effect; 2)Outcomes: image quality, artifacts; 3)Participants: 100; 4)Quality: randomized protocol comparison in clinical patients; 5)Report changes. Prospective randomized comparison with objective and subjective measures; results applicable to imaging protocols.

Study Details

PMID:21577132
Participants:100
Impact:best with high concentration, high IDR (1.6 gI/s) (statistically superior, p<0.05)
Trust score:4/5

beam-hardening artifacts / perfusion map quality

1 evidences

Higher iodine concentration combined with a higher iodine delivery rate produced the best CT pulmonary angiography image quality and fewer beam-hardening artifacts.

Trust comment: Checklist: 1)Confirm Iodine effect; 2)Outcomes: image quality, artifacts; 3)Participants: 100; 4)Quality: randomized protocol comparison in clinical patients; 5)Report changes. Prospective randomized comparison with objective and subjective measures; results applicable to imaging protocols.

Study Details

PMID:21577132
Participants:100
Impact:reduced artifacts and better perfusion maps with high concentration, high IDR (p<0.05)
Trust score:4/5

sternotomy wound infection rate

1 evidences

Patients undergoing CABG had sternotomy wounds irrigated with either Dermacyn or povidone-iodine; Dermacyn group had fewer infections.

Trust comment: Prospective randomized clinical trial with adequate sample size and statistically significant result; direct clinical outcome measured.

Study Details

PMID:20719724
Participants:178
Impact:povidone-iodine 15.6% vs Dermacyn 5.7% (difference +9.9 percentage points; P=0.033)
Trust score:4/5

aortic root CT attenuation

1 evidences

Compared fixed vs weight-adjusted iodine contrast dosing for cardiac CT; weight-adjusted dosing produced more consistent vascular enhancement and better image quality.

Trust comment: Randomized comparison with objective imaging endpoints but modest sample size.

Study Details

PMID:18580334
Participants:60
Impact:fixed-dose: lighter 421.3±51.5 HU vs heavier 397.2±42.3 HU (difference −24.1 HU, P=0.03); weight-adjusted: 407.6±85.1 vs 409.2±47.9 HU (P=0.17, no significant difference)
Trust score:4/5

image noise (SD)

1 evidences

Compared fixed vs weight-adjusted iodine contrast dosing for cardiac CT; weight-adjusted dosing produced more consistent vascular enhancement and better image quality.

Trust comment: Randomized comparison with objective imaging endpoints but modest sample size.

Study Details

PMID:18580334
Participants:60
Impact:SD significantly lower with weight-adjusted protocol vs fixed-dose (improved noise)
Trust score:4/5

beam-hardening artifact score

1 evidences

Compared fixed vs weight-adjusted iodine contrast dosing for cardiac CT; weight-adjusted dosing produced more consistent vascular enhancement and better image quality.

Trust comment: Randomized comparison with objective imaging endpoints but modest sample size.

Study Details

PMID:18580334
Participants:60
Impact:visual beam-hardening artifacts significantly lower (better) with weight-adjusted protocol (P<0.01)
Trust score:4/5

thyroid-stimulating hormone (TSH) level

1 evidences

Term and preterm infants randomized to povidone-iodine or chlorhexidine-alcohol showed similar sepsis rates, but povidone-iodine was associated with higher neonatal TSH.

Trust comment: Randomized trial with objective laboratory endpoints and adequate sample size; outcome relevant to iodine exposure in neonates.

Study Details

PMID:37350581
Participants:208
Impact:median TSH higher with povidone-iodine 4.05 mIU/L vs CHG-IA 3.09 mIU/L (P=0.016)
Trust score:4/5

neonatal sepsis rate

1 evidences

Term and preterm infants randomized to povidone-iodine or chlorhexidine-alcohol showed similar sepsis rates, but povidone-iodine was associated with higher neonatal TSH.

Trust comment: Randomized trial with objective laboratory endpoints and adequate sample size; outcome relevant to iodine exposure in neonates.

Study Details

PMID:37350581
Participants:208
Impact:no significant difference: PI 8.7% vs CHG-IA 4.8% (P=0.406)
Trust score:4/5

conjunctival bacterial load (positive cultures)

1 evidences

Preoperative conjunctival irrigation with povidone-iodine reduced bacterial load; 10% concentration was more effective than 1% or 5%.

Trust comment: Randomized clinical trial with a substantial sample size and microbiological endpoints; effect size reported with statistical significance.

Study Details

PMID:23680628
Participants:271
Impact:povidone-iodine 10% produced significantly fewer positive cultures than 1% (P=0.024) and 5% (P=0.029)
Trust score:4/5

surgical site infection (SSI) rate

2 evidences

In adults undergoing clean-contaminated surgery, skin preparation with povidone-iodine had a higher rate of surgical-site infection than chlorhexidine-alcohol.

Trust comment: Large multicenter randomized trial (n=849) with clinically meaningful endpoints and robust methodology.

Study Details

PMID:20054046
Participants:849
Impact:16.1% SSI with povidone-iodine vs 9.5% with chlorhexidine-alcohol (overall)
Trust score:5/5

Subgroup analysis comparing antiseptic agents in implant surgery showed similar surgical site infection rates between povidone-iodine regimens and chlorhexidine-alcohol.

Trust comment: Large randomized trial subgroup analysis with objective outcomes, but subgroup not powered to detect small differences.

Study Details

PMID:37944097
Participants:712
Impact:C-Alc 10.13% vs PI-Alc 11.52% and PI-Aq 11.26% (no significant superiority; mean differences small and CIs include zero)
Trust score:4/5

best-corrected visual acuity (BCVA)

1 evidences

Combination povidone-iodine+dexamethasone improved vision scores, reduced infiltrate severity, and lowered recurrence compared with either agent alone.

Trust comment: Randomized prospective study but small sample size, unvalidated scoring system, and clinical diagnosis without PCR reduce certainty.

Study Details

PMID:40995906
Participants:45
Impact:median BCVA at last visit: combination 0.9 vs dexamethasone 0.6 and povidone-iodine 0.6 (P<0.001)
Trust score:3/5

modified corneal subepithelial infiltrates score (CSIS)

1 evidences

Combination povidone-iodine+dexamethasone improved vision scores, reduced infiltrate severity, and lowered recurrence compared with either agent alone.

Trust comment: Randomized prospective study but small sample size, unvalidated scoring system, and clinical diagnosis without PCR reduce certainty.

Study Details

PMID:40995906
Participants:45
Impact:last-visit median CSIS: combination 5 vs dexamethasone 7 and povidone-iodine 8 (P<0.001)
Trust score:3/5

recurrence rate of SEIs

1 evidences

Combination povidone-iodine+dexamethasone improved vision scores, reduced infiltrate severity, and lowered recurrence compared with either agent alone.

Trust comment: Randomized prospective study but small sample size, unvalidated scoring system, and clinical diagnosis without PCR reduce certainty.

Study Details

PMID:40995906
Participants:45
Impact:combination 13.3% (2/15) vs dexamethasone 86.7% (13/15) and povidone-iodine 73.3% (11/15) (P<0.001)
Trust score:3/5

central venous catheter-related bloodstream infection rate

1 evidences

In ICU catheter dressings, povidone-iodine dressings had higher catheter-related bloodstream infection and exit-site infection signs than hypochlorous-acid dressings.

Trust comment: Single-center randomized trial with small sample size and short timeframe; statistically significant but limited generalizability.

Study Details

PMID:40408178
Participants:60
Impact:povidone-iodine group had a higher infection rate than hypochlorous acid group (difference statistically significant, P<0.05)
Trust score:3/5

catheter exit-site infection signs

1 evidences

In ICU catheter dressings, povidone-iodine dressings had higher catheter-related bloodstream infection and exit-site infection signs than hypochlorous-acid dressings.

Trust comment: Single-center randomized trial with small sample size and short timeframe; statistically significant but limited generalizability.

Study Details

PMID:40408178
Participants:60
Impact:more frequent/significantly higher with povidone-iodine dressings vs hypochlorous acid (P<0.05)
Trust score:3/5

conjunctival bacterial load

2 evidences

Irrigating the conjunctival sac with 1% povidone-iodine markedly reduced conjunctival bacterial load before cataract surgery.

Trust comment: Prospective randomized study with objective microbiological outcomes but moderate sample size (133) and single-center design.

Study Details

PMID:25840297
Participants:133
Impact:significant decrease after 10 mL povidone-iodine 1.0% irrigation (largest reduction vs antibiotic regimens)
Trust score:4/5

Randomized comparison of three eye‑washing methods before cataract surgery; a single drop of 5% povidone‑iodine reduced conjunctival bacteria immediately after washing.

Trust comment: Randomized prospective study in patients with objective culture outcomes; open‑label but methods and endpoints are appropriate.

Study Details

PMID:23080269
Participants:73
Impact:decreased after 5% povidone‑iodine washing (significant, p=0.008)
Trust score:4/5

aerobic and microaerophilic flora

1 evidences

Irrigating the conjunctival sac with 1% povidone-iodine markedly reduced conjunctival bacterial load before cataract surgery.

Trust comment: Prospective randomized study with objective microbiological outcomes but moderate sample size (133) and single-center design.

Study Details

PMID:25840297
Participants:133
Impact:reduced by topical neomycin/polymyxin-B given either 1 hour or 1 day preop (both regimens effective; Group1 P=.028, Group2 P=.000)
Trust score:4/5

anaerobic bacteria

1 evidences

Irrigating the conjunctival sac with 1% povidone-iodine markedly reduced conjunctival bacterial load before cataract surgery.

Trust comment: Prospective randomized study with objective microbiological outcomes but moderate sample size (133) and single-center design.

Study Details

PMID:25840297
Participants:133
Impact:no significant change with topical antibiotics (Group1 P=.201; Group2 P=.117)
Trust score:4/5

requirement for revision surgery

1 evidences

Postoperative topical povidone-iodine ointment did not significantly reduce the need for revision surgery compared with control; lipid Amphotericin-B gel was effective.

Trust comment: Randomized single-blinded RCT but small arms (15 per group) limit precision and generalizability.

Study Details

PMID:36521349
Participants:45
Impact:no significant reduction with povidone-iodine (control risk reported as 1.50× that of povidone-iodine arm; difference not statistically significant)
Trust score:3/5

contrast-induced nephropathy (CIN)

1 evidences

Use of iodinated contrast (iohexol) was associated with increases in creatinine and a measurable rate of contrast-induced nephropathy compared with gadodiamide mixed with a small amount of iohexol.

Trust comment: Randomized study in high-risk patients with clear clinical endpoints but small sample (42) limits precision.

Study Details

PMID:16715187
Participants:42
Impact:0% CIN in gadolinium+iohexol mix vs 23% (5 patients) CIN in iodine (iohexol) group (P=0.048)
Trust score:3/5

superficial surgical site infection (SSI)

1 evidences

Reapplying an iodophor-containing surgical site preparation (including povidone-iodine components) before draping significantly lowered superficial surgical site infection after joint arthroplasty.

Trust comment: Large, randomized, double-blinded trial with low loss to follow-up and clinically meaningful endpoint.

Study Details

PMID:26781394
Participants:577
Impact:reduced from 6.5% (19/294) in single-prep group to 1.8% (5/283) in reapplication group (P=0.02)
Trust score:5/5

skin blistering

1 evidences

Reapplying an iodophor-containing surgical site preparation (including povidone-iodine components) before draping significantly lowered superficial surgical site infection after joint arthroplasty.

Trust comment: Large, randomized, double-blinded trial with low loss to follow-up and clinically meaningful endpoint.

Study Details

PMID:26781394
Participants:577
Impact:lower in reapplication group (3.5% vs 6.5%) but difference not statistically significant (P=0.13)
Trust score:5/5

CI-AKI incidence (sensitive definition)

1 evidences

Exposure to high-osmolal iodinated contrast (ioxitalamate) was associated with substantial rates of contrast-induced AKI; adding NAC or sodium bicarbonate to saline hydration provided no clear additional protection versus saline alone.

Trust comment: Large randomized trial (n=500) with rigorous measurement but single-center and use of high-osmolal contrast limit generalizability.

Study Details

PMID:25254489
Participants:500
Impact:overall incidence 51.4% (257/500) using the more sensitive definition; incidence varied by treatment group (Group1 38.9%, Group2 60.0%, Group3 58.1%, Group4 48.8%)
Trust score:4/5

CI-AKI incidence (less sensitive definition)

1 evidences

Exposure to high-osmolal iodinated contrast (ioxitalamate) was associated with substantial rates of contrast-induced AKI; adding NAC or sodium bicarbonate to saline hydration provided no clear additional protection versus saline alone.

Trust comment: Large randomized trial (n=500) with rigorous measurement but single-center and use of high-osmolal contrast limit generalizability.

Study Details

PMID:25254489
Participants:500
Impact:overall 7.6% (38/500) using less sensitive definition
Trust score:4/5

treatment effect (NAC/NaHCO3)

1 evidences

Exposure to high-osmolal iodinated contrast (ioxitalamate) was associated with substantial rates of contrast-induced AKI; adding NAC or sodium bicarbonate to saline hydration provided no clear additional protection versus saline alone.

Trust comment: Large randomized trial (n=500) with rigorous measurement but single-center and use of high-osmolal contrast limit generalizability.

Study Details

PMID:25254489
Participants:500
Impact:no evidence that NAC or NaHCO3 added to saline reduced CI-AKI vs saline alone (primary conclusion of trial)
Trust score:4/5

proportion of sites with PPD ≥5 mm

1 evidences

Using 10% povidone-iodine as the cooling liquid during ultrasonic non-surgical periodontal therapy gave limited additional clinical benefit but reduced certain microbiological markers and the proportion of deep pockets at 6 months.

Trust comment: Randomized parallel-arm trial but small completed sample (28) reduces statistical power; outcomes clinically relevant.

Study Details

PMID:21308291
Participants:28
Impact:at 6 months: 36.84% in povidone-iodine group vs 70.00% in control (p=0.04)
Trust score:3/5

BAPNA trypsin-like enzyme activity

1 evidences

Using 10% povidone-iodine as the cooling liquid during ultrasonic non-surgical periodontal therapy gave limited additional clinical benefit but reduced certain microbiological markers and the proportion of deep pockets at 6 months.

Trust comment: Randomized parallel-arm trial but small completed sample (28) reduces statistical power; outcomes clinically relevant.

Study Details

PMID:21308291
Participants:28
Impact:lower in povidone-iodine group at 6 months (significant between groups)
Trust score:3/5

PPD and RAL mean changes

1 evidences

Using 10% povidone-iodine as the cooling liquid during ultrasonic non-surgical periodontal therapy gave limited additional clinical benefit but reduced certain microbiological markers and the proportion of deep pockets at 6 months.

Trust comment: Randomized parallel-arm trial but small completed sample (28) reduces statistical power; outcomes clinically relevant.

Study Details

PMID:21308291
Participants:28
Impact:both groups showed PPD reduction and RAL gain with no significant overall difference between groups for mean changes
Trust score:3/5

bacterial colonization

1 evidences

Preoperative skin preparation with chlorhexidine reduced bacterial colonization and postoperative wound infections more than povidone-iodine.

Trust comment: Prospective randomized trial with large sample and clear outcome differences.

Study Details

PMID:19626807
Participants:500
Impact:reduced with chlorhexidine vs povidone-iodine (significant)
Trust score:4/5

surgical wound infection rate

1 evidences

Preoperative skin preparation with chlorhexidine reduced bacterial colonization and postoperative wound infections more than povidone-iodine.

Trust comment: Prospective randomized trial with large sample and clear outcome differences.

Study Details

PMID:19626807
Participants:500
Impact:reduced with chlorhexidine vs povidone-iodine (significant)
Trust score:4/5

wound redness

1 evidences

Compared lavender oil to povidone-iodine for episiotomy care; povidone-iodine was associated with more redness while pain and complication rates were similar.

Trust comment: Randomized controlled trial with moderate sample size but compared to an alternative therapy (lavender) rather than placebo.

Study Details

PMID:21168115
Participants:120
Impact:higher with povidone-iodine vs lavender (p<0.001)
Trust score:3/5

pain

3 evidences

Using povidone-iodine as an irrigant after third-molar removal was associated with more pain, alveolar osteitis, swelling, and trismus compared with chlorhexidine.

Trust comment: Small cross-sectional study (48 patients) with multiple clinical outcomes but limited power and nonrandomized design.

Study Details

PMID:30287719
Participants:48
Impact:More pain in povidone-iodine and saline groups vs chlorhexidine at 24 hours and day 7 (no numeric values provided)
Trust score:3/5

Low-concentration povidone-iodine irrigation during third molar extraction reduced postoperative swelling and trismus but did not significantly change pain; higher patient satisfaction reported for the PVI-treated side.

Trust comment: Randomized split-mouth pilot with objective measures but small sample size limits precision.

Study Details

PMID:25249172
Participants:30
Impact:no significant change
Trust score:3/5

Compared lavender oil to povidone-iodine for episiotomy care; povidone-iodine was associated with more redness while pain and complication rates were similar.

Trust comment: Randomized controlled trial with moderate sample size but compared to an alternative therapy (lavender) rather than placebo.

Study Details

PMID:21168115
Participants:120
Impact:no significant difference (p=0.06)
Trust score:3/5

surgical site complications

1 evidences

Compared lavender oil to povidone-iodine for episiotomy care; povidone-iodine was associated with more redness while pain and complication rates were similar.

Trust comment: Randomized controlled trial with moderate sample size but compared to an alternative therapy (lavender) rather than placebo.

Study Details

PMID:21168115
Participants:120
Impact:no significant difference
Trust score:3/5

irritation symptoms

1 evidences

Sterile saline and 1% povidone-iodine had similar antimicrobial effectiveness and surgical success for VVF repair, but povidone-iodine was associated with more irritation symptoms.

Trust comment: Randomized trial but modest sample size and some outcome reporting ambiguity; findings consistent for patient-reported irritation.

Study Details

PMID:39957596
Participants:61
Impact:increased with povidone-iodine vs saline (more pain and vaginal/urinary symptoms)
Trust score:3/5

bacterial load at lower urinary tract and vagina

1 evidences

Sterile saline and 1% povidone-iodine had similar antimicrobial effectiveness and surgical success for VVF repair, but povidone-iodine was associated with more irritation symptoms.

Trust comment: Randomized trial but modest sample size and some outcome reporting ambiguity; findings consistent for patient-reported irritation.

Study Details

PMID:39957596
Participants:61
Impact:no significant difference between povidone-iodine and saline
Trust score:3/5

successful repair rate

1 evidences

Sterile saline and 1% povidone-iodine had similar antimicrobial effectiveness and surgical success for VVF repair, but povidone-iodine was associated with more irritation symptoms.

Trust comment: Randomized trial but modest sample size and some outcome reporting ambiguity; findings consistent for patient-reported irritation.

Study Details

PMID:39957596
Participants:61
Impact:no significant difference (PI vs saline)
Trust score:3/5

use of povidone-iodine for skin antisepsis

1 evidences

Compared shower+saline skin prep vs traditional scrub with povidone-iodine/chlorhexidine in outpatient plastic surgery; no wound infections occurred in either group.

Trust comment: Large prospective study with very large sample but likely non-randomized and limited detail on allocation, so moderate trust.

Study Details

PMID:16079686
Participants:1810
Impact:no reduction in wound infections compared with saline/shower (no benefit detected)
Trust score:3/5

technical success rate

1 evidences

Randomized trial comparing CO2 vs iodinated contrast for ilio-femoral angioplasty: iodinated contrast gave similar technical success and no worsening of renal function, with higher contrast costs and uniformly good image ratings.

Trust comment: Randomized prospective study with clear outcomes but very small sample (n=21), limiting power.

Study Details

PMID:26598079
Participants:21
Impact:ICM 90% (similar to CO2)
Trust score:4/5

creatinine clearance (renal function)

2 evidences

In a small randomized study, CO2 contrast produced comparable angiographic images and clinical outcomes to iodine contrast without worsening kidney function and reduced contrast costs.

Trust comment: Prospective randomized study but small sample (n=35) and limited power to detect differences in renal outcomes.

Study Details

PMID:24704050
Participants:35
Impact:no statistically significant difference (numerical increase with CO2 vs decrease with iodine; delta not significant)
Trust score:3/5

Randomized trial comparing CO2 vs iodinated contrast for ilio-femoral angioplasty: iodinated contrast gave similar technical success and no worsening of renal function, with higher contrast costs and uniformly good image ratings.

Trust comment: Randomized prospective study with clear outcomes but very small sample (n=21), limiting power.

Study Details

PMID:26598079
Participants:21
Impact:no significant post-op change for ICM (delta clearance 0)
Trust score:4/5

angiographic image quality with iodinated contrast

1 evidences

Randomized trial comparing CO2 vs iodinated contrast for ilio-femoral angioplasty: iodinated contrast gave similar technical success and no worsening of renal function, with higher contrast costs and uniformly good image ratings.

Trust comment: Randomized prospective study with clear outcomes but very small sample (n=21), limiting power.

Study Details

PMID:26598079
Participants:21
Impact:all iodine arteriograms rated 'good' by observers
Trust score:4/5

dental plaque (TMQHPI) at Day 3

1 evidences

Double-blind RCT in toddlers comparing single topical 10% PVP-I vs 0.2% CHX gel vs water: PVP-I reduced plaque at Day 3 but was not superior to CHX or placebo by Day 7 after single application.

Trust comment: Randomized, double-blind trial but small sample and single application limits generalizability.

Study Details

PMID:37345210
Participants:45
Impact:mean decrease −0.83 (PVP-I) vs baseline; statistically significant (p=0.001)
Trust score:4/5

dental plaque (TMQHPI) at Day 7

1 evidences

Double-blind RCT in toddlers comparing single topical 10% PVP-I vs 0.2% CHX gel vs water: PVP-I reduced plaque at Day 3 but was not superior to CHX or placebo by Day 7 after single application.

Trust comment: Randomized, double-blind trial but small sample and single application limits generalizability.

Study Details

PMID:37345210
Participants:45
Impact:partial rebound to 1.57; not superior to controls (no between-group difference at Day 7)
Trust score:4/5

urinary infection rate (positive urine culture)

1 evidences

Prospective randomized trial in children prior to catheterization comparing sterile water vs 10% povidone-iodine periurethral cleansing: no difference in positive urine cultures.

Trust comment: Prospective randomized controlled trial with adequate sample and clear non-inferiority finding.

Study Details

PMID:19264723
Participants:186
Impact:16% (povidone-iodine) vs 18% (sterile water); no significant difference
Trust score:4/5

conjunctival bacterial culture positive rate after irrigation

1 evidences

Randomized study of 5% povidone-iodine conjunctival irrigation for varying durations before cataract surgery: 2.0 min and 3.5 min reduced conjunctival bacterial culture positivity more than 30 s or 1.0 min; 2.0 min balanced efficacy and lower short-term corneal epithelial injury compared with 3.5 min.

Trust comment: Large randomized controlled study (n=400) with clear, clinically relevant outcomes and consistent results.

Study Details

PMID:31288354
Participants:400
Impact:post-irrigation positives: 2.0 min 13.8%, 3.5 min 13.3% vs 30 s 29.2% and 1.0 min 31.1% (2.0/3.5 min significantly lower)
Trust score:5/5

corneal epithelial injury at 1 hour

1 evidences

Randomized study of 5% povidone-iodine conjunctival irrigation for varying durations before cataract surgery: 2.0 min and 3.5 min reduced conjunctival bacterial culture positivity more than 30 s or 1.0 min; 2.0 min balanced efficacy and lower short-term corneal epithelial injury compared with 3.5 min.

Trust comment: Large randomized controlled study (n=400) with clear, clinically relevant outcomes and consistent results.

Study Details

PMID:31288354
Participants:400
Impact:higher with 3.5 min (34.3%) vs 2.0 min (20.2%) and shorter durations; all resolved by 1 week
Trust score:5/5

nasal bioburden reduction (CFU)

1 evidences

A single intranasal application of a povidone-iodine solution sharply reduced nasal bacterial load without impairing mucociliary function and produced modest changes in microbial composition at 24 h.

Trust comment: Randomized, placebo-controlled human trial (n=50) with objective culture and sequencing endpoints and blinded statistical analysis.

Study Details

PMID:39033201
Participants:50
Impact:-3.68 log10 CFU (5 min); -3.57 log10 CFU (2 h); -1.17 log10 CFU (24 h) after PVP-I versus baseline (vs PBS: 0.94, 2 h data lower)
Trust score:5/5

microbial alpha diversity (Hill1)

1 evidences

A single intranasal application of a povidone-iodine solution sharply reduced nasal bacterial load without impairing mucociliary function and produced modest changes in microbial composition at 24 h.

Trust comment: Randomized, placebo-controlled human trial (n=50) with objective culture and sequencing endpoints and blinded statistical analysis.

Study Details

PMID:39033201
Participants:50
Impact:+7.74 (mean difference at 24 h, trend greater with PVP-I; p=0.08)
Trust score:5/5

mucociliary clearance (saccharin test time)

1 evidences

A single intranasal application of a povidone-iodine solution sharply reduced nasal bacterial load without impairing mucociliary function and produced modest changes in microbial composition at 24 h.

Trust comment: Randomized, placebo-controlled human trial (n=50) with objective culture and sequencing endpoints and blinded statistical analysis.

Study Details

PMID:39033201
Participants:50
Impact:no meaningful change (median 1.41 min at 24 h vs baseline 0.90 min; p=0.78)
Trust score:5/5

symptom resolution speed

1 evidences

Combination PVP-I 1% plus dexamethasone accelerated symptom resolution and viral clearance in adenoviral keratoconjunctivitis versus controls and reduced later complications.

Trust comment: Prospective, randomized, double-blinded clinical trial with PCR-confirmed cases and well-defined clinical endpoints (78 eyes).

Study Details

PMID:28342227
Participants:78
Impact:near-complete recovery in 5–7 days in PVP-I+dexamethasone group (faster than controls; p<0.001)
Trust score:4/5

adenovirus titer reduction

1 evidences

Combination PVP-I 1% plus dexamethasone accelerated symptom resolution and viral clearance in adenoviral keratoconjunctivitis versus controls and reduced later complications.

Trust comment: Prospective, randomized, double-blinded clinical trial with PCR-confirmed cases and well-defined clinical endpoints (78 eyes).

Study Details

PMID:28342227
Participants:78
Impact:faster reduction in PCR viral titres in PVP-I+dexamethasone group versus controls
Trust score:4/5

subepithelial infiltrates (SEI) incidence

1 evidences

Combination PVP-I 1% plus dexamethasone accelerated symptom resolution and viral clearance in adenoviral keratoconjunctivitis versus controls and reduced later complications.

Trust comment: Prospective, randomized, double-blinded clinical trial with PCR-confirmed cases and well-defined clinical endpoints (78 eyes).

Study Details

PMID:28342227
Participants:78
Impact:0% in study group vs 44% (control 1) and 20% (control 2)
Trust score:4/5

periodontal pocket depth (PD) reduction

1 evidences

Both subgingival irrigation with 1% PVP-I and 0.75% boric acid reduced periodontal pathogens and improved clinical parameters, but boric acid produced greater pocket depth and attachment gains over 12 months.

Trust comment: Double-blind randomized clinical trial (n=60) with 12-month follow-up and molecular bacterial outcomes, but PVP-I was compared to an active alternative showing superior results.

Study Details

PMID:38764161
Participants:60
Impact:PD reduced in PVP-I group at T3/T6/T12 but improvements were significantly smaller than in 0.75% boric acid group
Trust score:4/5

Clinical attachment level (CAL) gain

1 evidences

Both subgingival irrigation with 1% PVP-I and 0.75% boric acid reduced periodontal pathogens and improved clinical parameters, but boric acid produced greater pocket depth and attachment gains over 12 months.

Trust comment: Double-blind randomized clinical trial (n=60) with 12-month follow-up and molecular bacterial outcomes, but PVP-I was compared to an active alternative showing superior results.

Study Details

PMID:38764161
Participants:60
Impact:CAL improved in PVP-I group at follow-ups but less than boric acid (statistically significant differences favoring BA)
Trust score:4/5

bacterial counts (specific pathogens)

1 evidences

Both subgingival irrigation with 1% PVP-I and 0.75% boric acid reduced periodontal pathogens and improved clinical parameters, but boric acid produced greater pocket depth and attachment gains over 12 months.

Trust comment: Double-blind randomized clinical trial (n=60) with 12-month follow-up and molecular bacterial outcomes, but PVP-I was compared to an active alternative showing superior results.

Study Details

PMID:38764161
Participants:60
Impact:counts of Aa, Fn, Pg, Td, Tf, Sm and Ss decreased after PVP-I irrigation, though reductions for some species were greater with boric acid
Trust score:4/5

post-preparation positive skin cultures

1 evidences

Povidone-iodine skin prep left a higher rate of positive post-preparation cultures than chlorhexidine-alcohol in genitourinary prosthetic surgery patients.

Trust comment: Prospective randomized controlled study (n=100) with clear microbiological endpoints and clinical safety assessment.

Study Details

PMID:23164373
Participants:100
Impact:32% positive after povidone-iodine versus 8% after chlorhexidine-alcohol (p=0.0091)
Trust score:4/5

preparation safety (genital skin/urethral irritation)

1 evidences

Povidone-iodine skin prep left a higher rate of positive post-preparation cultures than chlorhexidine-alcohol in genitourinary prosthetic surgery patients.

Trust comment: Prospective randomized controlled study (n=100) with clear microbiological endpoints and clinical safety assessment.

Study Details

PMID:23164373
Participants:100
Impact:no urethral or genital skin complications reported with either agent
Trust score:4/5

mucositis incidence

1 evidences

Oral rinsing with povidone-iodine during radiochemotherapy markedly reduced incidence, severity and duration of oral mucositis compared with control rinsing.

Trust comment: Randomized prospective trial (n=40) with large and statistically significant clinical differences in mucositis outcomes and safety monitoring for thyroid effects.

Study Details

PMID:9695205
Participants:40
Impact:clinically manifest mucositis in 14/20 iodine group vs 20/20 control
Trust score:4/5

mucositis severity (mean grade)

1 evidences

Oral rinsing with povidone-iodine during radiochemotherapy markedly reduced incidence, severity and duration of oral mucositis compared with control rinsing.

Trust comment: Randomized prospective trial (n=40) with large and statistically significant clinical differences in mucositis outcomes and safety monitoring for thyroid effects.

Study Details

PMID:9695205
Participants:40
Impact:mean grade 1.0 (iodine) vs 3.0 (control)
Trust score:4/5

mucositis duration and burden (weeks / AUC)

1 evidences

Oral rinsing with povidone-iodine during radiochemotherapy markedly reduced incidence, severity and duration of oral mucositis compared with control rinsing.

Trust comment: Randomized prospective trial (n=40) with large and statistically significant clinical differences in mucositis outcomes and safety monitoring for thyroid effects.

Study Details

PMID:9695205
Participants:40
Impact:mean duration 2.75 weeks (iodine) vs 9.25 weeks (control); median AUC 2.5 vs 15.75
Trust score:4/5

time to complete healing

1 evidences

Topical liposome PVP-I hydrogel accelerated healing of partial-thickness burns and yielded better cosmetic outcomes versus silver-sulfadiazine cream.

Trust comment: Randomized controlled intraindividual comparison (n=43) showing statistically significant faster healing and better cosmetic outcomes.

Study Details

PMID:17901735
Participants:43
Impact:9.9 ± 4.5 days with liposome PVP-I hydrogel vs 11.3 ± 4.9 days with silver-sulfadiazine (P < 0.015)
Trust score:4/5

cosmetic result (excellent rating)

1 evidences

Topical liposome PVP-I hydrogel accelerated healing of partial-thickness burns and yielded better cosmetic outcomes versus silver-sulfadiazine cream.

Trust comment: Randomized controlled intraindividual comparison (n=43) showing statistically significant faster healing and better cosmetic outcomes.

Study Details

PMID:17901735
Participants:43
Impact:37% rated excellent for PVP-I hydrogel vs 13% for silver-sulfadiazine
Trust score:4/5

conjunctival culture positivity

2 evidences

Adding extra proparacaine drops did not change patient experience and had higher conjunctival culture positivity than povidone-iodine antisepsis.

Trust comment: Small randomized controlled trial (n=36) with clear endpoints but limited sample size reducing power.

Study Details

PMID:31983237
Participants:36
Impact:proparacaine alone 8.3% (3/36); after second proparacaine 5.8% (1/17); proparacaine + povidone-iodine 5.3% (1/19)
Trust score:3/5

Topical ofloxacin reduced conjunctival bacteria and adding preoperative 5% povidone-iodine further reduced conjunctival flora to very low levels; anterior chamber contamination was rare.

Trust comment: Large prospective surgical study with clear microbiological endpoints directly assessing povidone-iodine antisepsis; robust sample and objective measures.

Study Details

PMID:22218245
Participants:300
Impact:18.66% (on admission) → 6.33% (after topical ofloxacin) → 1.66% (after 5% povidone-iodine); addition of PI produced further significant reduction (P=0.0068)
Trust score:4/5

patient-reported experience

1 evidences

Adding extra proparacaine drops did not change patient experience and had higher conjunctival culture positivity than povidone-iodine antisepsis.

Trust comment: Small randomized controlled trial (n=36) with clear endpoints but limited sample size reducing power.

Study Details

PMID:31983237
Participants:36
Impact:no significant difference between groups
Trust score:3/5

stent evaluability

1 evidences

Iodixanol-320 at 5.0 mL/s produced better stent image evaluability and fewer artifacts than the other contrast protocols.

Trust comment: Large randomized imaging study (n=254) with objective imaging endpoints and clear group comparisons.

Study Details

PMID:24582042
Participants:254
Impact:iodixanol-320 (5.0 mL/s) 99% evaluability vs 91% (iodixanol-320 @6.2 mL/s) and 92% (iomeprol-400)
Trust score:4/5

artifact rate (beam-hardening)

1 evidences

Iodixanol-320 at 5.0 mL/s produced better stent image evaluability and fewer artifacts than the other contrast protocols.

Trust comment: Large randomized imaging study (n=254) with objective imaging endpoints and clear group comparisons.

Study Details

PMID:24582042
Participants:254
Impact:4% with iodixanol-320 (5.0 mL/s) vs 15% and 17% in the other groups
Trust score:4/5

post-caesarean endometritis rate

1 evidences

Preoperative vaginal disinfection with 10% povidone-iodine did not significantly change endometritis rates but lowered postoperative inflammatory markers.

Trust comment: Prospective randomized trial with adequate sample size (n=270) and statistically significant biomarker findings but no clinical endpoint improvement.

Study Details

PMID:33186774
Participants:270
Impact:4.6% (PVP-I) vs 6.4% (control); difference not statistically significant (p > 0.05)
Trust score:4/5

postoperative inflammatory markers (CRP and WBC)

1 evidences

Preoperative vaginal disinfection with 10% povidone-iodine did not significantly change endometritis rates but lowered postoperative inflammatory markers.

Trust comment: Prospective randomized trial with adequate sample size (n=270) and statistically significant biomarker findings but no clinical endpoint improvement.

Study Details

PMID:33186774
Participants:270
Impact:CRP and WBC decreased after CS in PVP-I group vs increased in control (CRP p = 0.01; WBC p = 0.001)
Trust score:4/5

intraoperative bacteraemia

1 evidences

Povidone-iodine meatal antisepsis did not match systemic antibiotic prophylaxis in preventing intraoperative bacteraemia or meatal bacterial growth, and none reduced catheter-related bacteriuria.

Trust comment: Prospective randomized controlled study (n=167) with clinically relevant infection outcomes, though some numeric details are not reported in the summary.

Study Details

PMID:12180224
Participants:167
Impact:significantly lower with parenteral cephradine than with PVP-I or control (exact rates not provided)
Trust score:4/5

bacteriuria at catheter removal

1 evidences

Povidone-iodine meatal antisepsis did not match systemic antibiotic prophylaxis in preventing intraoperative bacteraemia or meatal bacterial growth, and none reduced catheter-related bacteriuria.

Trust comment: Prospective randomized controlled study (n=167) with clinically relevant infection outcomes, though some numeric details are not reported in the summary.

Study Details

PMID:12180224
Participants:167
Impact:no significant difference between PVP-I, saline control, and parenteral antibiotic groups
Trust score:4/5

SARS-CoV-2 salivary viral load (E gene Ct)

1 evidences

A povidone-iodine mouth rinse produced a short-term reduction in salivary SARS-CoV-2 viral load as measured by increased RT-PCR Ct values.

Trust comment: Randomized clinical trial with laboratory viral-load endpoints but small group sizes (n=12 per arm) and short follow-up.

Study Details

PMID:35905275
Participants:48
Impact:PVP-I mouth rinse mean Ct increase 4.43 ± 4.78 (p < 0.01)
Trust score:4/5

SARS-CoV-2 salivary viral load (S gene Ct)

1 evidences

A povidone-iodine mouth rinse produced a short-term reduction in salivary SARS-CoV-2 viral load as measured by increased RT-PCR Ct values.

Trust comment: Randomized clinical trial with laboratory viral-load endpoints but small group sizes (n=12 per arm) and short follow-up.

Study Details

PMID:35905275
Participants:48
Impact:PVP-I mouth rinse mean Ct increase 3.33 ± 5.60 (p = 0.04); combined-gene reduction p < 0.001
Trust score:4/5

surgical site infection (overall)

1 evidences

Intraoperative wound irrigation with dilute povidone-iodine markedly reduced surgical site infection rates compared with saline plus gentamicin.

Trust comment: Prospective randomized comparative study (n=80) showing statistically significant reductions in SSI with dilute PVP-I.

Study Details

PMID:36608799
Participants:80
Impact:17.5% (saline+gentamicin) vs 2.5% (dilute PVP-I); p = 0.025
Trust score:4/5

surgical site infection (lumbosacral region)

1 evidences

Intraoperative wound irrigation with dilute povidone-iodine markedly reduced surgical site infection rates compared with saline plus gentamicin.

Trust comment: Prospective randomized comparative study (n=80) showing statistically significant reductions in SSI with dilute PVP-I.

Study Details

PMID:36608799
Participants:80
Impact:31.6% (saline+gentamicin) vs 0% (dilute PVP-I); p = 0.006
Trust score:4/5

bacterial contamination reduction

1 evidences

In dirty surgical wounds, packing with oxidized regenerated cellulose reduced bacterial contamination more often than gauze soaked in iodine; no clinical surgical-site infections occurred in either group.

Trust comment: Prospective randomized study with 98 patients and objective swab measures, but absence of SSI events limits clinical outcome conclusions.

Study Details

PMID:21389925
Participants:98
Impact:25% no/reduced contamination with iodine (12/48) vs 66% with ORC (33/50)
Trust score:4/5

glomerular filtration rate (GFR) change

1 evidences

In patients with severely impaired renal function, iodinated contrast (iohexol) produced a mean GFR decline at 48 h and a high incidence of acute renal failure, with no benefit over gadolinium.

Trust comment: Randomized clinical trial but small sample (n=21) in a high-risk population reduces precision and generalizability.

Study Details

PMID:15280530
Participants:21
Impact:Mean GFR decrease with iodinated contrast: -8.7 ± 8.8 ml/min/1.73 m2 at 48 h
Trust score:3/5

acute renal failure incidence

1 evidences

In patients with severely impaired renal function, iodinated contrast (iohexol) produced a mean GFR decline at 48 h and a high incidence of acute renal failure, with no benefit over gadolinium.

Trust comment: Randomized clinical trial but small sample (n=21) in a high-risk population reduces precision and generalizability.

Study Details

PMID:15280530
Participants:21
Impact:45% incidence of CM-induced acute renal failure (GFR decrease >50%) with iodinated contrast
Trust score:3/5

maximum hepatic enhancement (MHE)

1 evidences

Using lean body weight to calculate iodine dose for CT provided more consistent hepatic enhancement across patients and reduced variability compared with dosing by total body weight or estimated blood volume.

Trust comment: Randomized allocation with 120 patients and objective imaging endpoints; well-conducted for imaging optimization.

Study Details

PMID:20019137
Participants:120
Impact:MHE constant at 77.9 HU ±10.2 when dosing by lean body weight
Trust score:4/5

change in CT number per gram of iodine

1 evidences

Using lean body weight to calculate iodine dose for CT provided more consistent hepatic enhancement across patients and reduced variability compared with dosing by total body weight or estimated blood volume.

Trust comment: Randomized allocation with 120 patients and objective imaging endpoints; well-conducted for imaging optimization.

Study Details

PMID:20019137
Participants:120
Impact:Inverse correlation with body size (liver r = -0.79 TBW, r = -0.86 LBW), stronger when using LBW
Trust score:4/5

superficial and deep incisional SSI rates

1 evidences

In adults undergoing clean-contaminated surgery, skin preparation with povidone-iodine had a higher rate of surgical-site infection than chlorhexidine-alcohol.

Trust comment: Large multicenter randomized trial (n=849) with clinically meaningful endpoints and robust methodology.

Study Details

PMID:20054046
Participants:849
Impact:Superficial 8.6% and deep 3.0% with povidone-iodine (vs 4.2% and 1.0% with chlorhexidine)
Trust score:5/5

bacterial load reduction

1 evidences

In 28 healthy volunteers, adding alcohol to povidone-iodine increased reduction of bacterial load on the foot, but nailfolds remained contaminated with all methods.

Trust comment: Small randomized volunteer study with surrogate microbiological endpoints, limiting clinical infection inference.

Study Details

PMID:19665260
Participants:28
Impact:Povidone-iodine plus alcohol increased efficacy versus povidone-iodine alone; nailfold remained contaminated after all methods
Trust score:3/5

positive culture rate

2 evidences

In elective foot and ankle surgery patients, povidone-iodine skin prep resulted in more positive cultures than chlorhexidine with alcohol.

Trust comment: Prospective randomized study with clear microbiological endpoints and adequate sample size for the tested question.

Study Details

PMID:16131892
Participants:127
Impact:79% positive cultures with povidone-iodine (53/67) vs 38% with chlorhexidine/alcohol (23/60)
Trust score:4/5

Giving a second povidone-iodine eye drop within the first day did not reduce neonatal conjunctivitis compared with a single drop; double dosing had slightly more eyelid swelling.

Trust comment: Large masked, prospective controlled trial with clear outcomes, though single-center and pragmatic randomisation by alternating weeks.

Study Details

PMID:14660449
Participants:719
Impact:+2.2% (10.4% vs 8.2%)
Trust score:4/5

postoperative infectious morbidity (composite)

1 evidences

A preoperative vaginal wash with povidone-iodine before C-section reduced postoperative infectious events compared with no wash, but the difference was not statistically significant.

Trust comment: Randomized controlled trial with 300 women; well-designed but the primary difference was not statistically significant.

Study Details

PMID:20207251
Participants:300
Impact:6.5% vs 11.7% (−5.2 percentage points); RR 0.55; P = .11
Trust score:4/5

skin bacterial colony counts

1 evidences

A 1-minute povidone-iodine scrub followed by alcohol foam produced similar or fewer skin bacterial colonies than a 5-minute povidone-iodine scrub.

Trust comment: Small study (37 patients) with objective microbiologic endpoints but limited sample size.

Study Details

PMID:9542852
Participants:37
Impact:1-hour: 10 vs 18 colonies (1-min+alcohol vs 5-min PVI); 2-hour: 18 vs 44 colonies (1-min+alcohol vs 5-min PVI)
Trust score:3/5

bacterial counts (ocular prep)

1 evidences

Preoperative PVP-iodine was superior to topical antibiotics for eye prep, reducing bacterial counts substantially and eliminating fungi.

Trust comment: Comparative study with 100 patients reporting clear qualitative antiseptic benefits but limited numeric detail in the excerpt.

Study Details

PMID:9830286
Participants:100
Impact:Substantial reduction in bacterial counts versus topical antibiotics (extent not numerically specified)
Trust score:3/5

fungal presence

1 evidences

Preoperative PVP-iodine was superior to topical antibiotics for eye prep, reducing bacterial counts substantially and eliminating fungi.

Trust comment: Comparative study with 100 patients reporting clear qualitative antiseptic benefits but limited numeric detail in the excerpt.

Study Details

PMID:9830286
Participants:100
Impact:Fungi eliminated completely with PVP-iodine
Trust score:3/5

alveolar osteitis (dry socket)

1 evidences

Using povidone-iodine as an irrigant after third-molar removal was associated with more pain, alveolar osteitis, swelling, and trismus compared with chlorhexidine.

Trust comment: Small cross-sectional study (48 patients) with multiple clinical outcomes but limited power and nonrandomized design.

Study Details

PMID:30287719
Participants:48
Impact:Present in povidone-iodine and saline groups; nil in chlorhexidine group
Trust score:3/5

catheter-related bloodstream infection

1 evidences

Chlorhexidine-based skin antisepsis halved catheter colonization rates compared with alcohol-based povidone-iodine and showed a trend toward fewer bloodstream infections.

Trust comment: Large randomized trial of 538 catheters with significant reduction in colonization and robust methodology.

Study Details

PMID:17954800
Participants:538
Impact:1.7% vs 4.2% (chlorhexidine vs povidone-iodine); incidence density 1.4 vs 3.4 per 1,000 catheter-days (trend, P = .09)
Trust score:5/5

pin-site infection incidence

1 evidences

Randomized trial comparing 2% chlorhexidine-alcohol versus 10% povidone-iodine for pin-site care; no difference in pin-site infection rates, and infection risk rose with longer fixator duration.

Trust comment: Prospective randomized clinical trial with objective outcome and moderate sample size, but open-label single-center design.

Study Details

PMID:32371731
Participants:128
Impact:no significant difference between chlorhexidine-alcohol and povidone-iodine
Trust score:4/5

infection risk over time

1 evidences

Randomized trial comparing 2% chlorhexidine-alcohol versus 10% povidone-iodine for pin-site care; no difference in pin-site infection rates, and infection risk rose with longer fixator duration.

Trust comment: Prospective randomized clinical trial with objective outcome and moderate sample size, but open-label single-center design.

Study Details

PMID:32371731
Participants:128
Impact:increased risk with longer duration of fixator (time effect significant)
Trust score:4/5

conjunctival bacterial load (CFU)

1 evidences

Randomized study of preoperative topical ciprofloxacin with routine 10% povidone-iodine surgical field preparation; povidone-iodine substantially reduced conjunctival culture positivity immediately after application.

Trust comment: Randomized, single-blind controlled study with objective microbiological outcomes but small sample size.

Study Details

PMID:23988041
Participants:46
Impact:substantial reduction after povidone-iodine application (overall biota reduced in ~50–70% of patients)
Trust score:4/5

proportion with positive cultures immediately after povidone-iodine

1 evidences

Randomized study of preoperative topical ciprofloxacin with routine 10% povidone-iodine surgical field preparation; povidone-iodine substantially reduced conjunctival culture positivity immediately after application.

Trust comment: Randomized, single-blind controlled study with objective microbiological outcomes but small sample size.

Study Details

PMID:23988041
Participants:46
Impact:reduced to 21.7% (study group) and 8.7% (control) immediately after application
Trust score:4/5

superficial infection incidence at pin/wire sites

1 evidences

Randomized controlled trial comparing daily topical 10% PVP-I plus saline dressing versus saline alone for Ilizarov wire/pin sites; no reduction in superficial infection incidence with PVP-I.

Trust comment: Randomized controlled trial but small sample (n=30) and limited power to detect differences.

Study Details

PMID:15947831
Participants:30
Impact:no significant difference between PVP-I dressings and saline dressings
Trust score:3/5

signs/symptoms of local infection (fever, hyperemia, edema, pain, purulent exudate)

1 evidences

Randomized controlled trial comparing daily topical 10% PVP-I plus saline dressing versus saline alone for Ilizarov wire/pin sites; no reduction in superficial infection incidence with PVP-I.

Trust comment: Randomized controlled trial but small sample (n=30) and limited power to detect differences.

Study Details

PMID:15947831
Participants:30
Impact:no significant differences between groups
Trust score:3/5

Aggregatibacter actinomycetemcomitans (Aa) levels in deep pockets

1 evidences

Randomized trial of full-mouth ultrasonic debridement using 10% povidone-iodine versus saline as irrigant in generalized aggressive periodontitis; no additional clinical, immunological or broad microbiological benefit, though Aa levels in deep pockets decreased.

Trust comment: Randomized trial with objective measures but small sample size limits generalizability.

Study Details

PMID:25875425
Participants:28
Impact:decreased with 10% povidone-iodine irrigation
Trust score:3/5

clinical periodontal outcomes (PD, RCAL, FMPI, FMBS)

1 evidences

Randomized trial of full-mouth ultrasonic debridement using 10% povidone-iodine versus saline as irrigant in generalized aggressive periodontitis; no additional clinical, immunological or broad microbiological benefit, though Aa levels in deep pockets decreased.

Trust comment: Randomized trial with objective measures but small sample size limits generalizability.

Study Details

PMID:25875425
Participants:28
Impact:no additional benefit versus saline irrigation
Trust score:3/5

interleukin-2 (IL-2) level in gingival tissue

1 evidences

Double-blind randomized study of four mouthwashes including povidone-iodine used for two weeks in chronic gingivitis; povidone-iodine reduced plaque/gingival indices and pro-inflammatory cytokines IL-2 and IFN-γ significantly.

Trust comment: Well-powered double-blind randomized design with biochemical and clinical endpoints.

Study Details

PMID:18389675
Participants:80
Impact:statistically significant reduction after povidone-iodine mouthwash
Trust score:4/5

interferon-gamma (IFN-γ) level in gingival tissue

1 evidences

Double-blind randomized study of four mouthwashes including povidone-iodine used for two weeks in chronic gingivitis; povidone-iodine reduced plaque/gingival indices and pro-inflammatory cytokines IL-2 and IFN-γ significantly.

Trust comment: Well-powered double-blind randomized design with biochemical and clinical endpoints.

Study Details

PMID:18389675
Participants:80
Impact:statistically significant reduction after povidone-iodine mouthwash
Trust score:4/5

plaque and gingival indices

1 evidences

Double-blind randomized study of four mouthwashes including povidone-iodine used for two weeks in chronic gingivitis; povidone-iodine reduced plaque/gingival indices and pro-inflammatory cytokines IL-2 and IFN-γ significantly.

Trust comment: Well-powered double-blind randomized design with biochemical and clinical endpoints.

Study Details

PMID:18389675
Participants:80
Impact:statistically significant reduction with povidone-iodine
Trust score:4/5

OAG oral mucositis severity score

1 evidences

Pilot comparative study of DSIG (contains iodine glycerin) cream versus topical mouth rinse for chemotherapy-induced oral mucositis; DSIG produced lower OAG severity scores and faster complete regression.

Trust comment: Relatively large pilot cohort with clear clinical endpoints but design details (randomization/blinding) and single-study nature limit certainty.

Study Details

PMID:25465773
Participants:130
Impact:lower in DSIG group across days 2–5 (e.g., day5 mean 8.0 vs 10.4)
Trust score:3/5

oral mucositis repair time

1 evidences

Pilot comparative study of DSIG (contains iodine glycerin) cream versus topical mouth rinse for chemotherapy-induced oral mucositis; DSIG produced lower OAG severity scores and faster complete regression.

Trust comment: Relatively large pilot cohort with clear clinical endpoints but design details (randomization/blinding) and single-study nature limit certainty.

Study Details

PMID:25465773
Participants:130
Impact:shortened by ~4.08 days (mean 4.68 vs 8.76 days) with DSIG
Trust score:3/5

complete regression rate by day 5

1 evidences

Pilot comparative study of DSIG (contains iodine glycerin) cream versus topical mouth rinse for chemotherapy-induced oral mucositis; DSIG produced lower OAG severity scores and faster complete regression.

Trust comment: Relatively large pilot cohort with clear clinical endpoints but design details (randomization/blinding) and single-study nature limit certainty.

Study Details

PMID:25465773
Participants:130
Impact:DSIG: 85.7% complete regression vs 3.0% with topical mouth rinse
Trust score:3/5

maternal TSH

1 evidences

Randomized trial comparing daily 225 μg iodine capsules versus adequately iodized salt for 26 weeks in lactating women; maternal TSH and goiter prevalence decreased with supplementation and infants in the iodized salt arm showed higher novelty preference (memory) scores.

Trust comment: Well-conducted, registered randomized trial with meaningful clinical and biochemical outcomes and adequate sample for key endpoints.

Study Details

PMID:31589645
Participants:101
Impact:significant decrease vs baseline (capsule ~54% decrease; I-salt ~42% decrease)
Trust score:5/5

maternal goiter prevalence

1 evidences

Randomized trial comparing daily 225 μg iodine capsules versus adequately iodized salt for 26 weeks in lactating women; maternal TSH and goiter prevalence decreased with supplementation and infants in the iodized salt arm showed higher novelty preference (memory) scores.

Trust comment: Well-conducted, registered randomized trial with meaningful clinical and biochemical outcomes and adequate sample for key endpoints.

Study Details

PMID:31589645
Participants:101
Impact:decreased overall from 76% to 37% after 26 weeks
Trust score:5/5

infant novelty quotient (VIP memory measure)

1 evidences

Randomized trial comparing daily 225 μg iodine capsules versus adequately iodized salt for 26 weeks in lactating women; maternal TSH and goiter prevalence decreased with supplementation and infants in the iodized salt arm showed higher novelty preference (memory) scores.

Trust comment: Well-conducted, registered randomized trial with meaningful clinical and biochemical outcomes and adequate sample for key endpoints.

Study Details

PMID:31589645
Participants:101
Impact:higher proportion with NQ>0.55 in I-salt group (51%) vs capsule group (26%)
Trust score:5/5

splash basin contamination

1 evidences

Adding dilute povidone-iodine (0.02%) to sterile water splash basins eliminated intraoperative basin contamination during joint arthroplasty.

Trust comment: Randomized controlled trial with clear, large effect on objective microbiological outcome and low risk of bias.

Study Details

PMID:31537375
Participants:100
Impact:-47.9 percentage points (47.9% -> 0.0%)
Trust score:5/5

urinary iodine excretion (U-I)

1 evidences

Partially replacing animal proteins with plant proteins for 12 weeks lowered iodine intake and urinary iodine excretion in healthy adults.

Trust comment: Well-conducted 12-week randomized dietary trial (n=136) with objective biomarkers but limited to short duration and female-dominant sample.

Study Details

PMID:34837522
Participants:136
Impact:PLANT vs ANIMAL: -68.7 µg/d (128.7 vs 197.4 µg/d, p=0.002)
Trust score:4/5

post-operative pain (VAS at end of surgery)

1 evidences

Using 5% povidone-iodine drops at the end of cataract surgery caused less immediate postoperative pain than subconjunctival injection and produced similar inflammation and visual outcomes.

Trust comment: Prospective randomized study (n=60) with small sample size limiting precision, but outcomes are clinically relevant.

Study Details

PMID:20395917
Participants:60
Impact:-3.0 points (5.7 -> 2.7 at end of surgery)
Trust score:3/5

post-operative inflammation

1 evidences

Using 5% povidone-iodine drops at the end of cataract surgery caused less immediate postoperative pain than subconjunctival injection and produced similar inflammation and visual outcomes.

Trust comment: Prospective randomized study (n=60) with small sample size limiting precision, but outcomes are clinically relevant.

Study Details

PMID:20395917
Participants:60
Impact:no significant difference between groups
Trust score:3/5

Peristomal wound infection

1 evidences

Coating PEG tubes with 10% povidone-iodine did not reduce infections but reduced short-term inflammatory markers after the procedure.

Trust comment: Randomized controlled single-center trial with objective outcomes but small sample and early termination reducing power.

Study Details

PMID:37189057
Participants:50
Impact:No reduction (Betadine 24% vs Control 16%; p=0.725)
Trust score:4/5

Delta CRP (mg/dl)

1 evidences

Coating PEG tubes with 10% povidone-iodine did not reduce infections but reduced short-term inflammatory markers after the procedure.

Trust comment: Randomized controlled single-center trial with objective outcomes but small sample and early termination reducing power.

Study Details

PMID:37189057
Participants:50
Impact:Lower with Betadine: 1.16 vs 2.68 (difference -1.52 mg/dl; p=0.009)
Trust score:4/5

Delta N/L ratio

1 evidences

Coating PEG tubes with 10% povidone-iodine did not reduce infections but reduced short-term inflammatory markers after the procedure.

Trust comment: Randomized controlled single-center trial with objective outcomes but small sample and early termination reducing power.

Study Details

PMID:37189057
Participants:50
Impact:Lower with Betadine: 1.2 vs 3.1 (difference -1.9; p=0.047)
Trust score:4/5

Incisional surgical site infection

1 evidences

Intraoperative irrigation with 10% aqueous povidone-iodine did not reduce incisional surgical-site infections compared with saline.

Trust comment: Large randomized masked-endpoint trial at a single institute; robust sample but single-center limits generalizability.

Study Details

PMID:36538622
Participants:941
Impact:7.6% (PVP-I) vs 5.1% (saline); absolute difference +2.5% (risk ratio 1.484); not statistically significant (P=0.154)
Trust score:4/5

Oral mucositis incidence

2 evidences

Rinsing with povidone-iodine reduced how often and how bad mouth sores were during cancer radiochemotherapy.

Trust comment: Small randomized open-label study with clear, large effects but limited by size and lack of blinding.

Study Details

PMID:9403257
Participants:40
Impact:Treatment 70% (14/20) vs Control 100% (20/20); statistically significant
Trust score:3/5

In head-and-neck cancer patients receiving radiochemotherapy, adding povidone-iodine oral rinses reduced how often, how severe, and how long oral mucositis occurred compared with sterile water.

Trust comment: Prospective randomized trial (n=40) with clear, clinically relevant endpoints and statistically significant differences; moderate sample size limits generalizability.

Study Details

PMID:9524624
Participants:40
Impact:-30 percentage points (70% vs 100%; 14/20 vs 20/20)
Trust score:4/5

Oral mucositis severity (mean grade)

2 evidences

In head-and-neck cancer patients receiving radiochemotherapy, adding povidone-iodine oral rinses reduced how often, how severe, and how long oral mucositis occurred compared with sterile water.

Trust comment: Prospective randomized trial (n=40) with clear, clinically relevant endpoints and statistically significant differences; moderate sample size limits generalizability.

Study Details

PMID:9524624
Participants:40
Impact:-2.0 grade units (1.0 vs 3.0)
Trust score:4/5

Rinsing with povidone-iodine reduced how often and how bad mouth sores were during cancer radiochemotherapy.

Trust comment: Small randomized open-label study with clear, large effects but limited by size and lack of blinding.

Study Details

PMID:9403257
Participants:40
Impact:Mean grade 1.0 (treatment) vs 3.0 (control); statistically significant
Trust score:3/5

Oral mucositis duration (weeks)

1 evidences

Rinsing with povidone-iodine reduced how often and how bad mouth sores were during cancer radiochemotherapy.

Trust comment: Small randomized open-label study with clear, large effects but limited by size and lack of blinding.

Study Details

PMID:9403257
Participants:40
Impact:Mean 2.75 weeks (treatment) vs 9.25 weeks (control); statistically significant
Trust score:3/5

Immediate bacterial reduction (log10 cfu)

1 evidences

PVP-I plus alcohol produced rapid bacterial reductions but its antimicrobial persistence was shorter (up to 96 h) than chlorhexidine+alcohol (up to 7 days) in healthy volunteers.

Trust comment: Controlled clinical study in healthy volunteers with microbiological endpoints; not a clinical infection outcome trial.

Study Details

PMID:36049573
Participants:103
Impact:Mean reduction >2 log10 (abdomen) and >3 log10 (groin) at 10 min for both products
Trust score:3/5

Antiseptic persistence (duration)

1 evidences

PVP-I plus alcohol produced rapid bacterial reductions but its antimicrobial persistence was shorter (up to 96 h) than chlorhexidine+alcohol (up to 7 days) in healthy volunteers.

Trust comment: Controlled clinical study in healthy volunteers with microbiological endpoints; not a clinical infection outcome trial.

Study Details

PMID:36049573
Participants:103
Impact:PVP-I+IPA persisted up to 96 h; CHG+IPA persisted up to 7 days
Trust score:3/5

Antiseptic bacterial reduction (log10 cfu/cm2)

1 evidences

Alcoholic 5% povidone-iodine significantly reduced skin bacterial counts with all application modes; back-and-forth friction gave slightly better reduction than concentric circles.

Trust comment: Small randomized healthy-volunteer study with objective microbiological measures but limited sample size and open-label design.

Study Details

PMID:35271958
Participants:32
Impact:Significant reduction with all modes (mean reductions >3 log10 for some sites); P<0.05
Trust score:3/5

Application technique effect (log10 cfu/cm2 difference)

1 evidences

Alcoholic 5% povidone-iodine significantly reduced skin bacterial counts with all application modes; back-and-forth friction gave slightly better reduction than concentric circles.

Trust comment: Small randomized healthy-volunteer study with objective microbiological measures but limited sample size and open-label design.

Study Details

PMID:35271958
Participants:32
Impact:Back-and-forth friction superior to concentric circles (difference ~0.22 log10 cfu/cm2; 90% CI 0.07–0.37; P=0.017)
Trust score:3/5

residual bacterial count (povidone-iodine)

1 evidences

Sixty volunteers compared hand sanitizers (including povidone-iodine); alcohol-based products worked well and rings only worsened outcomes with povidone-iodine.

Trust comment: Randomized controlled study in humans with objective CFU outcomes; moderate sample size (n=60).

Study Details

PMID:17326029
Participants:60
Impact:greater with rings vs without rings (P<.05)
Trust score:4/5

residual bacterial count (waterless alcohol-chlorhexidine)

1 evidences

Sixty volunteers compared hand sanitizers (including povidone-iodine); alcohol-based products worked well and rings only worsened outcomes with povidone-iodine.

Trust comment: Randomized controlled study in humans with objective CFU outcomes; moderate sample size (n=60).

Study Details

PMID:17326029
Participants:60
Impact:lowest bacterial count vs other methods (P<.01)
Trust score:4/5

intracanal microbial presence

1 evidences

Twenty-four patients had root canals treated and filled with iodine-potassium-iodide dressing; microbial samples showed partial reduction of microbes with IKI but no difference between preparation methods.

Trust comment: Pilot randomized clinical trial with small sample (n=24) and culture-based outcomes, limiting precision and power.

Study Details

PMID:23126492
Participants:24
Impact:microbes present initially in 88% of teeth; ‘no growth’ in 50% after IKI dressing
Trust score:3/5

microbial reduction by preparation type

1 evidences

Twenty-four patients had root canals treated and filled with iodine-potassium-iodide dressing; microbial samples showed partial reduction of microbes with IKI but no difference between preparation methods.

Trust comment: Pilot randomized clinical trial with small sample (n=24) and culture-based outcomes, limiting precision and power.

Study Details

PMID:23126492
Participants:24
Impact:no significant difference between apical box and apical cone preparations
Trust score:3/5

total iodine intake

4 evidences

Forty patients underwent CT angiography with a low-iodine contrast protocol; image quality remained diagnostic while iodine dose and radiation dose were reduced.

Trust comment: Prospective randomized imaging study with objective dose metrics and blinded image assessment but modest sample size (n=40).

Study Details

PMID:27577517
Participants:40
Impact:reduced by 22.86% vs high-iodine protocol
Trust score:4/5

Low tube voltage + low-concentration contrast and iterative reconstruction produced similar image quality with lower radiation and iodine dose.

Trust comment: Randomized imaging study with objective measures but moderate sample size and single-technology setting limits generalizability.

Study Details

PMID:27577515
Participants:154
Impact:-22.9% (Group B vs Group A)
Trust score:3/5

Randomized study in obese patients comparing conventional CT protocol vs a 'double-low' protocol (lower kVp and lower-concentration iodine) plus AIIR reconstruction, assessing image quality, radiation dose, and iodine intake.

Trust comment: Randomized prospective human study (n=150) with detailed quantitative image quality, dose, and iodine-intake results; single-center and moderate sample size.

Study Details

PMID:40634847
Participants:150
Impact:Decreased by 10.71% (group B vs group A, p<0.001)
Trust score:4/5

Using spectral CT with a lower‑concentration iodinated contrast reduced total iodine dose by ~28% while achieving equal or better vascular image quality than conventional CTA.

Trust comment: Small randomized feasibility study (n=70) showing reduced iodinated contrast dose with maintained/better image quality; moderate risk of limited generalizability.

Study Details

PMID:26036793
Participants:70
Impact:Reduced by 28% compared with conventional CTA
Trust score:3/5

image quality (diagnostic)

1 evidences

Forty patients underwent CT angiography with a low-iodine contrast protocol; image quality remained diagnostic while iodine dose and radiation dose were reduced.

Trust comment: Prospective randomized imaging study with objective dose metrics and blinded image assessment but modest sample size (n=40).

Study Details

PMID:27577517
Participants:40
Impact:comparable subjective scores; no significant differences in CNR/CT values (differences not statistically significant)
Trust score:4/5

immediate nasal bacterial reduction (post-disinfection)

1 evidences

Fifty patients randomized to nasal disinfection with benzalkonium chloride or povidone-iodine showed that PVI gave a stronger immediate reduction in nasal bacteria but BZK provided more sustained suppression after intubation.

Trust comment: Prospectively registered randomized trial (CONSORT) with objective CFU counts and appropriate statistics (n=50 completed).

Study Details

PMID:31470798
Participants:50
Impact:PVI 20 CFU/swab vs BZK 1300 CFU/swab (≈65-fold lower; p=0.00005)
Trust score:4/5

postoperative bacterial proliferation

1 evidences

Fifty patients randomized to nasal disinfection with benzalkonium chloride or povidone-iodine showed that PVI gave a stronger immediate reduction in nasal bacteria but BZK provided more sustained suppression after intubation.

Trust comment: Prospectively registered randomized trial (CONSORT) with objective CFU counts and appropriate statistics (n=50 completed).

Study Details

PMID:31470798
Participants:50
Impact:greater proliferation after PVI (C/B rate ≈9867) vs BZK (C/B rate ≈100; p=0.002)
Trust score:4/5

sustained antimicrobial effect

1 evidences

Fifty patients randomized to nasal disinfection with benzalkonium chloride or povidone-iodine showed that PVI gave a stronger immediate reduction in nasal bacteria but BZK provided more sustained suppression after intubation.

Trust comment: Prospectively registered randomized trial (CONSORT) with objective CFU counts and appropriate statistics (n=50 completed).

Study Details

PMID:31470798
Participants:50
Impact:BZK maintained antimicrobial effect longer than PVI (MIC: BZK active to 2^9 dilution vs PVI 2^6)
Trust score:4/5

bacteriuria rate after catheterization

1 evidences

Sixty women were randomized to periurethral cleansing with water or povidone-iodine before catheter insertion; no difference was found in bacteriuria or UTI rates.

Trust comment: Randomized study in humans (n=60) with straightforward clinical endpoints but limited sample size reducing power to detect small differences.

Study Details

PMID:19507410
Participants:60
Impact:no significant difference between water and povidone-iodine groups
Trust score:3/5

urinary tract infection rate

2 evidences

Rectal cleansing with 10% povidone-iodine plus formalin dipping of the needle tip reduced infectious complications after transrectal prostate biopsy.

Trust comment: Large randomized controlled trial with clear endpoints and statistically significant primary outcome.

Study Details

PMID:36006040
Participants:1256
Impact:2.3% vs 4.1% (−1.8 percentage points; P = .071)
Trust score:5/5

Sixty women were randomized to periurethral cleansing with water or povidone-iodine before catheter insertion; no difference was found in bacteriuria or UTI rates.

Trust comment: Randomized study in humans (n=60) with straightforward clinical endpoints but limited sample size reducing power to detect small differences.

Study Details

PMID:19507410
Participants:60
Impact:no significant difference between water and povidone-iodine groups
Trust score:3/5

pleurodesis success rate

2 evidences

Iodopovidone and doxycycline had similar pleurodesis success rates; iodopovidone caused higher chest pain scores but similar complication rates.

Trust comment: Randomized clinical trial with clear outcome measures and adequate reporting; moderate sample size.

Study Details

PMID:37428348
Participants:110
Impact:complete response 79.3% (iodopovidone) vs 82.7% (doxycycline); p=0.3 (no significant difference)
Trust score:4/5

Randomized trial in patients with malignant pleural effusion found povidone-iodine pleurodesis had similar success and complication rates to talc.

Trust comment: Randomized controlled trial but small, non-blinded sample limits precision and generalizability.

Study Details

PMID:25947235
Participants:39
Impact:Povidone-iodine 72.2% (13/18) vs talc 80.9% (17/21); difference not statistically significant
Trust score:3/5

post-procedure pain

1 evidences

Randomized trial in patients with malignant pleural effusion found povidone-iodine pleurodesis had similar success and complication rates to talc.

Trust comment: Randomized controlled trial but small, non-blinded sample limits precision and generalizability.

Study Details

PMID:25947235
Participants:39
Impact:Povidone-iodine 50% (9/18) vs talc 66.7% (14/21); no significant difference
Trust score:3/5

recurrence of dyspnea

1 evidences

Randomized trial in patients with malignant pleural effusion found povidone-iodine pleurodesis had similar success and complication rates to talc.

Trust comment: Randomized controlled trial but small, non-blinded sample limits precision and generalizability.

Study Details

PMID:25947235
Participants:39
Impact:Povidone-iodine 27.8% (5/18) vs talc 19% (4/21); no significant difference
Trust score:3/5

radiation-induced oral mucositis (incidence/severity)

1 evidences

Randomized trial comparing turmeric gargle to povidone-iodine gargle during radiotherapy found povidone-iodine was less effective than turmeric at delaying and reducing mucositis.

Trust comment: Single-blinded randomized controlled trial with 80 patients and clear endpoints; comparator was povidone-iodine but primary intervention was turmeric.

Study Details

PMID:24165896
Participants:80
Impact:Povidone-iodine group had earlier and higher severity of mucositis compared with turmeric; turmeric significantly delayed and reduced mucositis (P<0.001 to P<0.0001)
Trust score:4/5

treatment interruptions

1 evidences

Randomized trial comparing turmeric gargle to povidone-iodine gargle during radiotherapy found povidone-iodine was less effective than turmeric at delaying and reducing mucositis.

Trust comment: Single-blinded randomized controlled trial with 80 patients and clear endpoints; comparator was povidone-iodine but primary intervention was turmeric.

Study Details

PMID:24165896
Participants:80
Impact:Higher incidence of treatment breaks in povidone-iodine group in the first half of treatment (before 4 weeks); turmeric reduced breaks (P<0.01)
Trust score:4/5

surgical site infections and wound-healing disorders

1 evidences

Prospective randomized trial found povidone-iodine skin prep was associated with more surgical-site infections and wound-healing disorders than chlorhexidine in lower limb trauma surgery.

Trust comment: Well-powered prospective randomized trial showing clinically meaningful differences favoring chlorhexidine over povidone-iodine for pre-op skin antisepsis.

Study Details

PMID:31604621
Participants:279
Impact:Povidone-iodine group: 21 complications (12.6%) vs chlorhexidine 5 (4.5%); odds ratio 3.5 for complications with povidone-iodine (95% CI 1.1–11.2, P=0.032)
Trust score:4/5

positive conjunctival cultures

1 evidences

Irrigating the fornices with 5% povidone-iodine before eye surgery reduced positive conjunctival bacterial cultures compared with two drops.

Trust comment: Randomized controlled trial with clear culture-based endpoints and reported p-values, though some attrition from initial 200 to 172 eyes.

Study Details

PMID:15710810
Participants:172
Impact:-17 percentage points before surgery (26% vs 43%); -14 percentage points at surgery end (18% vs 32%) (irrigation vs drops)
Trust score:4/5

vaginal operative field bacterial contamination

1 evidences

Chlorhexidine reduced early intraoperative vaginal bacterial contamination more than povidone-iodine; differences later during surgery were not significant.

Trust comment: Small randomized controlled trial with a clear microbiologic primary endpoint and significant p-value for the early-timepoint comparison.

Study Details

PMID:15695981
Participants:50
Impact:Povidone-iodine had +41 percentage points higher contaminated cultures at 30 min (63% vs 22%, povidone vs chlorhexidine)
Trust score:4/5

catheter tip bacterial colonization

1 evidences

Using chlorhexidine/propanol followed by povidone-iodine for skin disinfection before CVC insertion produced much lower catheter tip bacterial colonization than either agent alone.

Trust comment: Prospective randomized trial with quantitative cultures and statistically significant differences, though catheter-level outcomes and multiple catheters per patient noted.

Study Details

PMID:15085323
Participants:119
Impact:Combined regimen reduced colonization to 4.7% versus 30.8% (vs povidone alone) and 24.4% (vs chlorhexidine alone); p=0.006
Trust score:4/5

duration of conjunctivitis

1 evidences

Topical dexamethasone 0.1% with povidone-iodine 0.4% shortened conjunctivitis duration by about 2.4 days but caused more stinging than artificial tears.

Trust comment: Randomized, masked trial with PCR testing and multiple symptom/timepoint assessments; effect sizes and adverse sensation reported.

Study Details

PMID:25310347
Participants:122
Impact:-2.4 days (9.4 ± 4.6 d vs 11.8 ± 4.9 d; p = 0.009)
Trust score:4/5

ocular stinging (side effect)

1 evidences

Topical dexamethasone 0.1% with povidone-iodine 0.4% shortened conjunctivitis duration by about 2.4 days but caused more stinging than artificial tears.

Trust comment: Randomized, masked trial with PCR testing and multiple symptom/timepoint assessments; effect sizes and adverse sensation reported.

Study Details

PMID:25310347
Participants:122
Impact:increased (p < 0.001)
Trust score:4/5

CT/PET quantitative enhancement (HU, SUV)

1 evidences

When total iodine delivery rate and dose were kept constant per body surface area, CT and PET quantitative and visual results did not differ between contrast media with 300 mg/ml and 370 mg/ml iodine.

Trust comment: Consecutive patient comparison (non-randomized allocation by order) with clear imaging metrics but potential allocation bias.

Study Details

PMID:24113432
Participants:120
Impact:no significant differences between 300 mg/ml and 370 mg/ml iodine concentrations when iodine delivery rate and total dose were constant
Trust score:3/5

SARS-CoV-2 oral viral load (Ct value)

1 evidences

Gargling with povidone-iodine did not change SARS-CoV-2 Ct values overall, though more patients converted from positive to negative after antiseptic gargle in some analyses.

Trust comment: Randomized trial in hospitalized patients with objective PCR endpoints, but small sample and mixed/marginal outcomes limit certainty.

Study Details

PMID:35904769
Participants:75
Impact:no statistically significant change in Ct values before vs after gargling (p > 0.05)
Trust score:3/5

conversion to negative PCR in mouthwash samples

1 evidences

Gargling with povidone-iodine did not change SARS-CoV-2 Ct values overall, though more patients converted from positive to negative after antiseptic gargle in some analyses.

Trust comment: Randomized trial in hospitalized patients with objective PCR endpoints, but small sample and mixed/marginal outcomes limit certainty.

Study Details

PMID:35904769
Participants:75
Impact:increased number of samples turning negative after povidone-iodine (statistically significant)
Trust score:3/5

ulcer area reduction

1 evidences

Cadexomer iodine paste healed venous leg ulcers faster and reduced ulcer size more than comparators.

Trust comment: Randomized, multicentre controlled trial with clear endpoints and 153 patients, though open-label and some subgroup reporting.

Study Details

PMID:9620490
Participants:153
Impact:cadexomer iodine: 62% mean reduction overall (vs 41% hydrocolloid, 24% paraffin); 66% vs 18% at 12 weeks (n=51, P = 0.0127)
Trust score:4/5

healing rate (area/week)

1 evidences

Cadexomer iodine paste healed venous leg ulcers faster and reduced ulcer size more than comparators.

Trust comment: Randomized, multicentre controlled trial with clear endpoints and 153 patients, though open-label and some subgroup reporting.

Study Details

PMID:9620490
Participants:153
Impact:cadexomer iodine: 0.64 cm2/week vs paraffin: 0.19 cm2/week (P = 0.0353)
Trust score:4/5

cost-effectiveness

1 evidences

Cadexomer iodine paste healed venous leg ulcers faster and reduced ulcer size more than comparators.

Trust comment: Randomized, multicentre controlled trial with clear endpoints and 153 patients, though open-label and some subgroup reporting.

Study Details

PMID:9620490
Participants:153
Impact:more cost-effective over 12 weeks (study statement)
Trust score:4/5

immediate pain score

1 evidences

Povidone-iodine caused more immediate pain and corneal surface damage than aqueous chlorhexidine, with no difference in microbial culture rates.

Trust comment: Prospective randomized within-patient trial (50 patients, paired eyes) with objective outcomes and clear statistics.

Study Details

PMID:33221515
Participants:50
Impact:PI 1.44 vs AqCHX 0.44 (scale 0-10; P < 0.001)
Trust score:5/5

corneal epitheliopathy (ocular staining score)

1 evidences

Povidone-iodine caused more immediate pain and corneal surface damage than aqueous chlorhexidine, with no difference in microbial culture rates.

Trust comment: Prospective randomized within-patient trial (50 patients, paired eyes) with objective outcomes and clear statistics.

Study Details

PMID:33221515
Participants:50
Impact:PI 4.22 vs AqCHX 3.10 (P < 0.001)
Trust score:5/5

microbial culture positivity

1 evidences

Povidone-iodine caused more immediate pain and corneal surface damage than aqueous chlorhexidine, with no difference in microbial culture rates.

Trust comment: Prospective randomized within-patient trial (50 patients, paired eyes) with objective outcomes and clear statistics.

Study Details

PMID:33221515
Participants:50
Impact:no difference between PI and AqCHX
Trust score:5/5

hepatic parenchyma enhancement

1 evidences

Higher iodine concentration (400 mg/mL) produced greater liver and vascular enhancement and better image quality than 350 mg/mL in chronic liver disease patients.

Trust comment: Prospective within-patient randomized design with quantitative measures in 50 patients, though single-center and limited generalizability.

Study Details

PMID:26701234
Participants:50
Impact:+7.5 H (portal phase) and +4.8 H (equilibrium) with 400 mg/mL vs 350 mg/mL (P = 0.025 and P = 0.021)
Trust score:4/5

aortic enhancement

1 evidences

Higher iodine concentration (400 mg/mL) produced greater liver and vascular enhancement and better image quality than 350 mg/mL in chronic liver disease patients.

Trust comment: Prospective within-patient randomized design with quantitative measures in 50 patients, though single-center and limited generalizability.

Study Details

PMID:26701234
Participants:50
Impact:+28 H (arterial) and +17.1 H (portal) with 400 mg/mL (P = 0.005 and P = 0.002)
Trust score:4/5

visual image quality

1 evidences

Higher iodine concentration (400 mg/mL) produced greater liver and vascular enhancement and better image quality than 350 mg/mL in chronic liver disease patients.

Trust comment: Prospective within-patient randomized design with quantitative measures in 50 patients, though single-center and limited generalizability.

Study Details

PMID:26701234
Participants:50
Impact:higher scores with 400 mg/mL (e.g., grade 4 portal phase: 40/50 vs 12/50)
Trust score:4/5

intra-oral bacterial count reduction

1 evidences

Preoperative oral antiseptic washes reduced intra-oral bacterial counts; povidone-iodine worked well for procedures up to 1 hour but chlorhexidine and cetrimide had longer effects.

Trust comment: Prospective randomized study with 120 patients but abstract provides limited quantitative results and no detailed statistics.

Study Details

PMID:19167188
Participants:120
Impact:significant reduction with antiseptics vs control (no numeric values reported in abstract)
Trust score:3/5

duration of antiseptic effect

1 evidences

Preoperative oral antiseptic washes reduced intra-oral bacterial counts; povidone-iodine worked well for procedures up to 1 hour but chlorhexidine and cetrimide had longer effects.

Trust comment: Prospective randomized study with 120 patients but abstract provides limited quantitative results and no detailed statistics.

Study Details

PMID:19167188
Participants:120
Impact:povidone-iodine effective up to 1 hour; chlorhexidine better for >1 hour; cetrimide longest lasting
Trust score:3/5

total iodinated contrast volume

1 evidences

Using Dynamic Coronary Roadmap guidance significantly reduced the volume of iodinated contrast and number of cineangiography runs during PCI.

Trust comment: Large multicentre randomized trial with clear primary endpoint and significant findings, relevant to reducing iodinated contrast exposure.

Study Details

PMID:38343370
Participants:356
Impact:DCR 64.6±44.4 ml vs control 90.8±55.4 ml (P < 0.001)
Trust score:4/5

number of cineangiography runs

1 evidences

Using Dynamic Coronary Roadmap guidance significantly reduced the volume of iodinated contrast and number of cineangiography runs during PCI.

Trust comment: Large multicentre randomized trial with clear primary endpoint and significant findings, relevant to reducing iodinated contrast exposure.

Study Details

PMID:38343370
Participants:356
Impact:DCR 8.7±4.7 vs control 11.7±7.6 (P < 0.001)
Trust score:4/5

preoperative conjunctival culture positivity (T2)

1 evidences

Randomized trial (n=142) showed that adding PVI 10% plus levofloxacin 1 hour pre-op substantially reduced conjunctival culture positivity immediately before surgery.

Trust comment: Randomized controlled trial with adequate sample size and clear, statistically significant reductions in preoperative culture positivity.

Study Details

PMID:32947383
Participants:142
Impact:15.5% vs 71.8% (intervention vs control), −56.3 percentage points (P<0.001)
Trust score:4/5

conjunctival culture positivity 3 min after second PVI (T3)

1 evidences

Randomized trial (n=142) showed that adding PVI 10% plus levofloxacin 1 hour pre-op substantially reduced conjunctival culture positivity immediately before surgery.

Trust comment: Randomized controlled trial with adequate sample size and clear, statistically significant reductions in preoperative culture positivity.

Study Details

PMID:32947383
Participants:142
Impact:7.0% vs 19.7% (intervention vs control), −12.7 percentage points (P=0.027)
Trust score:4/5

postoperative conjunctival culture positivity (T4)

1 evidences

Randomized trial (n=142) showed that adding PVI 10% plus levofloxacin 1 hour pre-op substantially reduced conjunctival culture positivity immediately before surgery.

Trust comment: Randomized controlled trial with adequate sample size and clear, statistically significant reductions in preoperative culture positivity.

Study Details

PMID:32947383
Participants:142
Impact:5.6% vs 4.2% (intervention vs control), no significant difference (P=0.698)
Trust score:4/5

post-biopsy bacteremia (blood culture positivity)

1 evidences

Randomized trial (n=100) comparing rectal sterilization with 10% povidone-iodine versus control found a higher number of positive blood cultures in the PVI group in the reported results.

Trust comment: Randomized trial but reported results are counterintuitive (higher bacteremia with rectal PVI); potential methodological or reporting concerns warrant cautious interpretation.

Study Details

PMID:20043564
Participants:100
Impact:9/50 (18%) in rectum PVI group vs 2/50 (4%) in control (P=0.025) — higher bacteremia in PVI group as reported
Trust score:3/5

post-injection ocular surface symptoms (OSDI, SPEED II) overall

1 evidences

Randomized trial (n=126) testing dissolvable punctal plugs after intravitreal injection prep with PVI found no overall reduction in ocular surface symptoms, but benefit in subgroup with objective dry eye.

Trust comment: Moderately sized randomized trial; primary outcomes not significant overall, with a modest subgroup benefit.

Study Details

PMID:33746207
Participants:126
Impact:no significant difference between CPP and control (OSDI p=0.137; SPEED II p=0.381)
Trust score:3/5

post-injection symptoms in patients with objective dry eye

1 evidences

Randomized trial (n=126) testing dissolvable punctal plugs after intravitreal injection prep with PVI found no overall reduction in ocular surface symptoms, but benefit in subgroup with objective dry eye.

Trust comment: Moderately sized randomized trial; primary outcomes not significant overall, with a modest subgroup benefit.

Study Details

PMID:33746207
Participants:126
Impact:improvement with CPP in subgroup (p=0.046)
Trust score:3/5

umbilical cord colonization

1 evidences

Large randomized study (n=516) comparing cord care agents found chlorhexidine reduced cord colonization but prolonged cord separation time; povidone-iodine did not show superior colonization reduction.

Trust comment: Large randomized trial with clear findings favoring chlorhexidine for colonization reduction but showing increased cord separation time; povidone-iodine did not demonstrate clear benefit for colonization in reported results.

Study Details

PMID:28248676
Participants:516
Impact:significantly lower in chlorhexidine groups (groups 3 and 6) (P<0.001); povidone-iodine groups were not reported as superior
Trust score:4/5

cord separation time

1 evidences

Large randomized study (n=516) comparing cord care agents found chlorhexidine reduced cord colonization but prolonged cord separation time; povidone-iodine did not show superior colonization reduction.

Trust comment: Large randomized trial with clear findings favoring chlorhexidine for colonization reduction but showing increased cord separation time; povidone-iodine did not demonstrate clear benefit for colonization in reported results.

Study Details

PMID:28248676
Participants:516
Impact:longer with antiseptic use (median 10 days for chlorhexidine groups vs 7 days for dry care; P<0.001)
Trust score:4/5

omphalitis incidence

1 evidences

Large randomized study (n=516) comparing cord care agents found chlorhexidine reduced cord colonization but prolonged cord separation time; povidone-iodine did not show superior colonization reduction.

Trust comment: Large randomized trial with clear findings favoring chlorhexidine for colonization reduction but showing increased cord separation time; povidone-iodine did not demonstrate clear benefit for colonization in reported results.

Study Details

PMID:28248676
Participants:516
Impact:no significant difference between groups (8 cases overall, 1.5%)
Trust score:4/5

mucositis duration

1 evidences

In head-and-neck cancer patients receiving radiochemotherapy, adding povidone-iodine oral rinses reduced how often, how severe, and how long oral mucositis occurred compared with sterile water.

Trust comment: Prospective randomized trial (n=40) with clear, clinically relevant endpoints and statistically significant differences; moderate sample size limits generalizability.

Study Details

PMID:9524624
Participants:40
Impact:-6.5 weeks (2.75 vs 9.25 weeks)
Trust score:4/5

proportion of negative conjunctival cultures (PI plus)

1 evidences

Instilling three 5% povidone-iodine drops over ~28 minutes (PI plus) reduced conjunctival bacterial cultures more than a single drop, without detectable corneal toxicity.

Trust comment: Randomized, double-masked trial (n=124) with microbiological endpoints and appropriate methods; authors note limited power for some between-group comparisons.

Study Details

PMID:29261737
Participants:124
Impact:+14.8 percentage points after intervention (70.5% before vs 85.3% after; intra-group p=0.0177)
Trust score:4/5

central corneal thickness (CCT) change

1 evidences

Instilling three 5% povidone-iodine drops over ~28 minutes (PI plus) reduced conjunctival bacterial cultures more than a single drop, without detectable corneal toxicity.

Trust comment: Randomized, double-masked trial (n=124) with microbiological endpoints and appropriate methods; authors note limited power for some between-group comparisons.

Study Details

PMID:29261737
Participants:124
Impact:no significant change (mean change ~0–1.34 µm; p>0.4)
Trust score:4/5

post-treatment oral bacteraemia prevalence

1 evidences

Using 10% PVP-iodine rinsing before and during subgingival ultrasonic scaling substantially reduced the prevalence and magnitude of oral-derived bacteraemia compared with water.

Trust comment: Randomized placebo-controlled clinical trial (n=38) with quantitative microbiological outcomes showing significant reduction in prevalence and CFU counts with PVP-iodine.

Study Details

PMID:25950231
Participants:38
Impact:-31.6 percentage points (2/19 test [10.5%] vs 10/19 control [52.6%])
Trust score:4/5

magnitude of bacteraemia (CFU)

1 evidences

Using 10% PVP-iodine rinsing before and during subgingival ultrasonic scaling substantially reduced the prevalence and magnitude of oral-derived bacteraemia compared with water.

Trust comment: Randomized placebo-controlled clinical trial (n=38) with quantitative microbiological outcomes showing significant reduction in prevalence and CFU counts with PVP-iodine.

Study Details

PMID:25950231
Participants:38
Impact:mean CFU 3.0 vs 12.2 (reduction; p=0.003)
Trust score:4/5

aortic (arterial) enhancement

1 evidences

Shortening injection time with higher-concentration iodine increased arterial (aortic) enhancement on liver CT while portal and hepatic enhancement were unchanged.

Trust comment: Randomized study (124 exams) with objective imaging measures and clear between-group comparisons.

Study Details

PMID:15786754
Participants:124
Impact:increased (significant) in group 3 vs groups 1 and 2
Trust score:4/5

portal venous enhancement

1 evidences

Shortening injection time with higher-concentration iodine increased arterial (aortic) enhancement on liver CT while portal and hepatic enhancement were unchanged.

Trust comment: Randomized study (124 exams) with objective imaging measures and clear between-group comparisons.

Study Details

PMID:15786754
Participants:124
Impact:no significant difference between protocols
Trust score:4/5

hepatic (liver) enhancement

1 evidences

Shortening injection time with higher-concentration iodine increased arterial (aortic) enhancement on liver CT while portal and hepatic enhancement were unchanged.

Trust comment: Randomized study (124 exams) with objective imaging measures and clear between-group comparisons.

Study Details

PMID:15786754
Participants:124
Impact:no significant difference between protocols
Trust score:4/5

positive intraocular culture rate

1 evidences

Adding vancomycin to irrigating fluid reduced positive intraocular cultures after cataract surgery; intracameral vancomycin has a half-life under 2 hours.

Trust comment: Large 400-eye randomized clinical study with objective culture outcomes and a statistically significant result for intraoperative vancomycin.

Study Details

PMID:11239859
Participants:400
Impact:reduced from 11–13% (no vancomycin) to 2–5% with intraoperative vancomycin (lowest 2% in vancomycin+povidone; P=0.032)
Trust score:4/5

intracameral vancomycin half-life

1 evidences

Adding vancomycin to irrigating fluid reduced positive intraocular cultures after cataract surgery; intracameral vancomycin has a half-life under 2 hours.

Trust comment: Large 400-eye randomized clinical study with objective culture outcomes and a statistically significant result for intraoperative vancomycin.

Study Details

PMID:11239859
Participants:400
Impact:<2 hours
Trust score:4/5

deep surgical site infection (SSI) rate

1 evidences

Nasal povidone-iodine around surgery produced similar overall deep SSI rates to mupirocin, but per-protocol analysis showed elimination of S. aureus deep SSIs in the povidone group.

Trust comment: Large randomized trial with clinically important endpoints though open-label; per-protocol result for S. aureus was significant.

Study Details

PMID:24915210
Participants:1697
Impact:14/855 (1.6%) mupirocin vs 6/842 (0.7%) povidone; P=0.1 (modified intent-to-treat, not significant)
Trust score:4/5

Staphylococcus aureus deep SSI rate

1 evidences

Nasal povidone-iodine around surgery produced similar overall deep SSI rates to mupirocin, but per-protocol analysis showed elimination of S. aureus deep SSIs in the povidone group.

Trust comment: Large randomized trial with clinically important endpoints though open-label; per-protocol result for S. aureus was significant.

Study Details

PMID:24915210
Participants:1697
Impact:per-protocol 5/763 mupirocin vs 0/776 povidone; P=0.03 (per-protocol significant)
Trust score:4/5

residual intracanal microorganisms (postmedication)

1 evidences

One-visit treatment including a 10-min 5% iodine-potassium-iodide dressing left residual microbes in 29% of teeth, similar to 36% after two-visit treatment.

Trust comment: Randomized clinical trial (n=96) with microbiological sampling before/after procedures and clear reported percentages.

Study Details

PMID:15273638
Participants:96
Impact:29% in one-visit (with 5% iodine-potassium-iodide) vs 36% in two-visit; no significant difference
Trust score:4/5

post-instrumentation cultivable microbiota

1 evidences

One-visit treatment including a 10-min 5% iodine-potassium-iodide dressing left residual microbes in 29% of teeth, similar to 36% after two-visit treatment.

Trust comment: Randomized clinical trial (n=96) with microbiological sampling before/after procedures and clear reported percentages.

Study Details

PMID:15273638
Participants:96
Impact:reduced after instrumentation in both groups
Trust score:4/5

immediate clearance rate

1 evidences

Povidone iodine 0.2% was as effective as 1% silver nitrate for renal pelvic sclerotherapy with similar recurrence and slightly higher immediate clearance and less flank pain.

Trust comment: Prospective randomized comparative study with follow-up and clear outcome rates, though subgroup numbers are modest (85 analyzed for the two arms).

Study Details

PMID:15541132
Participants:85
Impact:91% silver nitrate vs 98% povidone
Trust score:4/5

recurrence rate after first course

1 evidences

Povidone iodine 0.2% was as effective as 1% silver nitrate for renal pelvic sclerotherapy with similar recurrence and slightly higher immediate clearance and less flank pain.

Trust comment: Prospective randomized comparative study with follow-up and clear outcome rates, though subgroup numbers are modest (85 analyzed for the two arms).

Study Details

PMID:15541132
Participants:85
Impact:21% silver nitrate vs 22% povidone (similar)
Trust score:4/5

treatment-related flank pain

1 evidences

Povidone iodine 0.2% was as effective as 1% silver nitrate for renal pelvic sclerotherapy with similar recurrence and slightly higher immediate clearance and less flank pain.

Trust comment: Prospective randomized comparative study with follow-up and clear outcome rates, though subgroup numbers are modest (85 analyzed for the two arms).

Study Details

PMID:15541132
Participants:85
Impact:11% silver nitrate vs 2% povidone
Trust score:4/5

exit site infection rate

2 evidences

Using povidone-iodine spray for CAPD exit care did not meaningfully reduce exit infections or peritonitis; it altered organism profile and caused rash in some patients.

Trust comment: Randomized trial (149 catheters/130 patients) but showed minimal effect on primary outcomes and some adverse events.

Study Details

PMID:9152821
Participants:130
Impact:14/77 (18%) with spray vs 15/72 (21%) without (no significant difference)
Trust score:3/5

Polyhexanide tended to reduce exit-site infections and peritonitis rates compared with povidone-iodine, but differences were not statistically significant.

Trust comment: Randomized controlled design with moderate follow-up but limited sample size and non-significant differences.

Study Details

PMID:31066988
Participants:88
Impact:Povidone-iodine group: 0.12 episodes/patient-year vs polyhexanide 0.06 episodes/patient-year (trend favoring polyhexanide, NS)
Trust score:3/5

peritonitis risk

1 evidences

Using povidone-iodine spray for CAPD exit care did not meaningfully reduce exit infections or peritonitis; it altered organism profile and caused rash in some patients.

Trust comment: Randomized trial (149 catheters/130 patients) but showed minimal effect on primary outcomes and some adverse events.

Study Details

PMID:9152821
Participants:130
Impact:similar between groups
Trust score:3/5

rash incidence

1 evidences

Using povidone-iodine spray for CAPD exit care did not meaningfully reduce exit infections or peritonitis; it altered organism profile and caused rash in some patients.

Trust comment: Randomized trial (149 catheters/130 patients) but showed minimal effect on primary outcomes and some adverse events.

Study Details

PMID:9152821
Participants:130
Impact:6% in spray group
Trust score:3/5

post-treatment bacteremia level/rate

1 evidences

Irrigating the gingival sulcus with povidone-iodine before dental treatment reduced post-treatment bacteremia compared with chlorhexidine or water.

Trust comment: Randomized study with 120 patients reporting lower bacteremia with povidone-iodine, but quantitative detail is limited.

Study Details

PMID:7560572
Participants:120
Impact:lower bacteremia levels observed with 10% povidone-iodine versus chlorhexidine or water (no absolute numbers reported)
Trust score:3/5

overall positive culture rate

1 evidences

Randomized study comparing three skin-prep solutions for shoulder surgery cultures; chlorhexidine performed best overall.

Trust comment: Prospective randomized trial (n=150) with objective culture outcomes and reported p-values.

Study Details

PMID:19651954
Participants:150
Impact:31% (povidone-iodine) vs 19% (DuraPrep, iodophor) vs 7% (ChloraPrep)
Trust score:4/5

eradication of coagulase-negative Staphylococcus

1 evidences

Randomized study comparing three skin-prep solutions for shoulder surgery cultures; chlorhexidine performed best overall.

Trust comment: Prospective randomized trial (n=150) with objective culture outcomes and reported p-values.

Study Details

PMID:19651954
Participants:150
Impact:ChloraPrep and DuraPrep superior to povidone-iodine (p<0.001)
Trust score:4/5

standardized coronary artery attenuation (HU)

1 evidences

Randomized comparison of two high-iodine contrast agents showing higher standardized attenuation for iopromide 370 but similar subjective image quality.

Trust comment: Prospective randomized study with blinded readers, standardized measurements, and adequate sample size (n=297).

Study Details

PMID:20849317
Participants:297
Impact:460 HU (iopromide 370) vs 435 HU (iomeprol 400), p=0.006
Trust score:4/5

subjective coronary segment image quality (grade 1)

1 evidences

Randomized comparison of two high-iodine contrast agents showing higher standardized attenuation for iopromide 370 but similar subjective image quality.

Trust comment: Prospective randomized study with blinded readers, standardized measurements, and adequate sample size (n=297).

Study Details

PMID:20849317
Participants:297
Impact:91.8% (iopromide 370) vs 91.6% (iomeprol 400), no significant difference
Trust score:4/5

signs of surgical-site infection (24 h)

1 evidences

Randomized trial showing lower wound inflammation signs and lower pain when combined alcohol-based antiseptic plus povidone-iodine was used versus povidone-iodine alone.

Trust comment: Randomized single-center trial (n=100) with blinded outcome assessors but small size and use of minor signs to define infection can limit interpretation.

Study Details

PMID:27147783
Participants:100
Impact:6% (experimental: Alkosol + povidone) vs 40% (povidone-only)
Trust score:3/5

signs of surgical-site infection (48 h)

1 evidences

Randomized trial showing lower wound inflammation signs and lower pain when combined alcohol-based antiseptic plus povidone-iodine was used versus povidone-iodine alone.

Trust comment: Randomized single-center trial (n=100) with blinded outcome assessors but small size and use of minor signs to define infection can limit interpretation.

Study Details

PMID:27147783
Participants:100
Impact:6% vs 44%
Trust score:3/5

postoperative pain VAS (24 h)

1 evidences

Randomized trial showing lower wound inflammation signs and lower pain when combined alcohol-based antiseptic plus povidone-iodine was used versus povidone-iodine alone.

Trust comment: Randomized single-center trial (n=100) with blinded outcome assessors but small size and use of minor signs to define infection can limit interpretation.

Study Details

PMID:27147783
Participants:100
Impact:1.12 (experimental) vs 2.52 (control)
Trust score:3/5

postoperative pain VAS (48 h)

1 evidences

Randomized trial showing lower wound inflammation signs and lower pain when combined alcohol-based antiseptic plus povidone-iodine was used versus povidone-iodine alone.

Trust comment: Randomized single-center trial (n=100) with blinded outcome assessors but small size and use of minor signs to define infection can limit interpretation.

Study Details

PMID:27147783
Participants:100
Impact:0.22 vs 1.04
Trust score:3/5

infectious complications (composite)

1 evidences

Large randomized trial that found a non-statistically-significant reduction in infectious complications with povidone-iodine rectal cleansing before prostate biopsy.

Trust comment: Large prospective randomized trial (n=865) with objective clinical endpoints though the primary difference was not statistically significant.

Study Details

PMID:23041343
Participants:865
Impact:2.6% (povidone-iodine cleansing) vs 4.5% (no cleansing), p=0.15 (not significant)
Trust score:4/5

sepsis

1 evidences

Large randomized trial that found a non-statistically-significant reduction in infectious complications with povidone-iodine rectal cleansing before prostate biopsy.

Trust comment: Large prospective randomized trial (n=865) with objective clinical endpoints though the primary difference was not statistically significant.

Study Details

PMID:23041343
Participants:865
Impact:1.0% vs 1.6%, p=0.55 (not significant)
Trust score:4/5

mean coronary artery contrast density (HU)

1 evidences

Randomized double-blind study showing similar coronary and chamber enhancement using 300 mg I/ml vs 400 mg I/ml protocols with adjusted volumes/flows.

Trust comment: Randomized double-blind design but small sample (n=60) limits power to detect modest differences.

Study Details

PMID:16625109
Participants:60
Impact:259.1 ± 46.7 HU (300 mg I/ml protocol) vs 251.6 ± 51.0 HU (400 mg I/ml protocol); no noteworthy difference
Trust score:3/5

differentiated thyroid carcinoma risk

1 evidences

People with differentiated thyroid cancer ate less vegetables, fruit, saltwater fish and cottage cheese than controls; diets rich in those foods may be protective.

Trust comment: Case-control design with reasonable sample size but observational data limit causal inference.

Study Details

PMID:22371400
Participants:629
Impact:Higher risk associated with dietary patterns low in vegetables/fruits/saltwater fish (cases had significantly lower consumption)
Trust score:3/5

saltwater fish (iodine source) consumption

1 evidences

People with differentiated thyroid cancer ate less vegetables, fruit, saltwater fish and cottage cheese than controls; diets rich in those foods may be protective.

Trust comment: Case-control design with reasonable sample size but observational data limit causal inference.

Study Details

PMID:22371400
Participants:629
Impact:Significantly lower in patients with thyroid carcinoma (protective when higher)
Trust score:3/5

vegetable and fruit consumption

1 evidences

People with differentiated thyroid cancer ate less vegetables, fruit, saltwater fish and cottage cheese than controls; diets rich in those foods may be protective.

Trust comment: Case-control design with reasonable sample size but observational data limit causal inference.

Study Details

PMID:22371400
Participants:629
Impact:Significantly lower in patients with thyroid carcinoma (protective when higher)
Trust score:3/5

conjunctival bacterial colony-forming units

1 evidences

Applying 5% povidone-iodine to the eye markedly reduced conjunctival bacteria; at least 30 seconds exposure needed; lid speculum had no effect.

Trust comment: Prospective randomized study with clear microbiological endpoints and adequate sample size (eyes = 131).

Study Details

PMID:23416514
Participants:131
Impact:Significant decrease after 5% povidone-iodine exposure (P < 0.0001); reduction significant at ≥30 seconds but not at 15 seconds
Trust score:4/5

lid speculum effect on conjunctival flora

1 evidences

Applying 5% povidone-iodine to the eye markedly reduced conjunctival bacteria; at least 30 seconds exposure needed; lid speculum had no effect.

Trust comment: Prospective randomized study with clear microbiological endpoints and adequate sample size (eyes = 131).

Study Details

PMID:23416514
Participants:131
Impact:No significant change in colony counts with lid speculum placement (P = 0.47)
Trust score:4/5

catheter insertion site colonization

1 evidences

No difference found between 10% povidone-iodine and 0.5% chlorhexidine ethanol in catheter site or tip colonization for short-term epidural catheters.

Trust comment: Randomized study but small sample and short catheter duration limit generalizability.

Study Details

PMID:12011520
Participants:62
Impact:No difference between povidone-iodine and chlorhexidine groups (25% vs 24% isolation rates)
Trust score:3/5

number of endoscope removals

1 evidences

Using FloShield resulted in fewer laparoscope removals than the reference water + povidone-iodine technique, with no difference in vision quality or cleaning time.

Trust comment: Randomized single-center trial with clear primary outcome but moderate sample size.

Study Details

PMID:28643058
Participants:104
Impact:Mean removals higher with water + povidone-iodine (7.0) versus FloShield (2.8); significantly fewer removals with FloShield (P < 0.001)
Trust score:3/5

operative lens vision quality / cleaning time

1 evidences

Using FloShield resulted in fewer laparoscope removals than the reference water + povidone-iodine technique, with no difference in vision quality or cleaning time.

Trust comment: Randomized single-center trial with clear primary outcome but moderate sample size.

Study Details

PMID:28643058
Participants:104
Impact:No difference between water + povidone-iodine and FloShield
Trust score:3/5

oral aerobic and anaerobic bacterial counts

1 evidences

Preoperative intraoral preparation with povidone-iodine significantly and sustainably reduced oral aerobic and anaerobic bacteria compared with saline or no preparation.

Trust comment: Small randomized experimental study showing clear microbiological effect but limited by small sample size.

Study Details

PMID:11007407
Participants:30
Impact:Significant and sustained reduction with povidone-iodine versus saline or no preparation
Trust score:3/5

peritonitis rate

2 evidences

Polyhexanide tended to reduce exit-site infections and peritonitis rates compared with povidone-iodine, but differences were not statistically significant.

Trust comment: Randomized controlled design with moderate follow-up but limited sample size and non-significant differences.

Study Details

PMID:31066988
Participants:88
Impact:Povidone-iodine group: 0.32 episodes/patient-year vs polyhexanide 0.26 episodes/patient-year (trend favoring polyhexanide, NS)
Trust score:3/5

In this small randomized pilot, adding povidone-iodine dressing plus mupirocin did not clearly reduce exit-site infections compared to mupirocin alone; peritonitis occurred sooner in the dressing group.

Trust comment: Randomized pilot trial with small completed sample (n=97), limiting precision despite randomized design.

Study Details

PMID:26374836
Participants:97
Impact:1 per 37.1 patient-month (dressing) vs 1 per 44.4 patient-months (non-dressing); median time to first peritonitis shorter in dressing (p=0.03)
Trust score:3/5

conjunctival bacterial contamination rate

1 evidences

Adding three drops of 10% povidone-iodine before cataract surgery further reduced conjunctival bacterial contamination compared with standard 1% irrigation alone.

Trust comment: Prospective randomized single-center trial with adequate sample and significant microbiological endpoints, though single-center.

Study Details

PMID:22180155
Participants:242
Impact:↓ from 69–93% (T1) to 1–16% (T3); outpatient T3: 4% vs 16% (−12 percentage points); inpatient T3: 1% vs 10% (−9 percentage points)
Trust score:4/5

percentage healed at 28 days

1 evidences

Alginate mesh and polyvidone-iodine mesh produced similar stoma healing at 28 days, but the polyvidone-iodine group required more meshes.

Trust comment: Multicenter randomized prospective trial but modest sample size and no difference in primary outcome.

Study Details

PMID:19603229
Participants:73
Impact:91% (alginate) vs 87% (polyvidone-iodine); p=0.49 (no significant difference)
Trust score:4/5

Healing time

1 evidences

Alginate mesh and polyvidone-iodine mesh produced similar stoma healing at 28 days, but the polyvidone-iodine group required more meshes.

Trust comment: Multicenter randomized prospective trial but modest sample size and no difference in primary outcome.

Study Details

PMID:19603229
Participants:73
Impact:31 days (alginate) vs 32 days (polyvidone-iodine); p=0.80 (no significant difference)
Trust score:4/5

number of meshes used

1 evidences

Alginate mesh and polyvidone-iodine mesh produced similar stoma healing at 28 days, but the polyvidone-iodine group required more meshes.

Trust comment: Multicenter randomized prospective trial but modest sample size and no difference in primary outcome.

Study Details

PMID:19603229
Participants:73
Impact:13±5 (alginate) vs 18±8 (polyvidone-iodine); p<0.005 (polyvidone-iodine used more)
Trust score:4/5

post-antisepsis bacterial growth at biopsy site

1 evidences

Use of nonsterile ultrasound gel before antisepsis did not significantly affect biopsy-site bacterial contamination after povidone-iodine antisepsis.

Trust comment: Randomized study but small sample and wide confidence intervals limit precision of effect estimates.

Study Details

PMID:17978849
Participants:60
Impact:no significant increase (adjusted OR 2.9, 95% CI 0.8–11.1; p=0.10)
Trust score:3/5

microbial growth from povidone-iodine swabs

1 evidences

Use of nonsterile ultrasound gel before antisepsis did not significantly affect biopsy-site bacterial contamination after povidone-iodine antisepsis.

Trust comment: Randomized study but small sample and wide confidence intervals limit precision of effect estimates.

Study Details

PMID:17978849
Participants:60
Impact:no bacterial growth detected on povidone-iodine swabs
Trust score:3/5

time to cure (conjunctivitis)

1 evidences

Povidone-iodine 1.25% was as effective as topical antibiotic for bacterial conjunctivitis and showed marginally better early chlamydial cure, but was ineffective for viral conjunctivitis.

Trust comment: Large double-masked controlled trial with adequate power and clear clinical endpoints.

Study Details

PMID:12429243
Participants:459
Impact:no significant difference between povidone-iodine and antibiotic (no exact days difference) across etiologies
Trust score:4/5

proportion cured at 1 and 2 weeks

1 evidences

Povidone-iodine 1.25% was as effective as topical antibiotic for bacterial conjunctivitis and showed marginally better early chlamydial cure, but was ineffective for viral conjunctivitis.

Trust comment: Large double-masked controlled trial with adequate power and clear clinical endpoints.

Study Details

PMID:12429243
Participants:459
Impact:no significant difference overall; chlamydial cure at 1 week marginally higher with povidone-iodine (p=0.057)
Trust score:4/5

port-site infection rate

1 evidences

No antiseptic solution (alcohol-based chlorhexidine, alcohol-based povidone-iodine, or water-based povidone-iodine) reduced surgical site infection rates compared with the others in gynecological laparoscopy.

Trust comment: Large double-blind randomized trial with modified intention-to-treat analysis and clinically relevant endpoints.

Study Details

PMID:32639545
Participants:640
Impact:overall 10.2% (65/640); no significant difference between solutions (ORs with 95% CI crossing 1)
Trust score:5/5

any surgical site infection rate

1 evidences

No antiseptic solution (alcohol-based chlorhexidine, alcohol-based povidone-iodine, or water-based povidone-iodine) reduced surgical site infection rates compared with the others in gynecological laparoscopy.

Trust comment: Large double-blind randomized trial with modified intention-to-treat analysis and clinically relevant endpoints.

Study Details

PMID:32639545
Participants:640
Impact:overall 16.3% (104/640); no difference between solutions
Trust score:5/5

postoperative sinonasal symptom scores (TWSNOT-22)

1 evidences

Postoperative 0.1% povidone-iodine nasal irrigation provided no additional benefit over normal saline for sinonasal surgery recovery.

Trust comment: Prospective randomized single-blind trial but small sample size limits power to detect small differences.

Study Details

PMID:34397104
Participants:55
Impact:improved in both groups at 3 months with no additional benefit from 0.1% PVP-I
Trust score:3/5

endoscopic scores and total nasal resistance

1 evidences

Postoperative 0.1% povidone-iodine nasal irrigation provided no additional benefit over normal saline for sinonasal surgery recovery.

Trust comment: Prospective randomized single-blind trial but small sample size limits power to detect small differences.

Study Details

PMID:34397104
Participants:55
Impact:improved in both groups postoperatively; no additional benefit from 0.1% PVP-I
Trust score:3/5

probing depth (PD) reduction

1 evidences

Adding topical PVP-I to non-surgical periodontal therapy provided no additional benefit over control at 6 months.

Trust comment: Randomized clinical trial with objective measures but small sample size and no benefit shown.

Study Details

PMID:16460246
Participants:44
Impact:-2.31 mm (both groups; no difference)
Trust score:3/5

relative attachment level (RAL) gain

1 evidences

Adding topical PVP-I to non-surgical periodontal therapy provided no additional benefit over control at 6 months.

Trust comment: Randomized clinical trial with objective measures but small sample size and no benefit shown.

Study Details

PMID:16460246
Participants:44
Impact:+1.17 mm (control) vs +1.23 mm (PVP-I)
Trust score:3/5

relative horizontal attachment level (RHAL) gain

1 evidences

Adding topical PVP-I to non-surgical periodontal therapy provided no additional benefit over control at 6 months.

Trust comment: Randomized clinical trial with objective measures but small sample size and no benefit shown.

Study Details

PMID:16460246
Participants:44
Impact:+1.00 mm (control) vs +1.02 mm (PVP-I)
Trust score:3/5

superficial punctate keratitis score (24 h)

1 evidences

Ocular safety (corneal punctate keratitis and conjunctival hyperemia) was similar between Amukine and 5% povidone-iodine.

Trust comment: Randomized comparative clinical study with adequate sample and clear safety endpoints.

Study Details

PMID:11941231
Participants:107
Impact:mean 0.27 (Amukine) vs 0.38 (povidone-iodine); no significant difference (p=0.27)
Trust score:4/5

conjunctival hyperemia

1 evidences

Ocular safety (corneal punctate keratitis and conjunctival hyperemia) was similar between Amukine and 5% povidone-iodine.

Trust comment: Randomized comparative clinical study with adequate sample and clear safety endpoints.

Study Details

PMID:11941231
Participants:107
Impact:no significant difference immediately after application or at 24 h (p>0.5)
Trust score:4/5

serum thyroxine (T4) concentration at 3 months

1 evidences

Adding lithium to radioactive iodine therapy produced earlier and greater reductions in serum T4 compared with RAI alone.

Trust comment: Prospective randomized comparative cohort with a substantial sample and clinically relevant biochemical endpoints.

Study Details

PMID:27121690
Participants:163
Impact:RAI-only 17.67 pmol/L vs RAI+lithium 11.55 pmol/L (difference −6.12 pmol/L; p=0.007)
Trust score:4/5

time to T4 reduction

1 evidences

Adding lithium to radioactive iodine therapy produced earlier and greater reductions in serum T4 compared with RAI alone.

Trust comment: Prospective randomized comparative cohort with a substantial sample and clinically relevant biochemical endpoints.

Study Details

PMID:27121690
Participants:163
Impact:significant T4 decrease at 1 month with RAI+lithium (p=0.0001) vs RAI-only (significant only at 3 months)
Trust score:4/5

probing depth

2 evidences

Minocycline ointment produced greater improvement than the control treatment (10% iodine applied around teeth) in plaque index, probing depth, and sulcus bleeding index for early peri-implantitis.

Trust comment: Controlled clinical comparison with clear outcomes but limited methodological detail in abstract; iodine was the control topical agent rather than the primary intervention under study.

Study Details

PMID:31894045
Participants:180
Impact:Minocycline group significantly superior to 10% iodine control (p<0.05)
Trust score:3/5

Scaling and root planing combined with subgingival irrigation using a 10% iodised solution produced greater clinical improvements than other techniques.

Trust comment: Randomized allocation and multiple clinical endpoints but small sample and limited numerical detail reported.

Study Details

PMID:16688105
Participants:60
Impact:greater improvement in 10% iodised irrigation group (Gs3) vs other groups (statistically significant)
Trust score:3/5

bleeding on probing / attachment loss

1 evidences

Scaling and root planing combined with subgingival irrigation using a 10% iodised solution produced greater clinical improvements than other techniques.

Trust comment: Randomized allocation and multiple clinical endpoints but small sample and limited numerical detail reported.

Study Details

PMID:16688105
Participants:60
Impact:greater improvement in 10% iodised irrigation group (Gs3) vs other groups (statistically significant)
Trust score:3/5

positive cultures (hallux)

1 evidences

Povidone-iodine based skin preparation left substantial residual bacterial contamination at foot sites and did not reliably eliminate pathogens.

Trust comment: Prospective culture-based study with clear microbiological outcomes but limited sample and single-center design.

Study Details

PMID:12579025
Participants:50
Impact:gel group 76% vs scrub+paint group 84%
Trust score:3/5

positive cultures (toe web spaces)

1 evidences

Povidone-iodine based skin preparation left substantial residual bacterial contamination at foot sites and did not reliably eliminate pathogens.

Trust comment: Prospective culture-based study with clear microbiological outcomes but limited sample and single-center design.

Study Details

PMID:12579025
Participants:50
Impact:gel group 68% vs scrub+paint group 76%
Trust score:3/5

positive cultures (anterior ankle control)

1 evidences

Povidone-iodine based skin preparation left substantial residual bacterial contamination at foot sites and did not reliably eliminate pathogens.

Trust comment: Prospective culture-based study with clear microbiological outcomes but limited sample and single-center design.

Study Details

PMID:12579025
Participants:50
Impact:gel group 16% vs scrub+paint group 28%
Trust score:3/5

URTI incidence (water gargling)

1 evidences

Adults randomized to water gargling, povidone-iodine gargling, or usual care; water gargling reduced new URTIs.

Trust comment: Randomized trial with adequate sample size and intention-to-treat analysis, but outcomes were self-reported which may introduce bias.

Study Details

PMID:16242593
Participants:387
Impact:-36% (incidence rate ratio 0.64 vs control; 0.17 vs 0.26 episodes/30 person-days)
Trust score:4/5

URTI incidence (povidone-iodine gargling)

1 evidences

Adults randomized to water gargling, povidone-iodine gargling, or usual care; water gargling reduced new URTIs.

Trust comment: Randomized trial with adequate sample size and intention-to-treat analysis, but outcomes were self-reported which may introduce bias.

Study Details

PMID:16242593
Participants:387
Impact:-11% (incidence rate ratio 0.89 vs control; 0.24 vs 0.26 episodes/30 person-days)
Trust score:4/5

Bronchial symptom severity (water gargling)

1 evidences

Adults randomized to water gargling, povidone-iodine gargling, or usual care; water gargling reduced new URTIs.

Trust comment: Randomized trial with adequate sample size and intention-to-treat analysis, but outcomes were self-reported which may introduce bias.

Study Details

PMID:16242593
Participants:387
Impact:trend toward reduction (p=0.055)
Trust score:4/5

Microbicidal activity

1 evidences

Small randomized clinical proof-of-concept in patients with mesh grafts showing the PVP-I liposome hydrogel improved antimicrobial effect and wound epithelial healing.

Trust comment: Randomized clinical proof-of-concept with small sample (n=35); positive signals but limited power and scope.

Study Details

PMID:11096195
Participants:35
Impact:increased (significantly better than conventional PVP-I)
Trust score:3/5

Neo-epithelization (wound healing rate)

1 evidences

Small randomized clinical proof-of-concept in patients with mesh grafts showing the PVP-I liposome hydrogel improved antimicrobial effect and wound epithelial healing.

Trust comment: Randomized clinical proof-of-concept with small sample (n=35); positive signals but limited power and scope.

Study Details

PMID:11096195
Participants:35
Impact:increased (significant improvement vs comparator)
Trust score:3/5

Transplant loss

1 evidences

Small randomized clinical proof-of-concept in patients with mesh grafts showing the PVP-I liposome hydrogel improved antimicrobial effect and wound epithelial healing.

Trust comment: Randomized clinical proof-of-concept with small sample (n=35); positive signals but limited power and scope.

Study Details

PMID:11096195
Participants:35
Impact:decreased (significant reduction vs comparator)
Trust score:3/5

Sensitivity for CIN2+ (VIA with iodine)

1 evidences

Among HPV-positive women who attended follow-up, adding Lugol's iodine to VIA increased sensitivity for detecting CIN2+ but was not statistically superior to VIA alone in this underpowered sample.

Trust comment: Randomized design and histopathology gold standard strengthen validity, but low disease prevalence and incomplete follow-up reduced power and precision.

Study Details

PMID:39362749
Participants:146
Impact:50% (per protocol; 2/4 cases)
Trust score:4/5

Sensitivity for CIN2+ (VIA alone)

1 evidences

Among HPV-positive women who attended follow-up, adding Lugol's iodine to VIA increased sensitivity for detecting CIN2+ but was not statistically superior to VIA alone in this underpowered sample.

Trust comment: Randomized design and histopathology gold standard strengthen validity, but low disease prevalence and incomplete follow-up reduced power and precision.

Study Details

PMID:39362749
Participants:146
Impact:25% (per protocol; 1/4 cases)
Trust score:4/5

Specificity for CIN2+

1 evidences

Among HPV-positive women who attended follow-up, adding Lugol's iodine to VIA increased sensitivity for detecting CIN2+ but was not statistically superior to VIA alone in this underpowered sample.

Trust comment: Randomized design and histopathology gold standard strengthen validity, but low disease prevalence and incomplete follow-up reduced power and precision.

Study Details

PMID:39362749
Participants:146
Impact:similar (~83–85% for both methods)
Trust score:4/5

Conjunctival culture positivity (after povidone-iodine)

1 evidences

All patients received 5% povidone-iodine preoperatively; mupirocin nasal ointment markedly reduced conjunctival culture positivity compared with control.

Trust comment: Prospective, blinded clinical trial but small sample size; povidone-iodine used in all patients so isolated effect of iodine is limited to observed post-prep culture rates.

Study Details

PMID:17471340
Participants:37
Impact:persistent positives: 36% in control vs 6.7% in mupirocin group (post-prep)
Trust score:4/5

Conjunctival culture positivity (before povidone-iodine)

1 evidences

All patients received 5% povidone-iodine preoperatively; mupirocin nasal ointment markedly reduced conjunctival culture positivity compared with control.

Trust comment: Prospective, blinded clinical trial but small sample size; povidone-iodine used in all patients so isolated effect of iodine is limited to observed post-prep culture rates.

Study Details

PMID:17471340
Participants:37
Impact:41% control vs 6.7% mupirocin (pre-prep)
Trust score:4/5

Catheter colonisation rate

1 evidences

Large randomized trial showed chlorhexidine+alcohol reduced catheter colonization and local infections compared with povidone-iodine+alcohol; device innovations increased catheter dwell time.

Trust comment: Large, randomized factorial trial with objective microbiological and clinical endpoints and robust sample size; high-quality evidence.

Study Details

PMID:33539734
Participants:1000
Impact:povidone-iodine+alcohol 17% vs chlorhexidine+alcohol 1% (difference ~+16 percentage points; adjusted subdistribution HR 0.08 favoring chlorhexidine)
Trust score:5/5

Local infection rate

1 evidences

Large randomized trial showed chlorhexidine+alcohol reduced catheter colonization and local infections compared with povidone-iodine+alcohol; device innovations increased catheter dwell time.

Trust comment: Large, randomized factorial trial with objective microbiological and clinical endpoints and robust sample size; high-quality evidence.

Study Details

PMID:33539734
Participants:1000
Impact:povidone-iodine+alcohol 1% vs chlorhexidine+alcohol 0% (fewer infections with chlorhexidine)
Trust score:5/5

Time to catheter failure (innovative devices)

1 evidences

Large randomized trial showed chlorhexidine+alcohol reduced catheter colonization and local infections compared with povidone-iodine+alcohol; device innovations increased catheter dwell time.

Trust comment: Large, randomized factorial trial with objective microbiological and clinical endpoints and robust sample size; high-quality evidence.

Study Details

PMID:33539734
Participants:1000
Impact:longer dwell time with innovations (median 50.4 h vs 30.0 h)
Trust score:5/5

contrast enhancement of abdominal vessels and pancreas

1 evidences

Higher iodine concentration in contrast agent produced stronger CT enhancement of abdominal vessels and pancreas but did not improve detection of hypovascular pancreatic tumors.

Trust comment: Randomized study (n=60) with blinded qualitative assessment; imaging endpoints robust but modest sample size.

Study Details

PMID:20221707
Participants:60
Impact:+significant increase
Trust score:4/5

detection/demarcation of hypovascular pancreatic carcinoma

1 evidences

Higher iodine concentration in contrast agent produced stronger CT enhancement of abdominal vessels and pancreas but did not improve detection of hypovascular pancreatic tumors.

Trust comment: Randomized study (n=60) with blinded qualitative assessment; imaging endpoints robust but modest sample size.

Study Details

PMID:20221707
Participants:60
Impact:no improvement
Trust score:4/5

iodine intake per capita

1 evidences

A double-low CT protocol reduced radiation and iodine dose while maintaining similar image quality for aortic CTA.

Trust comment: Prospective randomized trial (n=72) with clear quantitative endpoints and significant dose reductions reported.

Study Details

PMID:27671868
Participants:72
Impact:-18% (mgI/kg)
Trust score:4/5

effective nasal decolonization rate

1 evidences

Povidone-iodine and chlorhexidine had similar nasal decolonization efficacy; povidone-iodine caused more nasal discomfort.

Trust comment: Large, registered randomized trial (n=174) with predefined noninferiority margin and blinded outcome assessment; results clearly reported.

Study Details

PMID:39172724
Participants:174
Impact:PVP 82.56% vs CHG 86.64% (difference +6.10% favoring CHG; noninferior)
Trust score:5/5

intracranial infection rate

1 evidences

Povidone-iodine and chlorhexidine had similar nasal decolonization efficacy; povidone-iodine caused more nasal discomfort.

Trust comment: Large, registered randomized trial (n=174) with predefined noninferiority margin and blinded outcome assessment; results clearly reported.

Study Details

PMID:39172724
Participants:174
Impact:PVP 0% vs CHG 3.4% (no significant difference)
Trust score:5/5

patient comfort (VAS total)

1 evidences

Povidone-iodine and chlorhexidine had similar nasal decolonization efficacy; povidone-iodine caused more nasal discomfort.

Trust comment: Large, registered randomized trial (n=174) with predefined noninferiority margin and blinded outcome assessment; results clearly reported.

Study Details

PMID:39172724
Participants:174
Impact:PVP higher discomfort by +6 points (10 vs 4)
Trust score:5/5

rate of epithelialization

1 evidences

A PVP-iodine liposomal hydrogel accelerated wound epithelialization, improved healing quality and reduced graft loss compared with chlorhexidine gauze.

Trust comment: Randomized phase II pilot (n=36) with positive clinical signals but small open-label design limits generalizability.

Study Details

PMID:11350649
Participants:36
Impact:day13: 100% vs 82.3% (Betasom > control; p=0.005)
Trust score:3/5

graft loss rate

1 evidences

A PVP-iodine liposomal hydrogel accelerated wound epithelialization, improved healing quality and reduced graft loss compared with chlorhexidine gauze.

Trust comment: Randomized phase II pilot (n=36) with positive clinical signals but small open-label design limits generalizability.

Study Details

PMID:11350649
Participants:36
Impact:5% vs 35.7% (Betasom lower; p=0.001)
Trust score:3/5

total/clinical/multiple pregnancy rates

1 evidences

Using povidone-iodine (betadine) vaginal scrub left in place during egg retrieval did not change most IVF outcomes but was associated with a higher chemical pregnancy rate.

Trust comment: Large prospective randomized study (721 cycles) with comparable groups; reported an isolated increase in chemical pregnancies.

Study Details

PMID:18799887
Participants:721
Impact:no significant change
Trust score:4/5

chemical pregnancy rate

1 evidences

Using povidone-iodine (betadine) vaginal scrub left in place during egg retrieval did not change most IVF outcomes but was associated with a higher chemical pregnancy rate.

Trust comment: Large prospective randomized study (721 cycles) with comparable groups; reported an isolated increase in chemical pregnancies.

Study Details

PMID:18799887
Participants:721
Impact:increased (higher in betadine-not-washed group)
Trust score:4/5

surgery-related oral malodor (volatile sulfur compounds)

1 evidences

Chlorhexidine-containing rinses were more effective than povidone-iodine mouthwash for reducing surgery-related oral malodor in the first postoperative week.

Trust comment: Double-blind clinical trial (n=80) with objective and subjective malodor measures; shows CHX superiority over PVP for early postoperative malodor.

Study Details

PMID:18280939
Participants:80
Impact:PVP mouthwash showed higher malodor scores (worse) on days 3 and 8 vs chlorhexidine
Trust score:4/5

malodor at day 15

1 evidences

Chlorhexidine-containing rinses were more effective than povidone-iodine mouthwash for reducing surgery-related oral malodor in the first postoperative week.

Trust comment: Double-blind clinical trial (n=80) with objective and subjective malodor measures; shows CHX superiority over PVP for early postoperative malodor.

Study Details

PMID:18280939
Participants:80
Impact:no significant difference vs pre-op (all groups)
Trust score:4/5

childhood cognitive score

1 evidences

Pregnant women given 150 µg/day iodine had higher urinary iodine but no clear differences in child development or thyroid hormones at follow-up.

Trust comment: Randomised double-blind RCT but terminated early with small sample, reducing power and increasing risk of null bias.

Study Details

PMID:26654905
Participants:53
Impact:Mean difference −2.3 points (99.4 vs 101.7; MD −2.3; 95% CI −7.8, 3.2; P=0.42)
Trust score:3/5

urinary iodine concentration (maternal)

1 evidences

Pregnant women given 150 µg/day iodine had higher urinary iodine but no clear differences in child development or thyroid hormones at follow-up.

Trust comment: Randomised double-blind RCT but terminated early with small sample, reducing power and increasing risk of null bias.

Study Details

PMID:26654905
Participants:53
Impact:Median increase 87 µg/L from baseline in iodine group (P=0.001); no change in placebo
Trust score:3/5

maternal/newborn thyroid function

1 evidences

Pregnant women given 150 µg/day iodine had higher urinary iodine but no clear differences in child development or thyroid hormones at follow-up.

Trust comment: Randomised double-blind RCT but terminated early with small sample, reducing power and increasing risk of null bias.

Study Details

PMID:26654905
Participants:53
Impact:No significant differences in cord/newborn fT3, fT4, TSH or thyroglobulin between groups (P>0.05)
Trust score:3/5

pain (VAS / overall pain management)

1 evidences

Hydrofiber Ag dressings led to better pain management, comfort and exudate handling than povidone-iodine gauze; healing rates were numerically higher but not statistically significant.

Trust comment: Prospective randomised trial with modest sample size; clear clinical endpoints but limited power for healing outcomes.

Study Details

PMID:17425549
Participants:67
Impact:Hydrofiber Ag showed better overall pain management (P < 0.001); pain decreased while dressing in place for Hydrofiber but not for povidone-iodine
Trust score:3/5

complete healing rate

1 evidences

Hydrofiber Ag dressings led to better pain management, comfort and exudate handling than povidone-iodine gauze; healing rates were numerically higher but not statistically significant.

Trust comment: Prospective randomised trial with modest sample size; clear clinical endpoints but limited power for healing outcomes.

Study Details

PMID:17425549
Participants:67
Impact:23% (Hydrofiber Ag) vs 9% (povidone-iodine) at study end (difference not significant)
Trust score:3/5

adverse skin reaction / safety

1 evidences

Hydrofiber Ag dressings led to better pain management, comfort and exudate handling than povidone-iodine gauze; healing rates were numerically higher but not statistically significant.

Trust comment: Prospective randomised trial with modest sample size; clear clinical endpoints but limited power for healing outcomes.

Study Details

PMID:17425549
Participants:67
Impact:No adverse events with Hydrofiber Ag; one skin reaction led to discontinuation of povidone-iodine
Trust score:3/5

postoperative pain (NRS)

1 evidences

0.5% PVP-I rinse produced lower postoperative pain, less mucosal irritation and less staining than 0.12% CHX with similar early wound healing.

Trust comment: Randomised, registered RCT with clear endpoints and appropriate analyses, but single-center and short follow-up (4 weeks).

Study Details

PMID:40702480
Participants:83
Impact:PVP-I 1.68 ± 0.82 vs CHX 2.55 ± 1.38 (mean difference ≈ −0.87 points; P < 0.01)
Trust score:4/5

mucosal irritation

1 evidences

0.5% PVP-I rinse produced lower postoperative pain, less mucosal irritation and less staining than 0.12% CHX with similar early wound healing.

Trust comment: Randomised, registered RCT with clear endpoints and appropriate analyses, but single-center and short follow-up (4 weeks).

Study Details

PMID:40702480
Participants:83
Impact:PVP-I 7% vs CHX 29% (P = 0.011)
Trust score:4/5

mucosal staining

1 evidences

0.5% PVP-I rinse produced lower postoperative pain, less mucosal irritation and less staining than 0.12% CHX with similar early wound healing.

Trust comment: Randomised, registered RCT with clear endpoints and appropriate analyses, but single-center and short follow-up (4 weeks).

Study Details

PMID:40702480
Participants:83
Impact:PVP-I 5% vs CHX 24% (P = 0.013)
Trust score:4/5

infectious conjunctivitis incidence

1 evidences

A single 2.5% povidone-iodine ophthalmic drop at birth reduced infectious neonatal conjunctivitis compared with silver nitrate or erythromycin and had lower noninfectious conjunctivitis rates.

Trust comment: Large masked prospective trial with robust sample size and clear outcome differences, performed in a real-world hospital setting.

Study Details

PMID:7838190
Participants:3117
Impact:Povidone-iodine 13.1% vs silver nitrate 17.5% (P < 0.001) and vs erythromycin 15.2% (P = 0.01)
Trust score:4/5

noninfectious conjunctivitis incidence

1 evidences

A single 2.5% povidone-iodine ophthalmic drop at birth reduced infectious neonatal conjunctivitis compared with silver nitrate or erythromycin and had lower noninfectious conjunctivitis rates.

Trust comment: Large masked prospective trial with robust sample size and clear outcome differences, performed in a real-world hospital setting.

Study Details

PMID:7838190
Participants:3117
Impact:Povidone-iodine 9.7% vs silver nitrate 13.9% (P < 0.001) and vs erythromycin 13.3% (P = 0.004)
Trust score:4/5

30-day surgical site infection (SSI) incidence

1 evidences

In clean-contaminated surgery, aqueous povidone-iodine was associated with higher 30-day SSI (13%) than olanexidine (7%); adverse skin reactions were similar.

Trust comment: Multicentre, randomized, blinded-endpoint RCT with adequate sample size and clear primary outcome differences.

Study Details

PMID:32553191
Participants:587
Impact:Povidone-iodine group 13% vs olanexidine group 7% (adjusted risk difference −0.069; adjusted RR 0.48; p = 0.002)
Trust score:4/5

adverse skin reactions

1 evidences

In clean-contaminated surgery, aqueous povidone-iodine was associated with higher 30-day SSI (13%) than olanexidine (7%); adverse skin reactions were similar.

Trust comment: Multicentre, randomized, blinded-endpoint RCT with adequate sample size and clear primary outcome differences.

Study Details

PMID:32553191
Participants:587
Impact:2% in both povidone-iodine and olanexidine groups (no significant difference)
Trust score:4/5

oral mucositis (occurrence, severity, duration)

1 evidences

In patients after high-dose chemotherapy, diluted povidone-iodine mouthwash showed no benefit over saline for mouth sores and was less well tolerated.

Trust comment: Randomized multicentre RCT with adequate sample size but no blinding reported, giving moderate-high confidence.

Study Details

PMID:15798915
Participants:132
Impact:no significant difference between povidone-iodine and saline
Trust score:4/5

fever of unknown origin / other infections

1 evidences

In patients after high-dose chemotherapy, diluted povidone-iodine mouthwash showed no benefit over saline for mouth sores and was less well tolerated.

Trust comment: Randomized multicentre RCT with adequate sample size but no blinding reported, giving moderate-high confidence.

Study Details

PMID:15798915
Participants:132
Impact:no significant difference between groups
Trust score:4/5

tolerability of mouthwash

1 evidences

In patients after high-dose chemotherapy, diluted povidone-iodine mouthwash showed no benefit over saline for mouth sores and was less well tolerated.

Trust comment: Randomized multicentre RCT with adequate sample size but no blinding reported, giving moderate-high confidence.

Study Details

PMID:15798915
Participants:132
Impact:worse (less tolerable) with povidone-iodine
Trust score:4/5

overall exit-site and peritonitis infections (within 140 days)

1 evidences

Regular povidone-iodine ointment at catheter exit sites delayed early dialysis-related infections and greatly reduced Staphylococcus aureus infections during the first 140 days.

Trust comment: Prospective randomized single-blind study with clear infection outcomes and statistically significant results for early period.

Study Details

PMID:9159313
Participants:117
Impact:lower proportion of infections within 140 days (P = 0.04)
Trust score:4/5

Staphylococcus aureus infection rate

1 evidences

Regular povidone-iodine ointment at catheter exit sites delayed early dialysis-related infections and greatly reduced Staphylococcus aureus infections during the first 140 days.

Trust comment: Prospective randomized single-blind study with clear infection outcomes and statistically significant results for early period.

Study Details

PMID:9159313
Participants:117
Impact:3.3% in treated vs 21.4% in controls (absolute reduction ~18.1%, P = 0.009)
Trust score:4/5

thyroid autoantibody production

1 evidences

In middle-aged and elderly patients with endemic goitre, daily iodide reduced thyroid volume over 12 months by about 16%, similar to levothyroxine, without inducing thyroid antibodies.

Trust comment: Randomized treatment comparison with serial objective measurements (ultrasound, hormones), though sample size modest.

Study Details

PMID:9011485
Participants:67
Impact:no antibody production detected in iodine group
Trust score:4/5

plaque Streptococcus mutans counts

1 evidences

In this small pilot, povidone-iodine applied intermittently after dental rehab did not significantly change S. mutans suppression at 6 months versus control, but showed a non-significant trend to fewer new caries at 1 year.

Trust comment: Small pilot study with limited sample and partial follow-up, so findings are suggestive but not definitive.

Study Details

PMID:15080351
Participants:25
Impact:significant decrease at 6 months overall; no significant difference between povidone-iodine and control (P = 0.58)
Trust score:3/5

incidence of new caries at 1 year

1 evidences

In this small pilot, povidone-iodine applied intermittently after dental rehab did not significantly change S. mutans suppression at 6 months versus control, but showed a non-significant trend to fewer new caries at 1 year.

Trust comment: Small pilot study with limited sample and partial follow-up, so findings are suggestive but not definitive.

Study Details

PMID:15080351
Participants:25
Impact:trend to fewer new caries in povidone-iodine group (2/11 vs 5/8; P = 0.06)
Trust score:3/5

salivary SARS-CoV-2 viral load (PVP-I mouth rinse)

1 evidences

Povidone-iodine mouth rinse showed a large median drop in salivary SARS-CoV-2 RNA at 60 min versus no-rinse, but only a small number of PVP‑I patients were analyzed.

Trust comment: Randomized double‑blind trial with valid RT‑qPCR outcome, but small analyzed sample (55 total; PVP‑I n=6) reduces power.

Study Details

PMID:36527332
Participants:55
Impact:-91% median reduction at 60 min; significant vs no‑rinse (p=0.023); within-group vs baseline not statistically significant
Trust score:4/5

time to healing

2 evidences

A PVP‑iodine hydrogel dressing (Repithel) sped graft epithelialization and lowered graft loss compared with standard dressing.

Trust comment: Phase III randomized, observer‑blinded trial with a large sample (n=167) and highly significant clinical endpoints.

Study Details

PMID:16837138
Participants:167
Impact:-3.0 days (9.4 vs 12.4 days; p<0.0001)
Trust score:5/5

Iodine-impregnated dressing (Inadine) showed no advantage over non-iodine dressings for ulcer healing at 24 weeks; costs differed between products.

Trust comment: Large multicenter randomized trial with 317 randomized and 229 evaluable participants; robust design for dressing comparison.

Study Details

PMID:19922726
Participants:229
Impact:no significant difference between groups
Trust score:4/5

neo-epithelialization (days 7–11)

1 evidences

A PVP‑iodine hydrogel dressing (Repithel) sped graft epithelialization and lowered graft loss compared with standard dressing.

Trust comment: Phase III randomized, observer‑blinded trial with a large sample (n=167) and highly significant clinical endpoints.

Study Details

PMID:16837138
Participants:167
Impact:+~9 percentage points (91.2% vs 82.3%; p<0.0001)
Trust score:5/5

graft loss / graft take rate

1 evidences

A PVP‑iodine hydrogel dressing (Repithel) sped graft epithelialization and lowered graft loss compared with standard dressing.

Trust comment: Phase III randomized, observer‑blinded trial with a large sample (n=167) and highly significant clinical endpoints.

Study Details

PMID:16837138
Participants:167
Impact:reduced graft losses (8 vs 20 grafts; p=0.0063) and higher take rate (p=0.0053)
Trust score:5/5

serum thyroglobulin (iodide group)

1 evidences

Iodide substitution after thyroid surgery was as effective as L‑thyroxine at preventing goiter recurrence over one year.

Trust comment: Randomized prospective sonographic study with standard biochemical and imaging endpoints; modest sample size but directly human and clinically relevant.

Study Details

PMID:8943171
Participants:107
Impact:significant decrease over 52 weeks in the iodide group (no antibody formation observed)
Trust score:4/5

salivary SARS-CoV-2 clearance rate (day 5)

1 evidences

Early repeated PVP‑I gargling increased saliva viral clearance at day 5 and reduced detectable infectious virus compared with later gargling with water then PVP‑I.

Trust comment: Large randomized trial with virologic and infectivity endpoints; open‑label design is a limitation but biological outcomes strengthen validity.

Study Details

PMID:36443363
Participants:411
Impact:+13.1 percentage points (34.5% early vs 21.4% late; p=0.015)
Trust score:4/5

saliva viral infectivity (CPE, day 5)

1 evidences

Early repeated PVP‑I gargling increased saliva viral clearance at day 5 and reduced detectable infectious virus compared with later gargling with water then PVP‑I.

Trust comment: Large randomized trial with virologic and infectivity endpoints; open‑label design is a limitation but biological outcomes strengthen validity.

Study Details

PMID:36443363
Participants:411
Impact:reduced from 9.3% (late) to 2.9% (early); p=0.025
Trust score:4/5

postoperative intra-abdominal abscess (IAA)

1 evidences

In this pilot RCT, intraoperative povidone‑iodine irrigation showed a probable reduction in postoperative abscesses and shorter hospital stays.

Trust comment: Pilot randomized trial with blinded patients/providers but small sample (n=100); Bayesian analysis suggests benefit but not definitive.

Study Details

PMID:31567357
Participants:100
Impact:12% (PVI) vs 16% (no irrigation); relative risk 0.72 (95% credible interval 0.38–1.23); Bayesian probability of benefit 89%
Trust score:3/5

total 30-day length of stay

1 evidences

In this pilot RCT, intraoperative povidone‑iodine irrigation showed a probable reduction in postoperative abscesses and shorter hospital stays.

Trust comment: Pilot randomized trial with blinded patients/providers but small sample (n=100); Bayesian analysis suggests benefit but not definitive.

Study Details

PMID:31567357
Participants:100
Impact:reduced in PVI arm; probability of benefit 96% and frequentist p=0.05
Trust score:3/5

simulated contrast flow rate to reach 350 HU

1 evidences

Comparing two iodine-containing contrast agents, iodixanol-320 required a different flow/iodine-delivery protocol to reach equivalent arterial enhancement.

Trust comment: Randomized clinical imaging study (n=389) with objective, simulated hemodynamic measures; results are small but statistically significant.

Study Details

PMID:28708716
Participants:389
Impact:3.90 vs 3.62 mL/s (iodixanol-320 vs iopromide-370); p=0.017 (higher flow for iodixanol)
Trust score:4/5

simulated iodine delivery rate (IDR) to reach 350 HU

1 evidences

Comparing two iodine-containing contrast agents, iodixanol-320 required a different flow/iodine-delivery protocol to reach equivalent arterial enhancement.

Trust comment: Randomized clinical imaging study (n=389) with objective, simulated hemodynamic measures; results are small but statistically significant.

Study Details

PMID:28708716
Participants:389
Impact:1.34 vs 1.25 g/s (iodixanol-320 vs iopromide-370); p=0.024 (reported difference in IDR)
Trust score:4/5

postcesarean endometritis

1 evidences

Preoperative vaginal preparation with povidone‑iodine halved postcesarean endometritis compared with no vaginal prep.

Trust comment: Randomized controlled study with clinically meaningful endpoints (n=308); effect on endometritis is statistically significant.

Study Details

PMID:15863540
Participants:308
Impact:7.0% with PVP‑I vs 14.5% control (adjusted OR 0.44; 95% CI 0.193–0.997; p<0.05)
Trust score:4/5

postoperative fever or wound infection

1 evidences

Preoperative vaginal preparation with povidone‑iodine halved postcesarean endometritis compared with no vaginal prep.

Trust comment: Randomized controlled study with clinically meaningful endpoints (n=308); effect on endometritis is statistically significant.

Study Details

PMID:15863540
Participants:308
Impact:no measurable effect
Trust score:4/5

infectious complication rate

1 evidences

Rectal cleansing with 10% povidone-iodine plus formalin dipping of the needle tip reduced infectious complications after transrectal prostate biopsy.

Trust comment: Large randomized controlled trial with clear endpoints and statistically significant primary outcome.

Study Details

PMID:36006040
Participants:1256
Impact:3.9% vs 6.4% (−2.5 percentage points; RR 0.61, 95% CI 0.36–0.99)
Trust score:5/5

positive urine culture rate

1 evidences

Rectal cleansing with 10% povidone-iodine plus formalin dipping of the needle tip reduced infectious complications after transrectal prostate biopsy.

Trust comment: Large randomized controlled trial with clear endpoints and statistically significant primary outcome.

Study Details

PMID:36006040
Participants:1256
Impact:5.2% vs 9.0% (−3.8 percentage points; RR 0.57, P = .015)
Trust score:5/5

pulmonary artery attenuation

1 evidences

Gadolinium-based contrast with dual-energy reconstructions can yield good pulmonary CT angiography; iodine-based iohexol gave highest attenuation but more SVC artifacts.

Trust comment: Randomized feasibility study comparing iodine and gadolinium techniques; clinically relevant but technical and comparatively small.

Study Details

PMID:36190598
Participants:66
Impact:highest with iohexol (iodine); dual-energy Gd at 40 keV lower than iohexol but higher than other Gd reconstructions
Trust score:3/5

catheter-related infection incidence

3 evidences

Alcoholic povidone-iodine skin disinfection reduced catheter colonization and catheter-related infection compared with aqueous povidone-iodine in an ICU unit-crossover trial.

Trust comment: Randomized unit-crossover design with clear microbiological and clinical endpoints though limited to two units and moderate sample size.

Study Details

PMID:15090951
Participants:223
Impact:reduced with alcoholic povidone-iodine (RR 0.34; 95% CI 0.13–0.91, p<.04)
Trust score:4/5

Using 2% chlorhexidine in alcohol for skin disinfection was associated with a lower risk of catheter-related infection compared with alcoholic povidone-iodine in ICU patients.

Trust comment: Large multicenter cohort with propensity adjustment and quasi-experimental component, though not a fully randomized comparison for all antiseptics.

Study Details

PMID:27311311
Participants:3362
Impact:reduced with 2% CHX-a vs PVI-a (aHR 0.51; 95% CI 0.28–0.96, p=0.037; quasi-experimental HR 0.35)
Trust score:4/5

In ICU adults, chlorhexidine-alcohol reduced short-term catheter-related infections versus povidone-iodine-alcohol; scrubbing provided no benefit and chlorhexidine caused more skin reactions.

Trust comment: Large multicentre randomized trial with blinded outcome assessment and significant primary outcome differences, high quality.

Study Details

PMID:26388532
Participants:2349
Impact:0.28 vs 1.77 per 1000 catheter-days (HR 0.15; ~85% reduction with chlorhexidine)
Trust score:5/5

mean liver attenuation

1 evidences

Room-temperature iodinated contrast was noninferior to prewarmed contrast for abdominal CT image quality and produced slightly higher liver attenuation and better comfort.

Trust comment: Double-blinded randomized noninferiority trial with objective and subjective outcomes and adequate sample size.

Study Details

PMID:34280944
Participants:218
Impact:mean difference +4.23 HU (122.2 ± 13.1 HU vs 118.0 ± 15.9 HU; noninferior, 95% CI +0.35 to +8.11)
Trust score:5/5

patient comfort

1 evidences

Room-temperature iodinated contrast was noninferior to prewarmed contrast for abdominal CT image quality and produced slightly higher liver attenuation and better comfort.

Trust comment: Double-blinded randomized noninferiority trial with objective and subjective outcomes and adequate sample size.

Study Details

PMID:34280944
Participants:218
Impact:higher comfort scores with room-temperature contrast (P = 0.03)
Trust score:5/5

catheter colonization incidence

2 evidences

Alcoholic povidone-iodine skin disinfection reduced catheter colonization and catheter-related infection compared with aqueous povidone-iodine in an ICU unit-crossover trial.

Trust comment: Randomized unit-crossover design with clear microbiological and clinical endpoints though limited to two units and moderate sample size.

Study Details

PMID:15090951
Participants:223
Impact:reduced with alcoholic povidone-iodine (RR 0.38; 95% CI 0.22–0.65, p<.001)
Trust score:4/5

Alcohol-based chlorhexidine (0.5% and 1.0%) reduced catheter-tip colonization compared with 10% aqueous povidone-iodine; no significant difference in bloodstream infection rates.

Trust comment: Large multicenter randomized trial with blinded microbiologic assessment and robust statistical analyses.

Study Details

PMID:29268759
Participants:796
Impact:0.5% CHG 3.7 and 1.0% CHG 3.9 vs 10% PVI 10.5 per 1000 catheter-days (HR 0.33 and 0.35 vs PVI; p=0.04)
Trust score:5/5

time to catheter colonization

1 evidences

Alcoholic povidone-iodine skin disinfection reduced catheter colonization and catheter-related infection compared with aqueous povidone-iodine in an ICU unit-crossover trial.

Trust comment: Randomized unit-crossover design with clear microbiological and clinical endpoints though limited to two units and moderate sample size.

Study Details

PMID:15090951
Participants:223
Impact:longer time to colonization with alcoholic solution (adjusted HR 0.3; 95% CI 0.2–0.6, p<.001)
Trust score:4/5

mutans streptococci levels

1 evidences

A single application of 10% povidone-iodine reduced oral mutans streptococci and lactobacilli for up to 3 months but did not reduce new caries at one year.

Trust comment: Small randomized trial with microbiological outcomes but limited sample size and no long-term clinical benefit shown.

Study Details

PMID:16913243
Participants:22
Impact:significantly reduced at 1 hour, 3 weeks, and 3 months after single 10% povidone-iodine application
Trust score:3/5

lactobacilli levels

1 evidences

A single application of 10% povidone-iodine reduced oral mutans streptococci and lactobacilli for up to 3 months but did not reduce new caries at one year.

Trust comment: Small randomized trial with microbiological outcomes but limited sample size and no long-term clinical benefit shown.

Study Details

PMID:16913243
Participants:22
Impact:significantly reduced at 1 hour, 3 weeks, and 3 months after application
Trust score:3/5

one-year caries increment

1 evidences

A single application of 10% povidone-iodine reduced oral mutans streptococci and lactobacilli for up to 3 months but did not reduce new caries at one year.

Trust comment: Small randomized trial with microbiological outcomes but limited sample size and no long-term clinical benefit shown.

Study Details

PMID:16913243
Participants:22
Impact:no significant difference in new caries at one year (≥60% had new lesions in each group)
Trust score:3/5

post-operative infectious morbidity (30 days)

1 evidences

Applying 20 cc povidone-iodine gel at the vaginal apex modestly lowered overall post-operative infections and prevented pelvic abscess after abdominal hysterectomy.

Trust comment: Large multicenter randomized controlled trial with clinically meaningful endpoints and adequate follow-up.

Study Details

PMID:15198760
Participants:1570
Impact:16% vs 18% (−2 percentage points; RR 0.9, 95% CI 0.7–1.1)
Trust score:5/5

pelvic abscess

1 evidences

Applying 20 cc povidone-iodine gel at the vaginal apex modestly lowered overall post-operative infections and prevented pelvic abscess after abdominal hysterectomy.

Trust comment: Large multicenter randomized controlled trial with clinically meaningful endpoints and adequate follow-up.

Study Details

PMID:15198760
Participants:1570
Impact:0 cases vs 7 cases (reduction)
Trust score:5/5

abdominal wound infection

1 evidences

Applying 20 cc povidone-iodine gel at the vaginal apex modestly lowered overall post-operative infections and prevented pelvic abscess after abdominal hysterectomy.

Trust comment: Large multicenter randomized controlled trial with clinically meaningful endpoints and adequate follow-up.

Study Details

PMID:15198760
Participants:1570
Impact:51 vs 58 (no significant difference)
Trust score:5/5

internal luer microbial contamination

1 evidences

Needleless connectors had lower internal luer contamination than standard caps; disinfecting connectors with povidone-iodine or chlorhexidine/alcohol reduced external contamination compared with isopropyl alcohol.

Trust comment: Randomized prospective trial with microbiological endpoints but small sample size.

Study Details

PMID:12919759
Participants:77
Impact:18% (standard caps) vs 6.6% (needleless connectors; P<0.0001)
Trust score:4/5

external contamination after povidone-iodine disinfection

1 evidences

Needleless connectors had lower internal luer contamination than standard caps; disinfecting connectors with povidone-iodine or chlorhexidine/alcohol reduced external contamination compared with isopropyl alcohol.

Trust comment: Randomized prospective trial with microbiological endpoints but small sample size.

Study Details

PMID:12919759
Participants:77
Impact:41.6% contaminated (lower than isopropyl alcohol 69.2%)
Trust score:4/5

infective parietoabdominal complications

1 evidences

Povidone-iodine enemas had similar infection rates to sodium hypochlorite but were better tolerated with less abdominal pain and fewer discontinuations.

Trust comment: Large multicenter randomized trial with clinical endpoints and clear patient-centered outcomes.

Study Details

PMID:17178958
Participants:517
Impact:13.7% (PVI) vs 15.0% (sodium hypochlorite); no significant difference
Trust score:5/5

tolerance to preparation

1 evidences

Povidone-iodine enemas had similar infection rates to sodium hypochlorite but were better tolerated with less abdominal pain and fewer discontinuations.

Trust comment: Large multicenter randomized trial with clinical endpoints and clear patient-centered outcomes.

Study Details

PMID:17178958
Participants:517
Impact:79.4% vs 67.9% (PVI better tolerated; +11.5 percentage points)
Trust score:5/5

abdominal pain during prep

1 evidences

Povidone-iodine enemas had similar infection rates to sodium hypochlorite but were better tolerated with less abdominal pain and fewer discontinuations.

Trust comment: Large multicenter randomized trial with clinical endpoints and clear patient-centered outcomes.

Study Details

PMID:17178958
Participants:517
Impact:13.0% (PVI) vs 24.6% (sodium hypochlorite); −11.6 percentage points
Trust score:5/5

Serum zinc

2 evidences

Two long-term dietary patterns affected several serum minerals over 24 months; serum calcium showed no significant change while other minerals (selenium, manganese, magnesium) increased and serum zinc decreased.

Trust comment: Large randomized controlled trial with repeated measures and adequate sample, but mineral status was an incidental (not primary) outcome.

Study Details

PMID:38701651
Participants:368
Impact:decrease
Trust score:4/5

Fortified salt containing iodine and other micronutrients given to children and women for 8 months improved iron and zinc status and reduced anemia; urinary iodine was maintained in the fortified group.

Trust comment: Randomized controlled community trial with clearly reported biomarker outcomes and reasonable sample size, though potential implementation/contextual confounders exist.

Study Details

PMID:33952731
Participants:212
Impact:+>12.23 μg/dL (experimental vs control)
Trust score:4/5

Aortic CT value (attenuation)

1 evidences

A prospective randomized study comparing low iodine dose/injection rate and low radiation (with AI denoising) versus standard protocol showed higher vascular CT attenuation, lower iodine intake, and substantially lower radiation dose with maintained diagnostic image quality.

Trust comment: Prospective randomized cohort (n=90) with objective quantitative imaging endpoints and statistically significant differences, though single-center and BMI-limited population.

Study Details

PMID:39739102
Participants:90
Impact:Experimental +159.55 HU (624.91 vs 465.36 HU)
Trust score:4/5

Total symptoms score

1 evidences

Randomized double-blind multicenter trial found povidone iodine and dequalinium chloride equivalently improved vaginal infection symptoms with good tolerability.

Trust comment: Multicenter, randomized double-blind design with 180 patients supports reliability of equivalence conclusion, though detailed subgroup effect sizes not provided in excerpt.

Study Details

PMID:12404887
Participants:180
Impact:Improved; treatments equivalent (equivalence proven at 5% level)
Trust score:4/5

Vaginal flora / pH restoration

1 evidences

Randomized double-blind multicenter trial found povidone iodine and dequalinium chloride equivalently improved vaginal infection symptoms with good tolerability.

Trust comment: Multicenter, randomized double-blind design with 180 patients supports reliability of equivalence conclusion, though detailed subgroup effect sizes not provided in excerpt.

Study Details

PMID:12404887
Participants:180
Impact:Comparable improvement between treatments
Trust score:4/5

Catheter colonization rate

1 evidences

In children receiving epidural catheters, skin prep with alcoholic chlorhexidine yielded fewer catheter colonizations than aqueous povidone iodine.

Trust comment: Randomized controlled trial with clear microbiological endpoints and near-complete follow-up (96 evaluable), supporting internal validity.

Study Details

PMID:11176087
Participants:96
Impact:Povidone iodine group 5/44 (11.4%) vs chlorhexidine 1/52 (1.9%); colonization per 100 catheter-days 5.6 vs 0.9
Trust score:4/5

Serum interleukin-6 (IL-6)

1 evidences

Comparing full-mouth versus quadrant-wise debridement (including a povidone-iodine arm), full-mouth treatments caused immediate rises in IL-6 and decreases in soluble thrombomodulin, indicating greater short-term systemic vascular effects.

Trust comment: Small randomized allocation (n=36) with biomarker endpoints; findings suggest transient systemic effects but limited power and generalizability.

Study Details

PMID:18976393
Participants:36
Impact:Increased immediately after debridement (largest rise in full-mouth groups, including povidone-iodine)
Trust score:3/5

Soluble thrombomodulin

1 evidences

Comparing full-mouth versus quadrant-wise debridement (including a povidone-iodine arm), full-mouth treatments caused immediate rises in IL-6 and decreases in soluble thrombomodulin, indicating greater short-term systemic vascular effects.

Trust comment: Small randomized allocation (n=36) with biomarker endpoints; findings suggest transient systemic effects but limited power and generalizability.

Study Details

PMID:18976393
Participants:36
Impact:Decreased significantly in full-mouth groups (including povidone-iodine)
Trust score:3/5

positive predictive value (PPV)

1 evidences

Compared visual inspection with acetic acid (VIA) and Lugol's iodine (VILI); VILI was less accurate than VIA, especially in HIV-positive women.

Trust comment: Large randomized trial with masked HIV status and clear diagnostic outcomes; open-label for procedures but robust sample size.

Study Details

PMID:29566322
Participants:1160
Impact:VILI PPV 77.7% vs VIA PPV 91.5% (p=0.01)
Trust score:4/5

sensitivity and specificity in severely immunocompromised HIV+

1 evidences

Compared visual inspection with acetic acid (VIA) and Lugol's iodine (VILI); VILI was less accurate than VIA, especially in HIV-positive women.

Trust comment: Large randomized trial with masked HIV status and clear diagnostic outcomes; open-label for procedures but robust sample size.

Study Details

PMID:29566322
Participants:1160
Impact:VILI sensitivity 70.0%, specificity 66.9% vs VIA sensitivity 71.3%, specificity 88.2% (VILI poorer)
Trust score:4/5

volume of povidone-iodine used

1 evidences

A single-application povidone-iodine applicator used much less solution and was non-inferior to conventional sterilization for wound infection after abdominal surgery.

Trust comment: Prospective randomized trial with adequate sample for non-inferiority and clear endpoints though single-center and not surgeon-blinded.

Study Details

PMID:31183443
Participants:486
Impact:median 25 ml (applicator) vs 76.7 ml (conventional) (p<0.001)
Trust score:4/5

skin adverse reactions

1 evidences

A single-application povidone-iodine applicator used much less solution and was non-inferior to conventional sterilization for wound infection after abdominal surgery.

Trust comment: Prospective randomized trial with adequate sample for non-inferiority and clear endpoints though single-center and not surgeon-blinded.

Study Details

PMID:31183443
Participants:486
Impact:0 cases (applicator) vs 3 cases (1.2%) in conventional group
Trust score:4/5

clinical recovery (good response) at 20 days

1 evidences

Topical povidone-iodine (betadine) and clotrimazole had similar recovery rates for otomycosis at days 4, 10 and 20.

Trust comment: Randomized single-blind clinical trial with moderate sample size and objective clinical end-points, but single-center and single-blind design limits certainty.

Study Details

PMID:28549873
Participants:204
Impact:betadine 68.6% vs clotrimazole 66.7% (p=0.46; no significant difference)
Trust score:3/5

early clinical response (day 4 and 10)

1 evidences

Topical povidone-iodine (betadine) and clotrimazole had similar recovery rates for otomycosis at days 4, 10 and 20.

Trust comment: Randomized single-blind clinical trial with moderate sample size and objective clinical end-points, but single-center and single-blind design limits certainty.

Study Details

PMID:28549873
Participants:204
Impact:no significant differences at day 4 or day 10 between groups
Trust score:3/5

treatment adverse effects

1 evidences

Topical povidone-iodine (betadine) and clotrimazole had similar recovery rates for otomycosis at days 4, 10 and 20.

Trust comment: Randomized single-blind clinical trial with moderate sample size and objective clinical end-points, but single-center and single-blind design limits certainty.

Study Details

PMID:28549873
Participants:204
Impact:no side effects observed with betadine (none reported)
Trust score:3/5

poor visual outcome (corrected VA worse than 20/400)

1 evidences

Adding povidone-iodine to standard antibiotic therapy for corneal ulcers did not improve visual outcomes at 2–4 months.

Trust comment: Randomized trial with reasonable sample but incomplete follow-up (81% examined) and no benefit shown for the addition of povidone-iodine.

Study Details

PMID:15548795
Participants:358
Impact:standard 3.9% vs povidone-iodine 6.9% (RR 1.77; 95% CI 0.62–5.03; not significant)
Trust score:3/5

corrected VA worse than 20/60

1 evidences

Adding povidone-iodine to standard antibiotic therapy for corneal ulcers did not improve visual outcomes at 2–4 months.

Trust comment: Randomized trial with reasonable sample but incomplete follow-up (81% examined) and no benefit shown for the addition of povidone-iodine.

Study Details

PMID:15548795
Participants:358
Impact:standard 9.4% vs povidone-iodine 13.1% (RR 1.39; 95% CI 0.71–2.77; not significant)
Trust score:3/5

scarring in visual axis

1 evidences

Adding povidone-iodine to standard antibiotic therapy for corneal ulcers did not improve visual outcomes at 2–4 months.

Trust comment: Randomized trial with reasonable sample but incomplete follow-up (81% examined) and no benefit shown for the addition of povidone-iodine.

Study Details

PMID:15548795
Participants:358
Impact:standard 17.0% vs povidone-iodine 18.8% (RR 1.11; 95% CI 0.67–1.82; not significant)
Trust score:3/5

stomal infection incidence (cumulative at end of week 1)

1 evidences

Combining systemic cefuroxime with povidone-iodine spray reduced stomal infections after PEG more than either treatment alone.

Trust comment: Randomized controlled trial with small groups and clear outcome differences, but limited sample size reduces precision.

Study Details

PMID:17099376
Participants:96
Impact:combination group 9% vs antibiotics-only 32% and Betadine-only 43% (p=0.003) — combination reduced infections
Trust score:3/5

stomal infection at midweek

1 evidences

Combining systemic cefuroxime with povidone-iodine spray reduced stomal infections after PEG more than either treatment alone.

Trust comment: Randomized controlled trial with small groups and clear outcome differences, but limited sample size reduces precision.

Study Details

PMID:17099376
Participants:96
Impact:Betadine-only 32% vs antibiotics-only 6% and combination 9% (p=0.0114)
Trust score:3/5

catheter-related bacteremia rate

1 evidences

No significant difference between 10% povidone-iodine and 0.5% chlorhexidine for prevention of catheter-related bacteremia or colonization; trend toward fewer exit-site infections with chlorhexidine.

Trust comment: Multicenter randomized controlled trial with appropriate clinical endpoints and intention-to-treat analysis, though some outcomes were underpowered to show small differences.

Study Details

PMID:11049783
Participants:242
Impact:chlorhexidine 4.6 vs povidone-iodine 4.1 cases per 1000 catheter-days (NS)
Trust score:4/5

significant catheter-tip colonization

1 evidences

No significant difference between 10% povidone-iodine and 0.5% chlorhexidine for prevention of catheter-related bacteremia or colonization; trend toward fewer exit-site infections with chlorhexidine.

Trust comment: Multicenter randomized controlled trial with appropriate clinical endpoints and intention-to-treat analysis, though some outcomes were underpowered to show small differences.

Study Details

PMID:11049783
Participants:242
Impact:povidone-iodine 27% vs chlorhexidine 34% (NS)
Trust score:4/5

exit-site infection trend

1 evidences

No significant difference between 10% povidone-iodine and 0.5% chlorhexidine for prevention of catheter-related bacteremia or colonization; trend toward fewer exit-site infections with chlorhexidine.

Trust comment: Multicenter randomized controlled trial with appropriate clinical endpoints and intention-to-treat analysis, though some outcomes were underpowered to show small differences.

Study Details

PMID:11049783
Participants:242
Impact:chlorhexidine 0 cases vs povidone-iodine 4 cases (P=0.053; trend only)
Trust score:4/5

pain score (VAS)

2 evidences

In infertile women, management guided by HyFoSy or HSG produced similar live-birth rates, while HyFoSy caused significantly less pain.

Trust comment: Large multicentre randomized trial with clear methods, prespecified outcomes, and reported CIs.

Study Details

PMID:35220432
Participants:1026
Impact:HyFoSy mean 3.1 vs HSG mean 5.4 (−2.3 points)
Trust score:5/5

Randomized study comparing povidone‑iodine lavage + lidocaine gel vs ceftriaxone + lavage for prostate biopsy; no difference in pain or infection rates.

Trust comment: Randomized human trial with clear outcomes but moderate sample size and limited pain-management findings.

Study Details

PMID:16502051
Participants:80
Impact:Group1 mean 3.70 vs Group2 mean 4.25; no significant difference (P>0.05)
Trust score:3/5

infective complications (urine/blood cultures)

1 evidences

Randomized study comparing povidone‑iodine lavage + lidocaine gel vs ceftriaxone + lavage for prostate biopsy; no difference in pain or infection rates.

Trust comment: Randomized human trial with clear outcomes but moderate sample size and limited pain-management findings.

Study Details

PMID:16502051
Participants:80
Impact:No significant difference between groups (P>0.05); povidone‑iodine lavage adequate for infection prevention
Trust score:3/5

oral SARS‑CoV‑2 viral load (copies/mL)

1 evidences

Randomized placebo‑controlled pilot trial in hospitalized COVID‑19 patients: PVP‑I 1% mouthrinse produced the largest immediate reduction in oral SARS‑CoV‑2 RNA compared with other rinses and placebo.

Trust comment: Randomized, placebo‑controlled clinical trial with objective molecular endpoints but small pilot sample size.

Study Details

PMID:35988522
Participants:38
Impact:PVP‑I median T0 67.4 → T1 0 copies/mL; 5/8 (62.5%) undetectable at T1; PVP‑I reduced viral load vs placebo at T1 (p=0.03) and T2 (p=0.024)
Trust score:4/5

rtPCR Ct value

1 evidences

Randomized placebo‑controlled pilot trial in hospitalized COVID‑19 patients: PVP‑I 1% mouthrinse produced the largest immediate reduction in oral SARS‑CoV‑2 RNA compared with other rinses and placebo.

Trust comment: Randomized, placebo‑controlled clinical trial with objective molecular endpoints but small pilot sample size.

Study Details

PMID:35988522
Participants:38
Impact:PVP‑I median Ct increased from 36.3 (T0) to 40.0 (T1), statistically significant (p=0.002)
Trust score:4/5

vaginal bacterial colony counts

1 evidences

Prospective randomized trial before cesarean: povidone‑iodine vaginal prep reduced aerobic and anaerobic bacterial colony counts more than chlorhexidine or saline.

Trust comment: Randomized controlled trial with blinded colony-count assessment but small sample size.

Study Details

PMID:33345865
Participants:29
Impact:Povidone‑iodine produced greater reduction vs chlorhexidine and saline (P≤.01 aerobic, P≤.0001 anaerobic); eliminated >99.9% of bacteria
Trust score:4/5

small-bowel transit time

1 evidences

Randomized study showed adding iodinated hyperosmolar contrast (Gastrografin) and/or effervescent agent to barium shortens small bowel transit time without reducing exam quality.

Trust comment: Randomized study with clear endpoints and reasonable sample but analysis reported after exclusions (119 analyzed).

Study Details

PMID:17174502
Participants:119
Impact:Addition of iodinated hyperosmolar agent (and combined additives) significantly reduced transit time vs barium alone (p<0.001); combined group faster than hyperosmolar alone (p=0.02)
Trust score:3/5

unplanned postprocedural RRT rate

1 evidences

Large cohort used to derive and validate a preprocedural risk score for unplanned postprocedural renal replacement therapy following invasive coronary procedures involving iodinated contrast exposure.

Trust comment: Large retrospective cohort with model development and validation and strong discrimination, relevant to iodinated contrast risk.

Study Details

PMID:34605397
Participants:3469
Impact:36 of 3,469 patients (1.0%) required unplanned RRT after ICA/PCI
Trust score:4/5

risk model performance

1 evidences

Large cohort used to derive and validate a preprocedural risk score for unplanned postprocedural renal replacement therapy following invasive coronary procedures involving iodinated contrast exposure.

Trust comment: Large retrospective cohort with model development and validation and strong discrimination, relevant to iodinated contrast risk.

Study Details

PMID:34605397
Participants:3469
Impact:Five predictors identified; risk score C‑statistic = 0.872 indicating high discrimination
Trust score:4/5

renal biomarkers (creatinine, NGAL, cystatin‑C)

1 evidences

Randomized, blinded trial assessing remote ischemic preconditioning (RIPC) vs sham before coronary angiography: biomarker responses favored RIPC, suggesting nephroprotection against contrast‑induced injury.

Trust comment: Small randomized trial with objective biomarkers but limited size; reported CIN rates in text appear inconsistent with other results, reducing confidence.

Study Details

PMID:27814282
Participants:51
Impact:Biomarkers increased in sham group and declined in RIPC group; differences between groups were statistically significant
Trust score:3/5

contrast‑induced nephropathy (CIN) occurrence

1 evidences

Randomized, blinded trial assessing remote ischemic preconditioning (RIPC) vs sham before coronary angiography: biomarker responses favored RIPC, suggesting nephroprotection against contrast‑induced injury.

Trust comment: Small randomized trial with objective biomarkers but limited size; reported CIN rates in text appear inconsistent with other results, reducing confidence.

Study Details

PMID:27814282
Participants:51
Impact:Study text reports differing CIN rates between groups (text reports 28% vs 3.8%); biomarkers and authors conclude RIPC was nephroprotective
Trust score:3/5

seroma formation rate

1 evidences

Randomized trial after mastectomy comparing talc, povidone‑iodine and standard care; iodine arm was stopped for increased drain output; talc did not reduce seroma frequency.

Trust comment: Randomized Phase II trial with moderate size; iodine arm stopped for harm and some outcomes underpowered.

Study Details

PMID:26950740
Participants:80
Impact:Talc 19.4% vs Control 23.3% (−3.9 percentage points; p=0.70, NS)
Trust score:3/5

volume drained per seroma

1 evidences

Randomized trial after mastectomy comparing talc, povidone‑iodine and standard care; iodine arm was stopped for increased drain output; talc did not reduce seroma frequency.

Trust comment: Randomized Phase II trial with moderate size; iodine arm stopped for harm and some outcomes underpowered.

Study Details

PMID:26950740
Participants:80
Impact:Talc 88.2 ± 73 vs Control 158.3 ± 90.5 (reduced with talc; p=0.17, NS)
Trust score:3/5

drainage duration and total drain output (iodine)

1 evidences

Randomized trial after mastectomy comparing talc, povidone‑iodine and standard care; iodine arm was stopped for increased drain output; talc did not reduce seroma frequency.

Trust comment: Randomized Phase II trial with moderate size; iodine arm stopped for harm and some outcomes underpowered.

Study Details

PMID:26950740
Participants:80
Impact:Increased drainage duration and total fluid drained in iodine arm (arm discontinued; exact values not reported)
Trust score:3/5

conjunctival disinfection rate (PI vs PAI)

1 evidences

Multicentre randomized study in cataract patients comparing diluted povidone‑iodine vs polyvinyl alcohol‑iodine and different durations of topical levofloxacin; 3‑day levofloxacin plus iodine wash gave best disinfection.

Trust comment: Large, multicenter randomized trial with clear microbiological endpoints and adequate sample size.

Study Details

PMID:18661264
Participants:272
Impact:PI 78.0% vs PAI 79.4% (PAI non‑inferior to PI)
Trust score:4/5

preoperative levofloxacin duration effect

1 evidences

Multicentre randomized study in cataract patients comparing diluted povidone‑iodine vs polyvinyl alcohol‑iodine and different durations of topical levofloxacin; 3‑day levofloxacin plus iodine wash gave best disinfection.

Trust comment: Large, multicenter randomized trial with clear microbiological endpoints and adequate sample size.

Study Details

PMID:18661264
Participants:272
Impact:3‑day LVFX application > 1‑day or 1‑hour (higher disinfection rate; P<0.05)
Trust score:4/5

pin site infection days rate

1 evidences

Randomized trial comparing routine pin‑site care with additional antiseptics (including povidone‑iodine); no antiseptic improved pin‑site infection rates over control.

Trust comment: Randomized, single‑blinded prospective study with all patients completing follow‑up; adequately reported outcomes.

Study Details

PMID:30711321
Participants:114
Impact:Control 2.04 ± 4.27 vs Povidone‑iodine 2.04 ± 3.65 per 1000 pin‑site days (p=0.92; no difference)
Trust score:4/5

dressing frequency effect (daily vs weekly)

1 evidences

Randomized trial comparing routine pin‑site care with additional antiseptics (including povidone‑iodine); no antiseptic improved pin‑site infection rates over control.

Trust comment: Randomized, single‑blinded prospective study with all patients completing follow‑up; adequately reported outcomes.

Study Details

PMID:30711321
Participants:114
Impact:Daily 1.56 ± 3.99 vs Weekly 2.10 ± 5.10 (p=0.35; no significant difference)
Trust score:4/5

positive toe cultures after prep

1 evidences

Randomized study of standard preoperative prep with povidone‑iodine with or without added alcohol for foot/ankle surgery; addition of alcohol did not reduce residual aerobic cultures.

Trust comment: Small randomized trial with complete follow‑up but limited power and no clinical infections observed.

Study Details

PMID:12398148
Participants:49
Impact:Standard 9/26 (35%) vs Standard+alcohol 13/23 (57%); P=0.12 (no statistically significant benefit of alcohol)
Trust score:3/5

post‑preparation conjunctival culture positivity

1 evidences

Randomized trial comparing reduced‑concentration (1.25%) povidone‑iodine plus levofloxacin versus standard 5% PI before intravitreal injection; similar reductions in conjunctival culture positivity.

Trust comment: Prospective randomized single‑blind clinical trial with 100 patients and microbiological endpoints; appropriate design.

Study Details

PMID:22740305
Participants:100
Impact:1.25% PI+LVFX 25/52 (48.1%) vs 5% PI 27/48 (56.3%); P=0.43 (no significant difference)
Trust score:4/5

needle contamination

1 evidences

Randomized trial comparing reduced‑concentration (1.25%) povidone‑iodine plus levofloxacin versus standard 5% PI before intravitreal injection; similar reductions in conjunctival culture positivity.

Trust comment: Prospective randomized single‑blind clinical trial with 100 patients and microbiological endpoints; appropriate design.

Study Details

PMID:22740305
Participants:100
Impact:No needle samples contaminated in either group (0/100)
Trust score:4/5

epithelialisation rate

1 evidences

Randomized comparison of hydrogel dressing versus standard conservative care (gauze with povidone‑iodine) for pressure ulcers in spinal‑cord injury patients; hydrogel increased epithelialisation rate.

Trust comment: Small randomized wound‑care study with wound‑level randomization; significant finding for epithelialisation but limited sample size.

Study Details

PMID:15656468
Participants:27
Impact:Hydrogel 84% vs Control (gauze + povidone‑iodine) 54% (difference +30 percentage points; p=0.04)
Trust score:3/5

healing rate (cm2/day)

1 evidences

Randomized comparison of hydrogel dressing versus standard conservative care (gauze with povidone‑iodine) for pressure ulcers in spinal‑cord injury patients; hydrogel increased epithelialisation rate.

Trust comment: Small randomized wound‑care study with wound‑level randomization; significant finding for epithelialisation but limited sample size.

Study Details

PMID:15656468
Participants:27
Impact:No statistically significant difference in mean healing rate (cm2/day) between groups
Trust score:3/5

ophthalmia neonatorum incidence (overall)

1 evidences

Randomized prospective study in Kenya comparing eye prophylaxis agents in newborns; maternal vaginitis raised risk of gonococcal eye infection.

Trust comment: Large randomized prospective study on humans; subgroup comparisons of prophylactic agents are based on very small numbers so subgroup estimates are imprecise.

Study Details

PMID:8771523
Participants:3117
Impact:No significant difference by the four perinatal factors (P > 0.14)
Trust score:4/5

ophthalmia neonatorum incidence after povidone-iodine prophylaxis (subgroup)

1 evidences

Randomized prospective study in Kenya comparing eye prophylaxis agents in newborns; maternal vaginitis raised risk of gonococcal eye infection.

Trust comment: Large randomized prospective study on humans; subgroup comparisons of prophylactic agents are based on very small numbers so subgroup estimates are imprecise.

Study Details

PMID:8771523
Participants:3117
Impact:25% frequency in povidone-iodine–treated neonates in the maternal vaginitis subgroup (differences vs other agents not significant)
Trust score:4/5

venereal/gonococcal ophthalmia neonatorum risk (maternal vaginitis)

1 evidences

Randomized prospective study in Kenya comparing eye prophylaxis agents in newborns; maternal vaginitis raised risk of gonococcal eye infection.

Trust comment: Large randomized prospective study on humans; subgroup comparisons of prophylactic agents are based on very small numbers so subgroup estimates are imprecise.

Study Details

PMID:8771523
Participants:3117
Impact:Relative risk 5.1 for venereal ON and 24.9 for gonococcal ON in infants of mothers with vaginitis (P = 0.0013 and P = 0.0000031 respectively)
Trust score:4/5

urinary iodine excretion (24-h U-I)

1 evidences

6-week RCT in healthy men replacing most red/processed meat with legumes; studied nutrient intakes and biomarkers including iodine intake and urinary iodine excretion.

Trust comment: Well-conducted randomized controlled trial with validated biochemical iodine measures, but short duration and limited to healthy men affecting generalizability.

Study Details

PMID:40828321
Participants:102
Impact:Lower in LEGUME group vs MEAT group (P = 0.041)
Trust score:4/5

proportion with U-I < 100 µg/d

1 evidences

6-week RCT in healthy men replacing most red/processed meat with legumes; studied nutrient intakes and biomarkers including iodine intake and urinary iodine excretion.

Trust comment: Well-conducted randomized controlled trial with validated biochemical iodine measures, but short duration and limited to healthy men affecting generalizability.

Study Details

PMID:40828321
Participants:102
Impact:Endpoint: MEAT 6% (3/49–50) vs LEGUME 14% (7/49–50)
Trust score:4/5

capsular contracture incidence (textured + Betadine)

1 evidences

4-year prospective, blinded study where each patient received both textured and smooth implants and saline or Betadine irrigation to assess capsular contracture incidence.

Trust comment: Randomized, blinded within-patient controlled clinical study over 4 years, but modest sample size (n=60) limits precision.

Study Details

PMID:7480228
Participants:60
Impact:4% incidence for textured implants irrigated with Betadine
Trust score:4/5

capsular contracture incidence (smooth + saline)

1 evidences

4-year prospective, blinded study where each patient received both textured and smooth implants and saline or Betadine irrigation to assess capsular contracture incidence.

Trust comment: Randomized, blinded within-patient controlled clinical study over 4 years, but modest sample size (n=60) limits precision.

Study Details

PMID:7480228
Participants:60
Impact:50% incidence for smooth implants irrigated with saline
Trust score:4/5

effect of Betadine irrigation

1 evidences

4-year prospective, blinded study where each patient received both textured and smooth implants and saline or Betadine irrigation to assess capsular contracture incidence.

Trust comment: Randomized, blinded within-patient controlled clinical study over 4 years, but modest sample size (n=60) limits precision.

Study Details

PMID:7480228
Participants:60
Impact:Betadine-irrigated devices had lower contracture incidence than saline-irrigated devices (cumulative with texture)
Trust score:4/5

number of dressing changes

1 evidences

Wet silver dressings healed skin wounds faster, reduced dressing changes and pain compared with povidone-iodine dressings.

Trust comment: Randomized controlled trial but small sample (58) and described as preliminary, so moderate confidence.

Study Details

PMID:33611826
Participants:58
Impact:- significant decrease
Trust score:3/5

main-bolus contrast density (HU)

1 evidences

Test bolus curve parameters (PD and AUC) and patient weight predict main-bolus contrast density in cardiac CT.

Trust comment: Prospective double-blind study with objective imaging endpoints and adequate analysis, moderate sample size.

Study Details

PMID:18078906
Participants:60
Impact:+ positive correlation with TB peak density and AUC (r=0.52–0.56; r=0.63–0.64 when weight included)
Trust score:4/5

post-prep culture sterility / number of isolates

1 evidences

Both 1% and 5% PVP-I preparations similarly reduced recoverable organisms from donor eyes; 1% is preferred to limit toxicity.

Trust comment: Randomized study of 100 donor pairs with clear microbiologic outcomes; results consistent and clinically applicable.

Study Details

PMID:21045655
Participants:100
Impact:both concentrations: - large reduction vs pre-prep; no meaningful difference between 1% and 5% (49 vs 47 sterile eyes)
Trust score:4/5

microorganism colony counts

1 evidences

Both 1% and 5% PVP-I preparations similarly reduced recoverable organisms from donor eyes; 1% is preferred to limit toxicity.

Trust comment: Randomized study of 100 donor pairs with clear microbiologic outcomes; results consistent and clinically applicable.

Study Details

PMID:21045655
Participants:100
Impact:no significant difference between 1% and 5% post-prep
Trust score:4/5

intracoronary / aortic attenuation (HU)

1 evidences

Iomeprol 400 (higher iodine concentration) produced greater arterial attenuation on 16-row CT than iopromide 370.

Trust comment: Randomized comparison with objective HU endpoints in 40 patients; small sample but clear quantitative differences.

Study Details

PMID:16481919
Participants:40
Impact:+ higher with iomeprol 400 (e.g., coronary origin 340±53 HU vs 313±42 HU; P<0.05)
Trust score:4/5

clinical conjunctivitis incidence

1 evidences

2.5% povidone-iodine (betadine) eye drops reduced newborn conjunctivitis compared with erythromycin or no prophylaxis.

Trust comment: Randomized trial with 330 neonates and statistically significant reduction in conjunctivitis with betadine, supporting moderate-high confidence.

Study Details

PMID:18055489
Participants:330
Impact:- betadine group 9% vs erythromycin 18.4% vs no prophylaxis 22.4% (p=0.030)
Trust score:4/5

catheter-related bloodstream infection (CR-BSI)

1 evidences

No difference in catheter-related bloodstream infection between chlorhexidine-alcohol and povidone-iodine, but povidone-iodine was linked to more thyroid dysfunction.

Trust comment: Randomized trial with adequate enrollment but underpowered for primary outcome and unblinded caregivers; thyroid finding statistically significant.

Study Details

PMID:29074717
Participants:304
Impact:no significant difference (CHX-IA 7% vs PI 5%; p=0.631)
Trust score:3/5

thyroid dysfunction / elevated TSH requiring thyroxine

1 evidences

No difference in catheter-related bloodstream infection between chlorhexidine-alcohol and povidone-iodine, but povidone-iodine was linked to more thyroid dysfunction.

Trust comment: Randomized trial with adequate enrollment but underpowered for primary outcome and unblinded caregivers; thyroid finding statistically significant.

Study Details

PMID:29074717
Participants:304
Impact:+ higher with PI (CHX-IA 0% vs PI 5%; p=0.003)
Trust score:3/5

pre-preparation conjunctival bacterial culture positivity

1 evidences

Povidone-iodine preparation before intravitreal injection reduced conjunctival bacterial cultures to low rates; 3-day topical gatifloxacin lowered pre-prep flora but provided no additional benefit after povidone-iodine.

Trust comment: Randomized single-blind trial with objective culture endpoints showing PVI-alone effectively reduces conjunctival bacterial contamination; moderate sample size.

Study Details

PMID:19501409
Participants:129
Impact:21% with 3-day gatifloxacin vs 48% untreated (P=0.005)
Trust score:4/5

post-povidone-iodine conjunctival culture positivity

1 evidences

Povidone-iodine preparation before intravitreal injection reduced conjunctival bacterial cultures to low rates; 3-day topical gatifloxacin lowered pre-prep flora but provided no additional benefit after povidone-iodine.

Trust comment: Randomized single-blind trial with objective culture endpoints showing PVI-alone effectively reduces conjunctival bacterial contamination; moderate sample size.

Study Details

PMID:19501409
Participants:129
Impact:8% (gatifloxacin) vs 4% (no antibiotic); no significant difference (P=0.324) — PVI effective as monotherapy
Trust score:4/5

recurrent nodular goiter prevalence at 20 years

1 evidences

150 patients randomized to postoperative levothyroxine (LT4) vs no LT4 after thyroid lobectomy: over 20 years LT4 greatly reduced recurrence of nodular goiter and need for further surgery, especially in iodine-deficient patients.

Trust comment: Randomized trial with long (20-year) follow-up and stratified urinary-iodine analysis; moderate sample and some loss to follow-up.

Study Details

PMID:39547954
Participants:150
Impact:3.3% with LT4 vs 30.0% without LT4 (P=0.031)
Trust score:4/5

need for contralateral intervention/surgery at 20 years

1 evidences

150 patients randomized to postoperative levothyroxine (LT4) vs no LT4 after thyroid lobectomy: over 20 years LT4 greatly reduced recurrence of nodular goiter and need for further surgery, especially in iodine-deficient patients.

Trust comment: Randomized trial with long (20-year) follow-up and stratified urinary-iodine analysis; moderate sample and some loss to follow-up.

Study Details

PMID:39547954
Participants:150
Impact:4.9% with LT4 vs 30.0% without LT4 (P=0.028)
Trust score:4/5

recurrence in iodine-deficient subgroup

1 evidences

150 patients randomized to postoperative levothyroxine (LT4) vs no LT4 after thyroid lobectomy: over 20 years LT4 greatly reduced recurrence of nodular goiter and need for further surgery, especially in iodine-deficient patients.

Trust comment: Randomized trial with long (20-year) follow-up and stratified urinary-iodine analysis; moderate sample and some loss to follow-up.

Study Details

PMID:39547954
Participants:150
Impact:10.0% with LT4 vs 70.0% without LT4 (P=0.037); no significant benefit in iodine-sufficient patients (0.0% vs 10.0%, P=0.056)
Trust score:4/5

superficial tissue bacterial contamination

1 evidences

In lumbar fusion surgery, intraoperative povidone-iodine soaking reduced superficial tissue bacterial contamination but not deep tissues or implants; chlorhexidine soaked implants showed the greatest reduction of implant contamination; SSI rates were low and similar.

Trust comment: Single-center randomized trial with objective culture and PCR outcomes directly comparing PVP-I and other antiseptics; moderate sample size.

Study Details

PMID:40334990
Participants:105
Impact:reduced after povidone-iodine irrigation (P=0.015)
Trust score:4/5

implant surface bacterial contamination

1 evidences

In lumbar fusion surgery, intraoperative povidone-iodine soaking reduced superficial tissue bacterial contamination but not deep tissues or implants; chlorhexidine soaked implants showed the greatest reduction of implant contamination; SSI rates were low and similar.

Trust comment: Single-center randomized trial with objective culture and PCR outcomes directly comparing PVP-I and other antiseptics; moderate sample size.

Study Details

PMID:40334990
Participants:105
Impact:povidone-iodine no significant implant effect; chlorhexidine significantly reduced implant contamination vs NS (OR 0.06, 95% CI 0.01–0.54, P=0.011) and vs PVP-I (OR 0.06, 95% CI 0.01–0.56, P=0.012)
Trust score:4/5

reoperation rate (primary composite)

1 evidences

Large multicenter randomized trial found no difference between chlorhexidine-alcohol and povidone-iodine-alcohol for reoperation, surgical site infection, mediastinitis, or mortality after major cardiac surgery.

Trust comment: Large multicenter RCT with blinded adjudication of outcomes and robust endpoints; high-quality evidence that PVI-alcohol is not inferior to CHX-alcohol in this setting.

Study Details

PMID:39531051
Participants:3242
Impact:7.7% chlorhexidine vs 7.5% povidone-iodine (risk difference 0.25; P=0.74)
Trust score:5/5

mediastinitis prevalence

1 evidences

Large multicenter randomized trial found no difference between chlorhexidine-alcohol and povidone-iodine-alcohol for reoperation, surgical site infection, mediastinitis, or mortality after major cardiac surgery.

Trust comment: Large multicenter RCT with blinded adjudication of outcomes and robust endpoints; high-quality evidence that PVI-alcohol is not inferior to CHX-alcohol in this setting.

Study Details

PMID:39531051
Participants:3242
Impact:2.3% vs 2.4% (P=0.81)
Trust score:5/5

ocular surface bacterial colony count

1 evidences

Repeated 1% povidone-iodine irrigations on the eye reduced bacteria and caused less corneal surface damage than a single 5% application.

Trust comment: Prospective, randomized, double-blind study with 102 patients and quantitative microbiologic and epithelial assessments; well executed.

Study Details

PMID:38477800
Participants:102
Impact:significant decrease from baseline; repeated 1% PI produced lower bacterial counts than single 5% PI (P<0.05)
Trust score:4/5

corneal epithelial damage (superficial punctate keratopathy)

1 evidences

Repeated 1% povidone-iodine irrigations on the eye reduced bacteria and caused less corneal surface damage than a single 5% application.

Trust comment: Prospective, randomized, double-blind study with 102 patients and quantitative microbiologic and epithelial assessments; well executed.

Study Details

PMID:38477800
Participants:102
Impact:significantly less damage with repeated 1% PI vs single 5% PI (P<0.001)
Trust score:4/5

hepatic contrast enhancement (MAX/CEI)

1 evidences

Uniphasic contrast injection gave better hepatic enhancement than biphasic; lower iodine doses can still give adequate enhancement, especially in thinner patients.

Trust comment: Large randomized outpatient study (n=487) comparing injection protocols with objective imaging metrics; applicable clinical endpoints.

Study Details

PMID:7568859
Participants:487
Impact:uniphasic injection superior to biphasic; no significant difference in enhancement for 38–44 g iodine with uniphasic technique
Trust score:4/5

iodine dose requirement for adequate enhancement

1 evidences

Uniphasic contrast injection gave better hepatic enhancement than biphasic; lower iodine doses can still give adequate enhancement, especially in thinner patients.

Trust comment: Large randomized outpatient study (n=487) comparing injection protocols with objective imaging metrics; applicable clinical endpoints.

Study Details

PMID:7568859
Participants:487
Impact:thin patients: adequate enhancement with ~26 g iodine (allowing up to ~40% dose reduction); heavy patients: adequate enhancement in >70% with ~38 g
Trust score:4/5

acute adverse symptom severity score

1 evidences

Spraying 2% vitamin C after Lugol iodine reduced acute and late mucosal irritation and sped fading of the iodine stain compared with saline; effects were similar or better than sodium thiosulfate for several symptoms.

Trust comment: Multicenter, randomized, double-blind trial with clear patient-centered endpoints and reported p-values; results directly applicable.

Study Details

PMID:31783028
Participants:240
Impact:reduced: NS 2.58 → VCS 1.61 (P=0.040)
Trust score:4/5

late adverse symptom severity score

1 evidences

Spraying 2% vitamin C after Lugol iodine reduced acute and late mucosal irritation and sped fading of the iodine stain compared with saline; effects were similar or better than sodium thiosulfate for several symptoms.

Trust comment: Multicenter, randomized, double-blind trial with clear patient-centered endpoints and reported p-values; results directly applicable.

Study Details

PMID:31783028
Participants:240
Impact:reduced: NS 1.70 → VCS 0.91 (P=0.002)
Trust score:4/5

incidence of acute acid regurgitation/heartburn

1 evidences

Spraying 2% vitamin C after Lugol iodine reduced acute and late mucosal irritation and sped fading of the iodine stain compared with saline; effects were similar or better than sodium thiosulfate for several symptoms.

Trust comment: Multicenter, randomized, double-blind trial with clear patient-centered endpoints and reported p-values; results directly applicable.

Study Details

PMID:31783028
Participants:240
Impact:reduced versus STS: 33% → 15% (P=0.017)
Trust score:4/5

incidence of late retrosternal discomfort/pain

1 evidences

Spraying 2% vitamin C after Lugol iodine reduced acute and late mucosal irritation and sped fading of the iodine stain compared with saline; effects were similar or better than sodium thiosulfate for several symptoms.

Trust comment: Multicenter, randomized, double-blind trial with clear patient-centered endpoints and reported p-values; results directly applicable.

Study Details

PMID:31783028
Participants:240
Impact:reduced versus STS: 21% → 9% (P=0.027)
Trust score:4/5

iodine-stained mucosa decolorization

1 evidences

Spraying 2% vitamin C after Lugol iodine reduced acute and late mucosal irritation and sped fading of the iodine stain compared with saline; effects were similar or better than sodium thiosulfate for several symptoms.

Trust comment: Multicenter, randomized, double-blind trial with clear patient-centered endpoints and reported p-values; results directly applicable.

Study Details

PMID:31783028
Participants:240
Impact:faster/more complete decolorization with VCS (decolorization score VCS 3.56 vs NS 2.26; P=0.000) and similar to STS
Trust score:4/5

aortic enhancement (HU)

1 evidences

Higher-concentration iodine contrast (370 mg I/mL) produced substantially greater vascular enhancement and higher image-quality scores than lower concentration (300 mg I/mL) with similar adverse reactions and modest cost savings.

Trust comment: Controlled comparative imaging study with objective measures and clear numeric differences, but moderate sample size (n=100) and limited clinical outcomes.

Study Details

PMID:16954936
Participants:100
Impact:higher with 370 mg/mL: 216 HU vs 153 HU (difference +63 HU; P<0.05)
Trust score:3/5

pulmonary artery enhancement (HU)

1 evidences

Higher-concentration iodine contrast (370 mg I/mL) produced substantially greater vascular enhancement and higher image-quality scores than lower concentration (300 mg I/mL) with similar adverse reactions and modest cost savings.

Trust comment: Controlled comparative imaging study with objective measures and clear numeric differences, but moderate sample size (n=100) and limited clinical outcomes.

Study Details

PMID:16954936
Participants:100
Impact:higher with 370 mg/mL: 208 HU vs 147 HU (difference +61 HU; P<0.05)
Trust score:3/5

superior vena cava enhancement (HU)

1 evidences

Higher-concentration iodine contrast (370 mg I/mL) produced substantially greater vascular enhancement and higher image-quality scores than lower concentration (300 mg I/mL) with similar adverse reactions and modest cost savings.

Trust comment: Controlled comparative imaging study with objective measures and clear numeric differences, but moderate sample size (n=100) and limited clinical outcomes.

Study Details

PMID:16954936
Participants:100
Impact:higher with 370 mg/mL: 299 HU vs 155 HU (difference +144 HU; P<0.05)
Trust score:3/5

overall qualitative enhancement score

1 evidences

Higher-concentration iodine contrast (370 mg I/mL) produced substantially greater vascular enhancement and higher image-quality scores than lower concentration (300 mg I/mL) with similar adverse reactions and modest cost savings.

Trust comment: Controlled comparative imaging study with objective measures and clear numeric differences, but moderate sample size (n=100) and limited clinical outcomes.

Study Details

PMID:16954936
Participants:100
Impact:higher with 370 mg/mL: 4.2 vs 3.3 (P<0.01)
Trust score:3/5

cost and adverse reactions

1 evidences

Higher-concentration iodine contrast (370 mg I/mL) produced substantially greater vascular enhancement and higher image-quality scores than lower concentration (300 mg I/mL) with similar adverse reactions and modest cost savings.

Trust comment: Controlled comparative imaging study with objective measures and clear numeric differences, but moderate sample size (n=100) and limited clinical outcomes.

Study Details

PMID:16954936
Participants:100
Impact:up to 5.5% cost savings with higher concentration and no increase in adverse reactions
Trust score:3/5

HSV shedding clearance at 2 hours

1 evidences

Betadine cold sore paint markedly reduced detectable infectious HSV on lip lesions at 2 hours compared with Stoxil topical ointment.

Trust comment: Randomized parallel-group open-label trial with small sample (n=72) and short-term virologic endpoint; results significant but limited by open-label design and brief follow-up.

Study Details

PMID:9403262
Participants:72
Impact:Betadine 63.6% vs Stoxil 9.2% (absolute difference +54.4 percentage points; p=0.00056)
Trust score:3/5

infectious morbidity (postoperative infections)

1 evidences

Preoperative vaginal douching with 1% povidone-iodine reduced postoperative infectious morbidity after total abdominal hysterectomy compared with no douching.

Trust comment: Multicenter randomized controlled trial with 300 patients and blinded external outcome assessment; credible reduction in infectious morbidity.

Study Details

PMID:14971530
Participants:300
Impact:8% (douching) vs 19% (no douching); absolute reduction -10.0 percentage points (statistically significant; adjusted OR 0.4)
Trust score:4/5

conjunctivitis incidence (red eye with discharge)

1 evidences

Giving a second povidone-iodine eye drop within the first day did not reduce neonatal conjunctivitis compared with a single drop; double dosing had slightly more eyelid swelling.

Trust comment: Large masked, prospective controlled trial with clear outcomes, though single-center and pragmatic randomisation by alternating weeks.

Study Details

PMID:14660449
Participants:719
Impact:+5.9% (24.3% vs 18.4%)
Trust score:4/5

eyelid oedema score

1 evidences

Giving a second povidone-iodine eye drop within the first day did not reduce neonatal conjunctivitis compared with a single drop; double dosing had slightly more eyelid swelling.

Trust comment: Large masked, prospective controlled trial with clear outcomes, though single-center and pragmatic randomisation by alternating weeks.

Study Details

PMID:14660449
Participants:719
Impact:+0.2 points (1.4 vs 1.2, p=0.0002)
Trust score:4/5

overall complication rate

1 evidences

Povidone-iodine (alcohol or aqueous) performed similarly to chlorhexidine-alcohol for 30-day surgical site infection, complications, and hospital stay after colorectal surgery.

Trust comment: Prospective randomized trial with moderate sample size and clinically relevant endpoints, though subset analysis and protocol change in chlorhexidine concentration limit interpretation.

Study Details

PMID:34933316
Participants:482
Impact:−8.5% for povidone-iodine in alcohol vs chlorhexidine (46.1% vs 54.6%)
Trust score:4/5

median length of stay

1 evidences

Povidone-iodine (alcohol or aqueous) performed similarly to chlorhexidine-alcohol for 30-day surgical site infection, complications, and hospital stay after colorectal surgery.

Trust comment: Prospective randomized trial with moderate sample size and clinically relevant endpoints, though subset analysis and protocol change in chlorhexidine concentration limit interpretation.

Study Details

PMID:34933316
Participants:482
Impact:0 days (median 6 days in all groups)
Trust score:4/5

aerobic flora log10 reduction

1 evidences

Povidone-iodine and chlorhexidine procedures had comparable rapid in vivo bactericidal activity on skin flora up to 2 hours after application.

Trust comment: Randomized volunteer study with objective microbiological endpoints but small sample and surrogate (skin flora) outcomes.

Study Details

PMID:10662566
Participants:44
Impact:~1.5 at 30 sec; ~2.1 at 3 min; ~2.0 at 2 h
Trust score:3/5

anaerobic flora log10 reduction

1 evidences

Povidone-iodine and chlorhexidine procedures had comparable rapid in vivo bactericidal activity on skin flora up to 2 hours after application.

Trust comment: Randomized volunteer study with objective microbiological endpoints but small sample and surrogate (skin flora) outcomes.

Study Details

PMID:10662566
Participants:44
Impact:~1.1 at 30 sec; ~1.8 at 3 min; ~1.3 at 2 h
Trust score:3/5

positive conjunctival culture after povidone-iodine irrigation

1 evidences

Adding topical levofloxacin before povidone-iodine irrigation reduced conjunctival bacterial cultures more than povidone-iodine irrigation alone in patients undergoing intraocular surgery.

Trust comment: Prospective randomized clinical trial with statistically significant microbiological outcomes, though evaluated adjunct antibiotic effect rather than iodine-alone comparison.

Study Details

PMID:17996212
Participants:132
Impact:PVI alone 30.8% vs PVI+levofloxacin 11.9% (−18.9 percentage points)
Trust score:4/5

positive conjunctival culture after surgery

1 evidences

Adding topical levofloxacin before povidone-iodine irrigation reduced conjunctival bacterial cultures more than povidone-iodine irrigation alone in patients undergoing intraocular surgery.

Trust comment: Prospective randomized clinical trial with statistically significant microbiological outcomes, though evaluated adjunct antibiotic effect rather than iodine-alone comparison.

Study Details

PMID:17996212
Participants:132
Impact:PVI alone 23.1% vs PVI+levofloxacin 9.0% (−14.1 percentage points)
Trust score:4/5

needle/suture contamination rate

1 evidences

Different povidone-iodine–based periocular preparation techniques did not meaningfully change needle or suture contamination rates during strabismus surgery.

Trust comment: Randomized study with clear microbiological endpoint but small sample and surrogate outcome (needle/suture contamination) limits clinical impact.

Study Details

PMID:21665501
Participants:77
Impact:overall 31.4% (group rates 29.6%, 34.6%, 29.2%; no significant differences)
Trust score:3/5

postoperative wound infection rate

2 evidences

Intraoperative diluted betadine irrigation was associated with no infected wounds compared with two superficial infections in the no-irrigation group.

Trust comment: Prospective randomized pediatric trial with clearly reported infection outcomes but small number of events limits precision.

Study Details

PMID:18454914
Participants:162
Impact:0 infections in betadine group (0/89) vs 2 infections in control (2/73) (~0% vs 2.7%)
Trust score:3/5

Randomized trial comparing povidone-iodine versus soap+methylated spirit for skin prep before hernia repair; infection rates were similar.

Trust comment: Randomized design in a clinical setting with clear outcome but moderate sample size and single-center limits robustness.

Study Details

PMID:11344395
Participants:200
Impact:no significant difference (5.1% povidone-iodine vs 5.9% soap/spirit)
Trust score:3/5

chest pain (VAS)

1 evidences

Iodopovidone and doxycycline had similar pleurodesis success rates; iodopovidone caused higher chest pain scores but similar complication rates.

Trust comment: Randomized clinical trial with clear outcome measures and adequate reporting; moderate sample size.

Study Details

PMID:37428348
Participants:110
Impact:iodopovidone higher VAS by mean +9.4 points (41.3 vs 31.9; p=0.017)
Trust score:4/5

time to pleurodesis

1 evidences

Iodopovidone and doxycycline had similar pleurodesis success rates; iodopovidone caused higher chest pain scores but similar complication rates.

Trust comment: Randomized clinical trial with clear outcome measures and adequate reporting; moderate sample size.

Study Details

PMID:37428348
Participants:110
Impact:mean 1.9 days (iodopovidone) vs 1.5 days (doxycycline), difference +0.4 days (not clinically meaningful)
Trust score:4/5

bacterial conjunctivitis efficacy (days 1–2)

1 evidences

Povidone-iodine had similar short-term efficacy but was 6% less effective than chloramphenicol from days 3–15 and nearly doubled risk of chlamydial conjunctivitis.

Trust comment: Large randomized equivalence trial with laboratory-confirmed outcomes and robust sample size.

Study Details

PMID:17947266
Participants:2004
Impact:similar efficacy in first 48 hours
Trust score:4/5

bacterial conjunctivitis efficacy (days 3–15)

1 evidences

Povidone-iodine had similar short-term efficacy but was 6% less effective than chloramphenicol from days 3–15 and nearly doubled risk of chlamydial conjunctivitis.

Trust comment: Large randomized equivalence trial with laboratory-confirmed outcomes and robust sample size.

Study Details

PMID:17947266
Participants:2004
Impact:PIED 6% less effective than chloramphenicol (95% CI -5.8% to -0.6%)
Trust score:4/5

Chlamydia trachomatis conjunctivitis risk

1 evidences

Povidone-iodine had similar short-term efficacy but was 6% less effective than chloramphenicol from days 3–15 and nearly doubled risk of chlamydial conjunctivitis.

Trust comment: Large randomized equivalence trial with laboratory-confirmed outcomes and robust sample size.

Study Details

PMID:17947266
Participants:2004
Impact:increased with PIED (RR 1.99; 95% CI 1.07–3.71)
Trust score:4/5

probing pocket depth (PPD)

1 evidences

Topical 0.1% PVP-iodine used with mechanical therapy improved pocket depth and attachment level gains compared with mechanical therapy alone.

Trust comment: Controlled clinical study with long follow-up but substantial withdrawals and exclusions affect certainty of effect size.

Study Details

PMID:11686823
Participants:150
Impact:significantly lower mean PPD at 3, 6, and 12 months in PVP-iodine adjunct group
Trust score:3/5

probing attachment level (PAL) gain

1 evidences

Topical 0.1% PVP-iodine used with mechanical therapy improved pocket depth and attachment level gains compared with mechanical therapy alone.

Trust comment: Controlled clinical study with long follow-up but substantial withdrawals and exclusions affect certainty of effect size.

Study Details

PMID:11686823
Participants:150
Impact:significantly greater PAL gain at 3, 6, and 12 months with PVP-iodine adjunct
Trust score:3/5

long-term treatment failure ('losers')

1 evidences

Topical 0.1% PVP-iodine used with mechanical therapy improved pocket depth and attachment level gains compared with mechanical therapy alone.

Trust comment: Controlled clinical study with long follow-up but substantial withdrawals and exclusions affect certainty of effect size.

Study Details

PMID:11686823
Participants:150
Impact:fewer losers in test group (9) vs control (31) over maintenance period
Trust score:3/5

wound bacterial load at day 10

1 evidences

In a randomized wound dressing trial, hypochlorous acid (100 μg/mL) reduced bacterial load and promoted granulation better than povidone-iodine dressings.

Trust comment: Small randomized clinical trial with objective microbiological outcomes showing superiority of hypochlorous acid over povidone-iodine in this sample.

Study Details

PMID:35325969
Participants:41
Impact:hypochlorous acid median 2.61×10^4 CFU/g vs povidone-iodine 4.77×10^4 CFU/g (p reported significant)
Trust score:3/5

wound exudate and granulation

1 evidences

In a randomized wound dressing trial, hypochlorous acid (100 μg/mL) reduced bacterial load and promoted granulation better than povidone-iodine dressings.

Trust comment: Small randomized clinical trial with objective microbiological outcomes showing superiority of hypochlorous acid over povidone-iodine in this sample.

Study Details

PMID:35325969
Participants:41
Impact:greater reduction in exudate and increased granulation with hypochlorous acid vs povidone-iodine (statistically significant)
Trust score:3/5

Live birth rate

1 evidences

In infertile women, management guided by HyFoSy or HSG produced similar live-birth rates, while HyFoSy caused significantly less pain.

Trust comment: Large multicentre randomized trial with clear methods, prespecified outcomes, and reported CIs.

Study Details

PMID:35220432
Participants:1026
Impact:HyFoSy −1.2% (−3.4% to 1.5%) vs HSG (estimated difference)
Trust score:5/5

live birth rate (discordant subgroup)

1 evidences

In infertile women, management guided by HyFoSy or HSG produced similar live-birth rates, while HyFoSy caused significantly less pain.

Trust comment: Large multicentre randomized trial with clear methods, prespecified outcomes, and reported CIs.

Study Details

PMID:35220432
Participants:1026
Impact:HyFoSy 41% vs HSG 49% (difference −8%; −27% to 10%)
Trust score:5/5

nasopharyngeal viral load reduction

1 evidences

Randomized trial in COVID-19 outpatients found nasal irrigation with 1% PVP-I plus hypertonic alkaline solution reduced nasopharyngeal viral load more than other arms.

Trust comment: Prospective randomized multicenter clinical trial with clear arms and statistical comparisons, but moderate sample size.

Study Details

PMID:36973223
Participants:120
Impact:All groups: significant decrease by day3 and day5; PVP-I+hypertonic group showed greater reduction by day3 (p<0.05)
Trust score:4/5

nasopharyngeal viral load reduction (day5)

1 evidences

Randomized trial in COVID-19 outpatients found nasal irrigation with 1% PVP-I plus hypertonic alkaline solution reduced nasopharyngeal viral load more than other arms.

Trust comment: Prospective randomized multicenter clinical trial with clear arms and statistical comparisons, but moderate sample size.

Study Details

PMID:36973223
Participants:120
Impact:Groups with 1% PVP-I (Groups 3 & 4) greater reduction vs standard care (p<0.05)
Trust score:4/5

severe skin reactions

1 evidences

In ICU adults, chlorhexidine-alcohol reduced short-term catheter-related infections versus povidone-iodine-alcohol; scrubbing provided no benefit and chlorhexidine caused more skin reactions.

Trust comment: Large multicentre randomized trial with blinded outcome assessment and significant primary outcome differences, high quality.

Study Details

PMID:26388532
Participants:2349
Impact:3% vs 1% (27 vs 7 patients; increased with chlorhexidine)
Trust score:5/5

effect of skin scrubbing on colonisation

1 evidences

In ICU adults, chlorhexidine-alcohol reduced short-term catheter-related infections versus povidone-iodine-alcohol; scrubbing provided no benefit and chlorhexidine caused more skin reactions.

Trust comment: Large multicentre randomized trial with blinded outcome assessment and significant primary outcome differences, high quality.

Study Details

PMID:26388532
Participants:2349
Impact:no significant difference (p=0.3877)
Trust score:5/5

catheter-related bacteremia

1 evidences

Aqueous povidone-iodine had higher catheter colonization (24.7%) than chlorhexidine solutions (~14–16%); bacteremia rates were similar across groups.

Trust comment: Prospective randomized trial with clear catheter-level outcomes; single-center design and catheter-based counts limit generalizability.

Study Details

PMID:18665819
Participants:631
Impact:no significant difference between groups
Trust score:4/5

dermatitis at chlorhexidine sites

1 evidences

In this small neonatal pilot RCT, catheter colonization rates were similar between povidone-iodine and chlorhexidine groups; no dermatitis observed at chlorhexidine sites and chlorhexidine was detectable in some infants' blood.

Trust comment: Small pilot randomized trial in neonates with limited power; useful for safety signals but underpowered for efficacy conclusions.

Study Details

PMID:19812587
Participants:48
Impact:no dermatitis observed at chlorhexidine sites
Trust score:3/5

chlorhexidine systemic absorption

1 evidences

In this small neonatal pilot RCT, catheter colonization rates were similar between povidone-iodine and chlorhexidine groups; no dermatitis observed at chlorhexidine sites and chlorhexidine was detectable in some infants' blood.

Trust comment: Small pilot randomized trial in neonates with limited power; useful for safety signals but underpowered for efficacy conclusions.

Study Details

PMID:19812587
Participants:48
Impact:detectable in 7 neonates (13–100 ng/ml)
Trust score:3/5

Clinical improvement

1 evidences

Topical 5% povidone-iodine ear drops were similarly effective to ciprofloxacin drops for chronic suppurative otitis media (approx. 88% vs 90% clinical improvement) and showed no in vitro resistance.

Trust comment: Double-blind randomized design but small sample size limits confidence and generalizability.

Study Details

PMID:14568795
Participants:40
Impact:88% (PVP-I) vs 90% (ciprofloxacin)
Trust score:3/5

in vitro resistance

1 evidences

Topical 5% povidone-iodine ear drops were similarly effective to ciprofloxacin drops for chronic suppurative otitis media (approx. 88% vs 90% clinical improvement) and showed no in vitro resistance.

Trust comment: Double-blind randomized design but small sample size limits confidence and generalizability.

Study Details

PMID:14568795
Participants:40
Impact:no resistance to PVP-I; 17% resistance to ciprofloxacin among isolates
Trust score:3/5

post-hygiene colony forming units (CFU)

1 evidences

Crossover trial in NICU nurses found alcohol rub and povidone-iodine scrub reduced hand bacterial counts more than plain soap.

Trust comment: Randomized crossover with objective microbiologic outcomes but small sample (35 nurses) limits precision.

Study Details

PMID:23585422
Participants:35
Impact:median CFU-C: soap 60; alcohol 8; povidone-iodine 10.5 (alcohol and povidone superior to soap)
Trust score:4/5

number of bacterial species in oral cavity

1 evidences

Small randomized study where intensive oral care including povidone-iodine gargle reduced oral bacterial species and was associated with fewer worsening pulmonary sounds.

Trust comment: Randomized but very small sample (30) and preliminary design; results are suggestive but limited in power.

Study Details

PMID:17002741
Participants:30
Impact:decrease from 3.08 to 2.62 species (−0.46 species; P<0.05)
Trust score:3/5

abnormal pulmonary sounds (dry/moist rales)

1 evidences

Small randomized study where intensive oral care including povidone-iodine gargle reduced oral bacterial species and was associated with fewer worsening pulmonary sounds.

Trust comment: Randomized but very small sample (30) and preliminary design; results are suggestive but limited in power.

Study Details

PMID:17002741
Participants:30
Impact:intervention increased 1→2 (+1) vs control 0→4 (+4), fewer adverse changes with oral care
Trust score:3/5

oral mucositis severity

1 evidences

Among patients receiving radiotherapy, alcohol-free 1% povidone-iodine mouthwash reduced severity and delayed onset of oral mucositis compared with control.

Trust comment: Randomized trial with clinical outcomes and good completion rate but moderate sample size and limited detail on magnitude of effect.

Study Details

PMID:18417894
Participants:76
Impact:significantly lower mucositis scores with povidone-iodine vs control (significant from week 1; later lower than other rinses at weeks 4–5)
Trust score:3/5

eyelid skin bacterial load

1 evidences

Randomized trial showing povidone-iodine scrub reduces eyelid skin bacterial load similarly to baby shampoo and isopropyl alcohol.

Trust comment: Prospective randomized interventional trial with direct microbiological outcomes, though modest sample size (n=42).

Study Details

PMID:28072611
Participants:42
Impact:-1.57 log CFU/cm (≈-96.6%)
Trust score:4/5

corneal ulcer bacterial load

1 evidences

Small randomized trial found a single application of 5% povidone-iodine did not reduce corneal ulcer bacterial load more than placebo/scraping.

Trust comment: Randomized clinical trial but small sample and negative result limits strength of evidence.

Study Details

PMID:16783144
Participants:35
Impact:no significant reduction versus placebo (P=0.16); 3/18 improved (17%) vs 7/17 (41%) in control
Trust score:3/5

pharyngeal potentially pathogenic bacterial colonization

1 evidences

Randomized study found nasal inhalation plus gargling with 1% PVP-I removed potentially pathogenic pharyngeal bacteria more often than gargling alone.

Trust comment: Randomized but small groups (16 vs 14) and limited follow-up, so moderate confidence in findings.

Study Details

PMID:10386022
Participants:30
Impact:PPB disappearance in 44% with nasal inhalation+gargle vs 14% with gargle alone (86% disappearance in N-group patients without chronic respiratory complications)
Trust score:3/5

bowel preparation quality

1 evidences

Randomized noninferiority study showing an iodine-only (Iopamidol) bowel-tagging regimen produced bowel cleansing comparable to an alternative minimal-prep regimen.

Trust comment: Randomized single-center noninferiority trial with small sample (n=52), supports equivalence but limited power.

Study Details

PMID:25149295
Participants:52
Impact:no significant difference; diagnostic-quality in 95.5% of segments and optimal per-patient prep in 84.6% with iodine-only regimen
Trust score:3/5

gingival inflammation and dental plaque

1 evidences

Randomized trial found 1% PVP-I mouthwash plus scaling/root planing improved clinical, microbial, and inflammatory periodontal indicators short-term and was not inferior to chlorhexidine while being better tolerated.

Trust comment: Randomized controlled trial with 63 completers showing short-term benefits, but limited long-term data and some statistical details unclear.

Study Details

PMID:40523816
Participants:63
Impact:improved clinical and microbial indicators at 1–12 weeks; efficacy not inferior to chlorhexidine; higher patient acceptability
Trust score:3/5

graft culture positivity

1 evidences

Soaking dropped ACL graft pieces in 10% povidone-iodine reduced but did not eliminate bacterial contamination.

Trust comment: Randomized ex vivo study on 50 grafts with clear culture outcomes but limited by model (sectioned grafts dropped and soaked) and moderate sample size.

Study Details

PMID:10802474
Participants:50
Impact:24% positive after 10% povidone-iodine soak (reduced from 58% untreated; −34 percentage points)
Trust score:3/5

liver parenchymal enhancement (HU)

1 evidences

Using a contrast containing 30 g of iodine, a monophasic 4 ml/s injection provided the best liver and portal vein enhancement on CT.

Trust comment: Randomized assignment with objective CT attenuation measurements in 75 patients gives reliable imaging outcomes.

Study Details

PMID:7790550
Participants:75
Impact:48.5 HU with monophasic 4 ml/s (Protocol 3) vs 21 HU early with 2 ml/s (Protocol 1)
Trust score:4/5

portal vein enhancement (HU)

1 evidences

Using a contrast containing 30 g of iodine, a monophasic 4 ml/s injection provided the best liver and portal vein enhancement on CT.

Trust comment: Randomized assignment with objective CT attenuation measurements in 75 patients gives reliable imaging outcomes.

Study Details

PMID:7790550
Participants:75
Impact:121 HU (Protocol 3) and 118 HU (Protocol 2) vs 64 HU early/75 HU late (Protocol 1)
Trust score:4/5

prevalence of any respiratory virus in saliva

1 evidences

Preprocedural mouthwashes (including 1% povidone-iodine) reduced the overall prevalence and number of detectable respiratory viruses in saliva, though no mouthwash was superior.

Trust comment: Triple-blind RCT with adequate sample size and objective molecular endpoints, though low baseline prevalence limits power for agent-specific conclusions.

Study Details

PMID:39370336
Participants:228
Impact:Decreased from 3.5% (8/228) prewash to 1.3% (3/228) postwash (−2.2 percentage points; P = .034)
Trust score:4/5

mean number of viruses detected

1 evidences

Preprocedural mouthwashes (including 1% povidone-iodine) reduced the overall prevalence and number of detectable respiratory viruses in saliva, though no mouthwash was superior.

Trust comment: Triple-blind RCT with adequate sample size and objective molecular endpoints, though low baseline prevalence limits power for agent-specific conclusions.

Study Details

PMID:39370336
Participants:228
Impact:Reduced from 0.04 to 0.01 (mean; P = .025)
Trust score:4/5

conjunctival bacterial colony forming units (CFU)

1 evidences

Preoperative conjunctival irrigation with 5% povidone-iodine reduced conjunctival bacterial counts more than 1% povidone-iodine.

Trust comment: Prospective randomized double-blind study with 100 patients and quantitative microbiological outcomes supports reliability.

Study Details

PMID:12543744
Participants:100
Impact:Median CFU reduced by 60% (100 to 40) with 5% PI vs 16.7% (120 to 100) with 1% PI (difference significant)
Trust score:4/5

requirement for dialysis at 30 days

1 evidences

Large randomized trial comparing two iodine-based contrast agents (low-osmolar vs iso-osmolar) in high-risk patients; measured contrast-induced nephropathy (CIN), dialysis, and 30-day outcomes.

Trust comment: Large randomized trial with clear clinical endpoints and adequate sample size, single-center but robust.

Study Details

PMID:37220640
Participants:2268
Impact:iso 13 vs low 11 patients (no significant difference)
Trust score:4/5

30-day mortality

1 evidences

Large randomized trial comparing two iodine-based contrast agents (low-osmolar vs iso-osmolar) in high-risk patients; measured contrast-induced nephropathy (CIN), dialysis, and 30-day outcomes.

Trust comment: Large randomized trial with clear clinical endpoints and adequate sample size, single-center but robust.

Study Details

PMID:37220640
Participants:2268
Impact:iso 3.3% vs low 2.6% (no significant difference)
Trust score:4/5

detection frequency in nonsymptomatic participants

1 evidences

Randomized trial (n=40 COVID-19 patients) testing four mouthrinses including 0.5% povidone-iodine; primary outcome was reduction in salivary SARS-CoV-2 load at 15 minutes.

Trust comment: Randomized in vivo trial with blinded virology assessment but small sample size for mouthrinse arms (n≈10 per group) limiting precision.

Study Details

PMID:34561086
Participants:40
Impact:23% asymptomatic, 28% presymptomatic, 99% symptomatic, 60% postsymptomatic carried virus in saliva
Trust score:3/5

immediate post-disinfection positive skin cultures

1 evidences

Randomized study in 60 laboring women comparing povidone iodine (PI) versus DuraPrep (iodophor in isopropyl alcohol) for skin antisepsis before epidural catheter insertion, assessing skin cultures and catheter colonization.

Trust comment: Randomized clinical study with clear microbiologic endpoints showing lower skin and catheter colonization with DuraPrep vs povidone iodine; moderate sample size (n=60).

Study Details

PMID:12502993
Participants:60
Impact:PI ~30% vs DuraPrep ~3% (P=0.01)
Trust score:4/5

positive skin cultures at catheter removal

1 evidences

Randomized study in 60 laboring women comparing povidone iodine (PI) versus DuraPrep (iodophor in isopropyl alcohol) for skin antisepsis before epidural catheter insertion, assessing skin cultures and catheter colonization.

Trust comment: Randomized clinical study with clear microbiologic endpoints showing lower skin and catheter colonization with DuraPrep vs povidone iodine; moderate sample size (n=60).

Study Details

PMID:12502993
Participants:60
Impact:PI ~97% vs DuraPrep ~50% (P=0.0001)
Trust score:4/5

plaque, probing depth, attachment level

1 evidences

Randomized trial (n=36) comparing single-visit full-mouth ultrasonic debridement (one arm used povidone iodine) versus quadrant-wise therapy for chronic periodontitis; clinical and microbiological outcomes assessed up to 6 months.

Trust comment: Small randomized clinical trial showing clinical improvements across groups; limited power to detect small differences and microbiologic changes were minimal.

Study Details

PMID:15966880
Participants:36
Impact:All groups showed significant improvements with no between-group differences
Trust score:3/5

number of pockets ≥5 mm

1 evidences

Randomized trial (n=36) comparing single-visit full-mouth ultrasonic debridement (one arm used povidone iodine) versus quadrant-wise therapy for chronic periodontitis; clinical and microbiological outcomes assessed up to 6 months.

Trust comment: Small randomized clinical trial showing clinical improvements across groups; limited power to detect small differences and microbiologic changes were minimal.

Study Details

PMID:15966880
Participants:36
Impact:Greater reduction in full-mouth groups; total treatment time shorter
Trust score:3/5

exit-site infection episodes

1 evidences

In this small randomized pilot, adding povidone-iodine dressing plus mupirocin did not clearly reduce exit-site infections compared to mupirocin alone; peritonitis occurred sooner in the dressing group.

Trust comment: Randomized pilot trial with small completed sample (n=97), limiting precision despite randomized design.

Study Details

PMID:26374836
Participants:97
Impact:4 episodes (dressing) vs 8 episodes (non-dressing); 1/241.3 vs 1/111.1 patient-months
Trust score:3/5

gastric noncardia adenocarcinoma risk

1 evidences

Self-reported goiter (a proxy for iodine deficiency) was associated with about double the risk of noncardia gastric adenocarcinoma in this large cohort.

Trust comment: Large prospective cohort with multivariable adjustment shows associations but relies on self-reported exposure and cannot establish causality.

Study Details

PMID:16642482
Participants:29584
Impact:HR 2.04 (95% CI 1.01–4.11) associated with self-reported goiter
Trust score:3/5

gastric cardia adenocarcinoma risk

1 evidences

Self-reported goiter (a proxy for iodine deficiency) was associated with about double the risk of noncardia gastric adenocarcinoma in this large cohort.

Trust comment: Large prospective cohort with multivariable adjustment shows associations but relies on self-reported exposure and cannot establish causality.

Study Details

PMID:16642482
Participants:29584
Impact:HR 1.45 (95% CI 0.91–2.30) (not statistically significant)
Trust score:3/5

esophageal squamous cell carcinoma risk

1 evidences

Self-reported goiter (a proxy for iodine deficiency) was associated with about double the risk of noncardia gastric adenocarcinoma in this large cohort.

Trust comment: Large prospective cohort with multivariable adjustment shows associations but relies on self-reported exposure and cannot establish causality.

Study Details

PMID:16642482
Participants:29584
Impact:HR 1.37 (95% CI 0.97–1.94) (borderline)
Trust score:3/5

liver contrast enhancement (CEI)

1 evidences

In obese patients, calculating lean body weight with the Boer formula to dose iodinated contrast resulted in higher liver enhancement than using the James formula.

Trust comment: Prospective randomized single-center study (n=55) showing significantly higher liver CEI with Boer formula but limited by small sample size.

Study Details

PMID:30186869
Participants:55
Impact:+9.66 HU (51.45 vs 41.79; P=0.007)
Trust score:3/5

liver contrast-to-noise ratio (CNR)

1 evidences

In obese patients, calculating lean body weight with the Boer formula to dose iodinated contrast resulted in higher liver enhancement than using the James formula.

Trust comment: Prospective randomized single-center study (n=55) showing significantly higher liver CEI with Boer formula but limited by small sample size.

Study Details

PMID:30186869
Participants:55
Impact:no significant change (3.75 vs 2.83; P≥0.177)
Trust score:3/5

subjective overall enhancement

1 evidences

In obese patients, calculating lean body weight with the Boer formula to dose iodinated contrast resulted in higher liver enhancement than using the James formula.

Trust comment: Prospective randomized single-center study (n=55) showing significantly higher liver CEI with Boer formula but limited by small sample size.

Study Details

PMID:30186869
Participants:55
Impact:no significant change (3.54 vs 3.20; P≥0.199)
Trust score:3/5

diagnostic correctness

1 evidences

In adults suspected of appendicitis, use of oral or IV iodinated contrast did not meaningfully improve diagnostic correctness or appendix visualization compared with reader variability.

Trust comment: Prospective randomized study (n=131) that found reader variability dominated diagnostic performance and contrast use had no clear benefit.

Study Details

PMID:19843741
Participants:131
Impact:no significant effect from IV/oral iodinated contrast; reader effect predominated
Trust score:4/5

appendix visualization

1 evidences

In adults suspected of appendicitis, use of oral or IV iodinated contrast did not meaningfully improve diagnostic correctness or appendix visualization compared with reader variability.

Trust comment: Prospective randomized study (n=131) that found reader variability dominated diagnostic performance and contrast use had no clear benefit.

Study Details

PMID:19843741
Participants:131
Impact:depended mainly on reader, not on use of IV/oral contrast or dose
Trust score:4/5

intra-procedural iodinated contrast volume

1 evidences

Image fusion of pre-procedural CT and live fluoroscopy is feasible in TAVI and helped navigation without increasing iodinated contrast use or radiation exposure.

Trust comment: Feasibility/comparative study with modest sample (27 IF vs 27 control) showing image-fusion aids guidance without increasing contrast or radiation; nonrandomized and limited size.

Study Details

PMID:28935463
Participants:54
Impact:no increase compared to controls (no compromise)
Trust score:3/5

radiation dose (x-ray/fluoroscopy)

1 evidences

Image fusion of pre-procedural CT and live fluoroscopy is feasible in TAVI and helped navigation without increasing iodinated contrast use or radiation exposure.

Trust comment: Feasibility/comparative study with modest sample (27 IF vs 27 control) showing image-fusion aids guidance without increasing contrast or radiation; nonrandomized and limited size.

Study Details

PMID:28935463
Participants:54
Impact:no increase compared to controls (no compromise)
Trust score:3/5

image quality (opacification)

1 evidences

Iodixanol and iohexol produced essentially equivalent image quality and safety profiles for adult excretory urography.

Trust comment: Randomized, double-blind parallel study (n=150) demonstrating no important differences in efficacy or safety between iodixanol and iohexol.

Study Details

PMID:8883532
Participants:150
Impact:no significant difference among agents
Trust score:4/5

adverse reactions / vital signs / labs

1 evidences

Iodixanol and iohexol produced essentially equivalent image quality and safety profiles for adult excretory urography.

Trust comment: Randomized, double-blind parallel study (n=150) demonstrating no important differences in efficacy or safety between iodixanol and iohexol.

Study Details

PMID:8883532
Participants:150
Impact:no significant difference; similar safety profile
Trust score:4/5

AFP decline (1 week)

1 evidences

In HCC patients receiving hepatic arterial chemotherapy with iodinated poppy seed oil emulsion, larger IPSO microdroplets led to substantially greater short-term declines in AFP.

Trust comment: Randomized small trial (n=32) showing significantly greater 1-week AFP decline with larger iodinated oil microdroplets; limited by small sample and short follow-up.

Study Details

PMID:10215657
Participants:32
Impact:large-droplet group 50.5% vs small-droplet group 18.9%; mean difference ≈+31.6% (P<0.005)
Trust score:3/5

CRBSI incidence (per 1000 catheterized patients)

1 evidences

Modeling based on the CLEAN trial indicates povidone-iodine (one-time application) was less effective and less cost-effective than chlorhexidine–alcohol at preventing catheter-related bloodstream infections in ICU patients.

Trust comment: Cost-effectiveness modeling using large RCT data (2,298 catheterized patients) showing povidone-iodine was less effective than chlorhexidine; robust methods but reliant on modeling assumptions and original trial context.

Study Details

PMID:29799871
Participants:2298
Impact:Observed: PVI-T1 26.04 vs CHG-T1 3.49 per 1000 (PVI less effective)
Trust score:4/5

mean cost per patient (100-day ICU horizon)

1 evidences

Modeling based on the CLEAN trial indicates povidone-iodine (one-time application) was less effective and less cost-effective than chlorhexidine–alcohol at preventing catheter-related bloodstream infections in ICU patients.

Trust comment: Cost-effectiveness modeling using large RCT data (2,298 catheterized patients) showing povidone-iodine was less effective than chlorhexidine; robust methods but reliant on modeling assumptions and original trial context.

Study Details

PMID:29799871
Participants:2298
Impact:Observed: PVI-T1 €23,795 vs CHG-T1 €21,927 (CHG-T1 more cost-effective)
Trust score:4/5

C-reactive protein (CRP)

1 evidences

Iodopovidone pleurodesis in malignant pleural effusion caused frequent adverse events and raised CRP; efficacy and quality of life were similar for 1% and 2% doses.

Trust comment: Double-blind randomized clinical trial (60 patients) with systematic adverse-event and biomarker measurement, though sample size moderate.

Study Details

PMID:26439936
Participants:60
Impact:substantial increase with peak at 48 h
Trust score:4/5

pleurodesis efficacy and quality of life

1 evidences

Iodopovidone pleurodesis in malignant pleural effusion caused frequent adverse events and raised CRP; efficacy and quality of life were similar for 1% and 2% doses.

Trust comment: Double-blind randomized clinical trial (60 patients) with systematic adverse-event and biomarker measurement, though sample size moderate.

Study Details

PMID:26439936
Participants:60
Impact:no difference between 1% and 2% iodopovidone
Trust score:4/5

mild-to-moderate adverse events

1 evidences

Iodixanol had fewer mild-to-moderate adverse events and less injection pain than ioxaglate, with equivalent angiographic image quality.

Trust comment: Randomized, double-blind phase III trial with objective safety and efficacy measures but modest sample size.

Study Details

PMID:8883529
Participants:54
Impact:more common with ioxaglate (p=0.041); fewer with iodixanol
Trust score:4/5

injection-associated pain

1 evidences

Iodixanol had fewer mild-to-moderate adverse events and less injection pain than ioxaglate, with equivalent angiographic image quality.

Trust comment: Randomized, double-blind phase III trial with objective safety and efficacy measures but modest sample size.

Study Details

PMID:8883529
Participants:54
Impact:reported in 3 patients with ioxaglate vs 0 with iodixanol
Trust score:4/5

angiographic image quality

2 evidences

In a small randomized study, CO2 contrast produced comparable angiographic images and clinical outcomes to iodine contrast without worsening kidney function and reduced contrast costs.

Trust comment: Prospective randomized study but small sample (n=35) and limited power to detect differences in renal outcomes.

Study Details

PMID:24704050
Participants:35
Impact:CO2 images graded good or fair and comparable to iodine (high interobserver concordance)
Trust score:3/5

Iodixanol had fewer mild-to-moderate adverse events and less injection pain than ioxaglate, with equivalent angiographic image quality.

Trust comment: Randomized, double-blind phase III trial with objective safety and efficacy measures but modest sample size.

Study Details

PMID:8883529
Participants:54
Impact:no difference between agents (p=0.711)
Trust score:4/5

vascular attenuation (descending aorta and coronary arteries)

1 evidences

Higher iodine concentration in contrast material produced significantly higher vascular attenuation in the descending aorta and coronary arteries.

Trust comment: Prospective randomized study in 125 patients with clear, statistically significant imaging endpoints.

Study Details

PMID:16040923
Participants:125
Impact:higher iodine concentration → significantly higher attenuation (P < .05)
Trust score:4/5

hand bacterial contamination after scrubbing (PVI group)

1 evidences

Using povidone-iodine for surgical hand rubbing reduced median bacterial counts but chlorhexidine reduced to zero; sterile water and brushes were not necessary.

Trust comment: Randomized comparison but small sample (22 nurses); clear microbiological measurements reported.

Study Details

PMID:16046831
Participants:22
Impact:median decreased from 5.0×10^3 to 8.7×10^2 cfu/H
Trust score:3/5

hand bacterial contamination after scrubbing (CHG group)

1 evidences

Using povidone-iodine for surgical hand rubbing reduced median bacterial counts but chlorhexidine reduced to zero; sterile water and brushes were not necessary.

Trust comment: Randomized comparison but small sample (22 nurses); clear microbiological measurements reported.

Study Details

PMID:16046831
Participants:22
Impact:median decreased from 4.0×10^3 to 0 cfu/H
Trust score:3/5

surgical and oncologic outcomes

1 evidences

Randomized trial with >10-year follow-up (analyzed n=151) comparing total thyroidectomy alone vs with prophylactic central compartment lymph node dissection: no differences in oncologic outcomes or rates of permanent hypocalcemia or serum calcium at long-term follow-up.

Trust comment: Large randomized controlled trial with long (>10-year) follow-up and objective biochemical and surgical endpoints.

Study Details

PMID:39983243
Participants:151
Impact:no significant differences between groups after >10 years
Trust score:5/5

parathyroid removal on histology

1 evidences

Randomized trial with >10-year follow-up (analyzed n=151) comparing total thyroidectomy alone vs with prophylactic central compartment lymph node dissection: no differences in oncologic outcomes or rates of permanent hypocalcemia or serum calcium at long-term follow-up.

Trust comment: Large randomized controlled trial with long (>10-year) follow-up and objective biochemical and surgical endpoints.

Study Details

PMID:39983243
Participants:151
Impact:more parathyroid tissue removed in prophylactic dissection group (P = .005)
Trust score:5/5

viral load

1 evidences

Double-masked pilot RCT in adults with adenoviral conjunctivitis: single in‑office 5% povidone‑iodine reduced viral load and hastened clinical improvement at day 4 compared with artificial tears.

Trust comment: Randomized, double‑masked pilot trial with objective virologic outcome but small sample (56), limiting precision and generalisability.

Study Details

PMID:34102153
Participants:56
Impact:Day 4: 2.5% vs 14.4% of peak viral titer (P=0.020) favoring 5% PVP‑I
Trust score:3/5

clinical signs and symptoms severity

1 evidences

Double-masked pilot RCT in adults with adenoviral conjunctivitis: single in‑office 5% povidone‑iodine reduced viral load and hastened clinical improvement at day 4 compared with artificial tears.

Trust comment: Randomized, double‑masked pilot trial with objective virologic outcome but small sample (56), limiting precision and generalisability.

Study Details

PMID:34102153
Participants:56
Impact:Reduced tearing, lid swelling, redness and clinician‑graded discharge/redness/edema on day 4 (P<0.05)
Trust score:3/5

corneal fluorescein staining

1 evidences

Double‑masked randomized study assessing safety/tolerability of one‑time 5% povidone‑iodine for adenoviral conjunctivitis: treatment was well tolerated with only transient corneal staining and no vision loss.

Trust comment: Randomized, masked safety trial with clear, objective ocular safety measures but small sample (56) limits detection of rare adverse events.

Study Details

PMID:31401340
Participants:56
Impact:Transient increase immediately post‑administration, returned to baseline by Day 1
Trust score:3/5

visual acuity and overall ocular discomfort

1 evidences

Double‑masked randomized study assessing safety/tolerability of one‑time 5% povidone‑iodine for adenoviral conjunctivitis: treatment was well tolerated with only transient corneal staining and no vision loss.

Trust comment: Randomized, masked safety trial with clear, objective ocular safety measures but small sample (56) limits detection of rare adverse events.

Study Details

PMID:31401340
Participants:56
Impact:No change in visual acuity (baseline to Day 1) and no sustained increase in participant‑rated discomfort
Trust score:3/5

satisfaction (VAS)

1 evidences

Triple‑blind RCT comparing povidone‑iodine, hydrogen peroxide, and chlorhexidine mouthrinses for pre‑procedural use: high satisfaction and acceptability overall and no difference between mouthrinses.

Trust comment: Triple‑blind randomized design with moderate sample (228) assessing patient‑reported acceptability; not an efficacy trial for infection reduction.

Study Details

PMID:38762080
Participants:228
Impact:Mean overall VAS satisfaction 7.35 (SD 1.68); no significant differences between groups
Trust score:4/5

acceptability / willingness to reuse

1 evidences

Triple‑blind RCT comparing povidone‑iodine, hydrogen peroxide, and chlorhexidine mouthrinses for pre‑procedural use: high satisfaction and acceptability overall and no difference between mouthrinses.

Trust comment: Triple‑blind randomized design with moderate sample (228) assessing patient‑reported acceptability; not an efficacy trial for infection reduction.

Study Details

PMID:38762080
Participants:228
Impact:89.5% willing to use again; no between‑group differences
Trust score:4/5

abnormal bowel wall enhancement

1 evidences

Randomized comparison of water (neutral) vs 2% iodinated enteral contrast in 40 patients: water improved detection of abnormal bowel wall enhancement and overall diagnostic accuracy, while iodinated contrast better visualized the ileocaecal junction.

Trust comment: Small randomized human study (n=40) with clear outcomes but limited sample size reduces generalizability.

Study Details

PMID:21239131
Participants:40
Impact:observed only with neutral enteral contrast (n=12)
Trust score:3/5

ileocaecal junction evaluation

1 evidences

Randomized comparison of water (neutral) vs 2% iodinated enteral contrast in 40 patients: water improved detection of abnormal bowel wall enhancement and overall diagnostic accuracy, while iodinated contrast better visualized the ileocaecal junction.

Trust comment: Small randomized human study (n=40) with clear outcomes but limited sample size reduces generalizability.

Study Details

PMID:21239131
Participants:40
Impact:positive enteral contrast 100% vs neutral 85% (+15%)
Trust score:3/5

diagnostic performance (sensitivity/specificity)

1 evidences

Randomized comparison of water (neutral) vs 2% iodinated enteral contrast in 40 patients: water improved detection of abnormal bowel wall enhancement and overall diagnostic accuracy, while iodinated contrast better visualized the ileocaecal junction.

Trust comment: Small randomized human study (n=40) with clear outcomes but limited sample size reduces generalizability.

Study Details

PMID:21239131
Participants:40
Impact:neutral contrast sensitivity 100% vs positive 92.8% (-7.2%); specificity 88% vs 83.3% (-4.7%)
Trust score:3/5

contrast-induced nephropathy (≥25% ↑ serum creatinine)

1 evidences

Compared iopamidol and iodixanol in 122 diabetic patients undergoing angiography and found similar rates of contrast-induced nephropathy between agents.

Trust comment: Reasonable sample size with clinically relevant endpoint; direct human comparison though differences were nonsignificant.

Study Details

PMID:18413220
Participants:122
Impact:17/122 (13.9%); 10 cases with iopamidol vs 7 with iodixanol; no significant difference between agents
Trust score:4/5

venous attenuation (HU)

1 evidences

Randomized clinical and phantom study (88 patients) showing 100 kVp CT protocol increases venous enhancement and CNR and allows comparable venous attenuation with ~19% less iodine compared with conventional 120 kVp.

Trust comment: Prospective randomized clinical study with blinded readers and quantitative measures; moderate sample size supports conclusions.

Study Details

PMID:23482914
Participants:88
Impact:+19.4% for 100 kVp vs 120 kVp
Trust score:4/5

vein-to-muscle contrast-to-noise ratio (CNR)

1 evidences

Randomized clinical and phantom study (88 patients) showing 100 kVp CT protocol increases venous enhancement and CNR and allows comparable venous attenuation with ~19% less iodine compared with conventional 120 kVp.

Trust comment: Prospective randomized clinical study with blinded readers and quantitative measures; moderate sample size supports conclusions.

Study Details

PMID:23482914
Participants:88
Impact:+28.9% for 100 kVp vs 120 kVp
Trust score:4/5

iodine dose reduction with maintained attenuation

1 evidences

Randomized clinical and phantom study (88 patients) showing 100 kVp CT protocol increases venous enhancement and CNR and allows comparable venous attenuation with ~19% less iodine compared with conventional 120 kVp.

Trust comment: Prospective randomized clinical study with blinded readers and quantitative measures; moderate sample size supports conclusions.

Study Details

PMID:23482914
Participants:88
Impact:18.9% less iodine (MC-CM vs HC-CM) with 100 kVp produced similar venous attenuation to 120 kVp with HC-CM
Trust score:4/5

healing rate at 6 months

1 evidences

Randomized trial in 40 patients comparing a super-oxidized wound solution to povidone iodine; the super-oxidized solution had higher healing rates and faster culture clearance than povidone iodine.

Trust comment: Small RCT (n=40) directly compares topical povidone iodine to a new agent; limited size but randomized design.

Study Details

PMID:20207618
Participants:40
Impact:povidone iodine 55% vs super-oxidized solution 90% (−35% absolute for povidone iodine)
Trust score:3/5

time to negative cultures

1 evidences

Randomized trial in 40 patients comparing a super-oxidized wound solution to povidone iodine; the super-oxidized solution had higher healing rates and faster culture clearance than povidone iodine.

Trust comment: Small RCT (n=40) directly compares topical povidone iodine to a new agent; limited size but randomized design.

Study Details

PMID:20207618
Participants:40
Impact:longer with povidone iodine (significantly shorter with super-oxidized solution, P<.05)
Trust score:3/5

reinfection rate

1 evidences

Randomized trial in 40 patients comparing a super-oxidized wound solution to povidone iodine; the super-oxidized solution had higher healing rates and faster culture clearance than povidone iodine.

Trust comment: Small RCT (n=40) directly compares topical povidone iodine to a new agent; limited size but randomized design.

Study Details

PMID:20207618
Participants:40
Impact:more frequent with povidone iodine (P<.01)
Trust score:3/5

arterial contrast enhancement

1 evidences

Prospective study of 140 patients comparing 370 vs 300 mgI/mL contrast (identical total iodine load) showing higher arterial enhancement with 300 mgI/mL, no venous difference, and increased SUV values with contrast-enhanced vs non-enhanced PET/CT.

Trust comment: Large prospective cohort (n=140) with controlled iodine load and multiphase imaging; well-powered for imaging endpoints.

Study Details

PMID:22591760
Participants:140
Impact:significantly higher with 300 mgI/mL vs 370 mgI/mL (all anatomic sites)
Trust score:4/5

venous contrast enhancement

1 evidences

Prospective study of 140 patients comparing 370 vs 300 mgI/mL contrast (identical total iodine load) showing higher arterial enhancement with 300 mgI/mL, no venous difference, and increased SUV values with contrast-enhanced vs non-enhanced PET/CT.

Trust comment: Large prospective cohort (n=140) with controlled iodine load and multiphase imaging; well-powered for imaging endpoints.

Study Details

PMID:22591760
Participants:140
Impact:no significant difference between 300 and 370 mgI/mL
Trust score:4/5

PET tracer uptake (SUVmean/SUVmax)

1 evidences

Prospective study of 140 patients comparing 370 vs 300 mgI/mL contrast (identical total iodine load) showing higher arterial enhancement with 300 mgI/mL, no venous difference, and increased SUV values with contrast-enhanced vs non-enhanced PET/CT.

Trust comment: Large prospective cohort (n=140) with controlled iodine load and multiphase imaging; well-powered for imaging endpoints.

Study Details

PMID:22591760
Participants:140
Impact:SUVmean and SUVmax higher on contrast-enhanced vs non-enhanced PET/CT (significant)
Trust score:4/5

neoepithelization rate

1 evidences

A PVP-iodine liposomal hydrogel (Repithel) applied to mesh graft wounds sped healing and reduced graft loss versus lipid gauze alone.

Trust comment: Phase III randomized clinical trial with clear clinical endpoints and a substantial sample size supports moderate-high trust.

Study Details

PMID:17004191
Participants:167
Impact:increased (faster neoepithelization vs control)
Trust score:4/5

graft loss (frequency and area)

1 evidences

A PVP-iodine liposomal hydrogel (Repithel) applied to mesh graft wounds sped healing and reduced graft loss versus lipid gauze alone.

Trust comment: Phase III randomized clinical trial with clear clinical endpoints and a substantial sample size supports moderate-high trust.

Study Details

PMID:17004191
Participants:167
Impact:decreased (fewer and smaller graft losses)
Trust score:4/5

time to complete wound closure

1 evidences

A PVP-iodine liposomal hydrogel (Repithel) applied to mesh graft wounds sped healing and reduced graft loss versus lipid gauze alone.

Trust comment: Phase III randomized clinical trial with clear clinical endpoints and a substantial sample size supports moderate-high trust.

Study Details

PMID:17004191
Participants:167
Impact:shorter (wounds closed sooner vs control)
Trust score:4/5

pain score (during cleaning)

1 evidences

Pre-cleaning skin with warm 5% NaHCO3 reduced patient pain and increased satisfaction versus 75% alcohol; bacterial counts after subsequent iodine disinfection were similar.

Trust comment: Randomized, controlled, single-blind prospective trial with clear outcomes, though group totals reported suggest some enrollment/ reporting inconsistencies.

Study Details

PMID:28104097
Participants:126
Impact:decreased (lower verbal rating scale pain, P < 0.001)
Trust score:4/5

patient and nurse satisfaction

1 evidences

Pre-cleaning skin with warm 5% NaHCO3 reduced patient pain and increased satisfaction versus 75% alcohol; bacterial counts after subsequent iodine disinfection were similar.

Trust comment: Randomized, controlled, single-blind prospective trial with clear outcomes, though group totals reported suggest some enrollment/ reporting inconsistencies.

Study Details

PMID:28104097
Participants:126
Impact:increased (higher satisfaction with NaHCO3 cleaning)
Trust score:4/5

bacterial count after iodine disinfection

1 evidences

Pre-cleaning skin with warm 5% NaHCO3 reduced patient pain and increased satisfaction versus 75% alcohol; bacterial counts after subsequent iodine disinfection were similar.

Trust comment: Randomized, controlled, single-blind prospective trial with clear outcomes, though group totals reported suggest some enrollment/ reporting inconsistencies.

Study Details

PMID:28104097
Participants:126
Impact:no change (no difference between groups, P = 0.455)
Trust score:4/5

body iron stores (BIS)

1 evidences

Using multiple micronutrient-fortified salt in school meals improved markers of iron status but did not change urinary iodine or serum ferritin over one year.

Trust comment: Pre-post field study with an intervention and reference group gives useful real-world data but lacks randomized individual allocation and has potential confounders.

Study Details

PMID:32990618
Participants:228
Impact:increased in intervention (+0.09 mg/kg) vs decreased in reference (-0.58 mg/kg)
Trust score:3/5

detection rates and counts of respiratory pathogens

1 evidences

Mechanical plus povidone-iodine oral cleansing before surgery reduced detection rates and counts of several potential respiratory pathogens versus no oral cleansing.

Trust comment: Small randomized clinical study with microbiological endpoints; supports effect but limited by small sample size.

Study Details

PMID:12903918
Participants:32
Impact:decreased (reduction in MSSA, Streptococcus pneumoniae, Haemophilus influenzae)
Trust score:3/5

paronychia severity (PSG scale)

1 evidences

Topical 2% povidone-iodine twice daily improved paronychia severity versus vehicle control and reduced nail pain in patients with cancer therapy-associated paronychia.

Trust comment: Prospective, randomized, double-blind multicenter phase 2 trial with clinically relevant endpoints and significant results for 2% PVP-I.

Study Details

PMID:31240513
Participants:102
Impact:improved (52.7% of affected nails met primary endpoint with 2% PVP-I vs 37.9% with control; P = 0.0063)
Trust score:4/5

nail pain

1 evidences

Topical 2% povidone-iodine twice daily improved paronychia severity versus vehicle control and reduced nail pain in patients with cancer therapy-associated paronychia.

Trust comment: Prospective, randomized, double-blind multicenter phase 2 trial with clinically relevant endpoints and significant results for 2% PVP-I.

Study Details

PMID:31240513
Participants:102
Impact:decreased (fewer patients reporting moderate/very painful nails over visits)
Trust score:4/5

contrast-induced nephropathy incidence

2 evidences

In patients at risk for contrast-induced nephropathy, withholding prophylactic IV hydration was non-inferior to IV hydration for preventing creatinine-defined nephropathy after iodinated contrast and was cost-saving.

Trust comment: Large, prospective, randomized phase 3 non-inferiority trial with objective lab outcomes and rigorous follow-up supports high trust.

Study Details

PMID:28233565
Participants:660
Impact:no difference (8/307 [2.6%] no prophylaxis vs 8/296 [2.7%] hydration)
Trust score:5/5

In ICU patients receiving ≥100 mL iodinated contrast, theophylline reduced incidence of contrast-induced nephropathy more than acetylcysteine.

Trust comment: Randomized ICU trial with clear clinical endpoints directly related to injury from iodinated contrast; results reported with percentages and timepoint creatinine values.

Study Details

PMID:16714461
Participants:91
Impact:Theophylline 2% vs N-acetylcysteine 12% vs both 4% (theophylline significantly lower than acetylcysteine, P=0.047)
Trust score:4/5

hydration-related complications

1 evidences

In patients at risk for contrast-induced nephropathy, withholding prophylactic IV hydration was non-inferior to IV hydration for preventing creatinine-defined nephropathy after iodinated contrast and was cost-saving.

Trust comment: Large, prospective, randomized phase 3 non-inferiority trial with objective lab outcomes and rigorous follow-up supports high trust.

Study Details

PMID:28233565
Participants:660
Impact:present (18/328 [5.5%] had complications associated with IV hydration)
Trust score:5/5

prolonged mucosal irritation (retrosternal discomfort)

1 evidences

After Lugol's iodine staining during endoscopy, spraying 5% sodium thiosulfate reduced mucosal irritation lasting >30 minutes compared with no treatment.

Trust comment: - Checklist of steps performed: 1) Confirm human study of iodine-related procedure and symptom outcomes; 2) Extract top outcomes (mucosal irritation symptoms); 3) Confirm participant count and randomization; 4) Assess study quality and report observed changes. Randomized trial in 120 healthy men with clear randomized groups and patient-reported outcomes; reduction described but exact percent not provided, so qualitative effect reported.

Study Details

PMID:11174292
Participants:120
Impact:substantially reduced vs no treatment (qualitative)
Trust score:4/5

diagnostic contrast quality

1 evidences

Randomized comparison of two iodinated contrast agent concentrations showed similar diagnostic image quality; few transient adverse effects observed.

Trust comment: - Checklist of steps performed: 1) Confirm human study involving iodinated contrast agents; 2) Identify main outcomes (diagnostic efficacy, acute adverse events, hemodynamic/ECG monitoring); 3) Verify participant count and randomization; 4) Assess quality and report observed differences. Prospective randomized study in 100 patients; outcomes clinically relevant though limited detail on quantitative efficacy metrics; small number of adverse events reported.

Study Details

PMID:15584360
Participants:100
Impact:no difference between Melitrast-270 and Melitrast-300
Trust score:3/5

acute adverse effects after contrast (vertigo, sickness, sweating)

1 evidences

Randomized comparison of two iodinated contrast agent concentrations showed similar diagnostic image quality; few transient adverse effects observed.

Trust comment: - Checklist of steps performed: 1) Confirm human study involving iodinated contrast agents; 2) Identify main outcomes (diagnostic efficacy, acute adverse events, hemodynamic/ECG monitoring); 3) Verify participant count and randomization; 4) Assess quality and report observed differences. Prospective randomized study in 100 patients; outcomes clinically relevant though limited detail on quantitative efficacy metrics; small number of adverse events reported.

Study Details

PMID:15584360
Participants:100
Impact:3 patients (3%) had side effects noted within 2 hours
Trust score:3/5

IgG titre to Porphyromonas gingivalis

1 evidences

Full-mouth ultrasonic debridement (including a povidone-iodine group) led to earlier reductions in some serum IgG titres and increased antibody avidity at 3 months in the povidone group.

Trust comment: - Checklist of steps performed: 1) Confirm human periodontal study using povidone-iodine as an intervention; 2) Extract main immunologic outcomes (IgG titres, avidity); 3) Confirm randomized groups and participant count; 4) Rate study quality and map observed changes. Small randomized trial (n=36) with serial serology; findings reported with timepoints but limited sample size, so effects are credible but imprecise.

Study Details

PMID:16856899
Participants:36
Impact:earlier reduction after full-mouth debridement (water and povidone groups) vs quadrant-wise (qualitative: earlier by 1–2 months)
Trust score:3/5

antibody avidity to P. gingivalis and A. actinomycetemcomitans

1 evidences

Full-mouth ultrasonic debridement (including a povidone-iodine group) led to earlier reductions in some serum IgG titres and increased antibody avidity at 3 months in the povidone group.

Trust comment: - Checklist of steps performed: 1) Confirm human periodontal study using povidone-iodine as an intervention; 2) Extract main immunologic outcomes (IgG titres, avidity); 3) Confirm randomized groups and participant count; 4) Rate study quality and map observed changes. Small randomized trial (n=36) with serial serology; findings reported with timepoints but limited sample size, so effects are credible but imprecise.

Study Details

PMID:16856899
Participants:36
Impact:increased at 3 months after full-mouth debridement with povidone
Trust score:3/5

healing rate at 12 weeks

1 evidences

In patients with bacterially burdened leg ulcers, cadexomer iodine and nanocrystalline silver produced comparable overall healing rates at 12 weeks, though silver showed faster early healing in certain wound subgroups.

Trust comment: - Checklist of steps performed: 1) Confirm RCT comparing iodine-containing dressing to silver in humans; 2) Identify main clinical outcomes (healing rate, time to heal, subgroup effects); 3) Confirm participant count and randomization; 4) Assess trial quality and report observed effects. Large RCT (n=281) with clinically relevant endpoints; randomized design supports reliability though subgroup findings are secondary.

Study Details

PMID:20636550
Participants:281
Impact:64% overall healed within 12 weeks; no significant difference between cadexomer iodine and silver
Trust score:4/5

early healing rate (first 2 weeks) and in larger/older/high-exudate wounds

1 evidences

In patients with bacterially burdened leg ulcers, cadexomer iodine and nanocrystalline silver produced comparable overall healing rates at 12 weeks, though silver showed faster early healing in certain wound subgroups.

Trust comment: - Checklist of steps performed: 1) Confirm RCT comparing iodine-containing dressing to silver in humans; 2) Identify main clinical outcomes (healing rate, time to heal, subgroup effects); 3) Confirm participant count and randomization; 4) Assess trial quality and report observed effects. Large RCT (n=281) with clinically relevant endpoints; randomized design supports reliability though subgroup findings are secondary.

Study Details

PMID:20636550
Participants:281
Impact:nanocrystalline silver associated with quicker healing in first 2 weeks and in larger/older/exudative wounds (qualitative)
Trust score:4/5

serum creatinine change at day 5

1 evidences

In patients undergoing coronary angiography with iodinated contrast, nebivolol pretreatment showed a nonsignificant trend toward less creatinine rise and slightly lower CIN incidence versus controls.

Trust comment: - Checklist of steps performed: 1) Confirm human trial involving iodinated contrast and prophylactic interventions; 2) Extract main renal outcomes (CIN incidence, serum creatinine changes); 3) Verify participant count and group allocation; 4) Judge study quality and report observed changes. Randomized study in 120 patients; primary endpoint differences were not statistically significant, so conclusions about protection are tentative.

Study Details

PMID:22262230
Participants:120
Impact:statistically significant increase at day 5 vs baseline in NAC and hydration groups; nebivolol group increase not statistically significant (nebivolol p=0.06)
Trust score:3/5

tissue culture positivity pre-irrigation

1 evidences

In this multicenter pilot RCT of pediatric posterior spine fusion, povidone-iodine wound soak produced similar pre- and post-irrigation tissue culture positivity and similar short-term infection rates compared with sterile saline.

Trust comment: - Checklist of steps performed: 1) Confirm multicenter randomized pilot trial comparing povidone-iodine (iodine) vs saline irrigation; 2) Extract main microbiological and clinical outcomes (culture positivity, infection rate); 3) Confirm completed participant count; 4) Assess feasibility and interpret similarity of results. Pilot RCT with 153 completers; results show no meaningful difference between irrigation types, but study not powered for clinical infections.

Study Details

PMID:33044376
Participants:153
Impact:PVP-I 18% vs saline 17% (14/77 vs 13/76)
Trust score:3/5

tissue culture positivity post-irrigation

1 evidences

In this multicenter pilot RCT of pediatric posterior spine fusion, povidone-iodine wound soak produced similar pre- and post-irrigation tissue culture positivity and similar short-term infection rates compared with sterile saline.

Trust comment: - Checklist of steps performed: 1) Confirm multicenter randomized pilot trial comparing povidone-iodine (iodine) vs saline irrigation; 2) Extract main microbiological and clinical outcomes (culture positivity, infection rate); 3) Confirm completed participant count; 4) Assess feasibility and interpret similarity of results. Pilot RCT with 153 completers; results show no meaningful difference between irrigation types, but study not powered for clinical infections.

Study Details

PMID:33044376
Participants:153
Impact:PVP-I 16% vs saline 18% (12/77 vs 14/76)
Trust score:3/5

30-day postoperative infection in high-risk patients

1 evidences

In this multicenter pilot RCT of pediatric posterior spine fusion, povidone-iodine wound soak produced similar pre- and post-irrigation tissue culture positivity and similar short-term infection rates compared with sterile saline.

Trust comment: - Checklist of steps performed: 1) Confirm multicenter randomized pilot trial comparing povidone-iodine (iodine) vs saline irrigation; 2) Extract main microbiological and clinical outcomes (culture positivity, infection rate); 3) Confirm completed participant count; 4) Assess feasibility and interpret similarity of results. Pilot RCT with 153 completers; results show no meaningful difference between irrigation types, but study not powered for clinical infections.

Study Details

PMID:33044376
Participants:153
Impact:3/37 high-risk patients (8%) developed infection (1 PVP-I, 2 saline); no low-risk infections
Trust score:3/5

localized contact dermatitis

1 evidences

In neonates requiring central venous catheters, skin disinfection with 10% povidone-iodine was as effective as a chlorhexidine-impregnated dressing for preventing bloodstream infections, but had higher catheter-tip colonization and no contact dermatitis.

Trust comment: Large multicenter randomized trial with clear randomization and clinically relevant outcomes.

Study Details

PMID:11389271
Participants:705
Impact:PI 0% vs chlorhexidine 15.3% in very low birthweight subgroup (PI lower)
Trust score:5/5

composite postoperative infectious morbidity

1 evidences

Preoperative vaginal cleansing with 1% povidone-iodine before unscheduled cesarean delivery did not reduce postoperative infectious morbidity compared with no vaginal cleansing.

Trust comment: Large randomized clinical trial with 30-day follow-up and prespecified composite outcome.

Study Details

PMID:36462539
Participants:608
Impact:PI 11.8% vs control 11.5% (no significant difference; +0.3 pp)
Trust score:5/5

deep wound infection rate

1 evidences

Irrigation of spinal surgical wounds with dilute povidone-iodine (betadine) before closure markedly reduced postoperative wound infections compared with no betadine irrigation.

Trust comment: Prospective, randomized, single-blinded study with a substantial sample size and statistically significant differences in infection rates.

Study Details

PMID:16094267
Participants:414
Impact:Betadine 0% vs control 2.9% (absolute reduction 2.9 percentage points)
Trust score:5/5

total wound infection rate

1 evidences

Irrigation of spinal surgical wounds with dilute povidone-iodine (betadine) before closure markedly reduced postoperative wound infections compared with no betadine irrigation.

Trust comment: Prospective, randomized, single-blinded study with a substantial sample size and statistically significant differences in infection rates.

Study Details

PMID:16094267
Participants:414
Impact:Betadine 0% vs control 3.4% (absolute reduction 3.4 percentage points)
Trust score:5/5

wound induration (day 7)

1 evidences

Topical povidone-iodine and purified human placental extract produced similar overall wound healing after orthopaedic surgery, but povidone-iodine had more wound induration at day 7.

Trust comment: Randomized but open-label and small sample size; objective measures limited.

Study Details

PMID:18839655
Participants:79
Impact:PI 38.46% vs placentrex 15.00% (PI higher by +23.46 percentage points)
Trust score:3/5

overall wound healing

1 evidences

Topical povidone-iodine and purified human placental extract produced similar overall wound healing after orthopaedic surgery, but povidone-iodine had more wound induration at day 7.

Trust comment: Randomized but open-label and small sample size; objective measures limited.

Study Details

PMID:18839655
Participants:79
Impact:All patients in both groups healed by day 10 (no difference)
Trust score:3/5

time to complete remission of lesions

1 evidences

In chemotherapy-induced oral mucositis, the povidone-iodine–containing antiseptic regimen (AA) was associated with longer symptom duration and slower lesion remission than topical GM-CSF.

Trust comment: Small randomized study with limited sample size and AA being a combination therapy rather than povidone-iodine alone.

Study Details

PMID:11597376
Participants:31
Impact:AA 6.3 days vs GM-CSF 2.8 days (AA longer by +3.5 days)
Trust score:3/5

glycated hemoglobin (HbA1c)

1 evidences

In poorly controlled T2D patients, nonsurgical periodontal therapy including subgingival irrigation with 10% povidone-iodine significantly improved periodontal status and reduced HbA1c versus control.

Trust comment: Randomized, single-blind RCT with objective biological endpoints but small sample size limiting precision and generalizability.

Study Details

PMID:29482543
Participants:30
Impact:Treatment group: mean HbA1c reduced from 9.7% to 6.7% (−3.0 ±2.4); attributable reduction vs control ≈ −2.2 ±2.5 percentage points (p=0.02)
Trust score:4/5

Streptococcus mutans count (plaque and saliva)

1 evidences

In children with early childhood caries, topical 10% povidone-iodine applied twice significantly reduced S. mutans counts versus control, though fluoride varnish showed the greatest reduction.

Trust comment: Randomized, triple-blind RCT with clear microbiological outcomes but small sample (n=60), moderate quality.

Study Details

PMID:28492198
Participants:60
Impact:decrease vs control (10% PI significant; less reduction than fluoride varnish at 60 and 90 days)
Trust score:4/5

positive conjunctival bacterial culture rate

1 evidences

Conjunctival disinfection with 5% povidone-iodine before vitreoretinal surgery produced near-complete bacterial eradication regardless of preoperative levofloxacin duration.

Trust comment: Multicenter randomized trial primarily on antibiotic duration but shows consistent, strong conjunctival bacterial eradication after povidone-iodine application.

Study Details

PMID:28161927
Participants:209
Impact:marked decrease to ~0-1.33% after povidone-iodine (100% eradication at T2 across groups)
Trust score:4/5

clinical resolution (day 6)

1 evidences

Topical povidone-iodine 0.6% combined with dexamethasone improved clinical resolution and accelerated adenoviral eradication versus vehicle in acute adenoviral conjunctivitis.

Trust comment: Randomized, double-masked multicenter phase 2 trial with moderate sample and clinically relevant virologic and clinical endpoints.

Study Details

PMID:29787732
Participants:144
Impact:+20.4 percentage points vs vehicle (31.3% vs 10.9%; P=0.0158)
Trust score:4/5

adenoviral eradication (day 3)

1 evidences

Topical povidone-iodine 0.6% combined with dexamethasone improved clinical resolution and accelerated adenoviral eradication versus vehicle in acute adenoviral conjunctivitis.

Trust comment: Randomized, double-masked multicenter phase 2 trial with moderate sample and clinically relevant virologic and clinical endpoints.

Study Details

PMID:29787732
Participants:144
Impact:+26.7 percentage points vs vehicle (35.4% vs 8.7%; P=0.0019)
Trust score:4/5

adenoviral eradication (day 6)

1 evidences

Topical povidone-iodine 0.6% combined with dexamethasone improved clinical resolution and accelerated adenoviral eradication versus vehicle in acute adenoviral conjunctivitis.

Trust comment: Randomized, double-masked multicenter phase 2 trial with moderate sample and clinically relevant virologic and clinical endpoints.

Study Details

PMID:29787732
Participants:144
Impact:+22.7 percentage points vs vehicle (79.2% vs 56.5%; P=0.0186)
Trust score:4/5

relief of abnormal vaginal discharge

1 evidences

Compared Praneem tablets to Betadine (povidone-iodine) vaginal pessary in women with abnormal vaginal discharge; both reduced symptoms, Betadine relieved symptoms in 81.6% of women.

Trust comment: Phase II randomized controlled trial with moderate sample size and clear outcome reporting; limited to symptomatic relief and single-center.

Study Details

PMID:19783561
Participants:99
Impact:81.6% relieved (Betadine group); 92% relieved (Praneem group)
Trust score:3/5

lower abdominal pain

1 evidences

Compared Praneem tablets to Betadine (povidone-iodine) vaginal pessary in women with abnormal vaginal discharge; both reduced symptoms, Betadine relieved symptoms in 81.6% of women.

Trust comment: Phase II randomized controlled trial with moderate sample size and clear outcome reporting; limited to symptomatic relief and single-center.

Study Details

PMID:19783561
Participants:99
Impact:significant reduction (both treatments)
Trust score:3/5

vaginal itching and dysuria

1 evidences

Compared Praneem tablets to Betadine (povidone-iodine) vaginal pessary in women with abnormal vaginal discharge; both reduced symptoms, Betadine relieved symptoms in 81.6% of women.

Trust comment: Phase II randomized controlled trial with moderate sample size and clear outcome reporting; limited to symptomatic relief and single-center.

Study Details

PMID:19783561
Participants:99
Impact:significant reduction (both treatments)
Trust score:3/5

carotid artery attenuation

1 evidences

Randomized study of right vs left arm IV injection of iodinated contrast for head/neck CT; right-arm injection reduced perivenous artifacts and retrograde flow and produced slightly higher vascular attenuation (not statistically significant for CA/IJV).

Trust comment: Prospective randomized study with objective imaging measures but modest sample size (n=60); results are directly applicable to iodinated contrast administration.

Study Details

PMID:17895776
Participants:60
Impact:slightly higher with right-arm injection (P=0.06; not significant)
Trust score:4/5

internal jugular vein attenuation

1 evidences

Randomized study of right vs left arm IV injection of iodinated contrast for head/neck CT; right-arm injection reduced perivenous artifacts and retrograde flow and produced slightly higher vascular attenuation (not statistically significant for CA/IJV).

Trust comment: Prospective randomized study with objective imaging measures but modest sample size (n=60); results are directly applicable to iodinated contrast administration.

Study Details

PMID:17895776
Participants:60
Impact:slightly higher with right-arm injection (P=0.07; not significant)
Trust score:4/5

perivenous artifacts and retrograde flow

1 evidences

Randomized study of right vs left arm IV injection of iodinated contrast for head/neck CT; right-arm injection reduced perivenous artifacts and retrograde flow and produced slightly higher vascular attenuation (not statistically significant for CA/IJV).

Trust comment: Prospective randomized study with objective imaging measures but modest sample size (n=60); results are directly applicable to iodinated contrast administration.

Study Details

PMID:17895776
Participants:60
Impact:significantly reduced with right-arm injection
Trust score:4/5

incidence of chemotherapy-induced phlebitis

1 evidences

Randomized trial comparing sesame oil, nitroglycerin ointment, and alcohol/Betadine for prevention of chemotherapy-induced phlebitis; no statistically significant differences between groups in phlebitis incidence.

Trust comment: Randomized single-blind clinical trial with adequate sample size and clear outcome measures but limited blinding and single-center conduct.

Study Details

PMID:37116130
Participants:138
Impact:no significant difference between alcohol/Betadine, nitroglycerin, and sesame oil groups (examples: alcohol group 6.5% first 24h; sesame oil 0% first 24h)
Trust score:3/5

phlebitis symptoms over 72 hours

1 evidences

Randomized trial comparing sesame oil, nitroglycerin ointment, and alcohol/Betadine for prevention of chemotherapy-induced phlebitis; no statistically significant differences between groups in phlebitis incidence.

Trust comment: Randomized single-blind clinical trial with adequate sample size and clear outcome measures but limited blinding and single-center conduct.

Study Details

PMID:37116130
Participants:138
Impact:no significant difference across groups (p>0.05)
Trust score:3/5

overall incidence of acute adverse reactions

1 evidences

Prospective recording of acute adverse reactions to five iodinated contrast agents in 8,931 CT patients; overall reaction rate 2.7% with higher rates for iomeprol (3.9%) and iopromide (3.5%).

Trust comment: Large prospective dataset across consecutive CT patients with clear outcome measurement; strong external validity for acute reaction rates.

Study Details

PMID:20033176
Participants:8931
Impact:2.7% (241/8,931)
Trust score:4/5

agent-specific reaction rates

1 evidences

Prospective recording of acute adverse reactions to five iodinated contrast agents in 8,931 CT patients; overall reaction rate 2.7% with higher rates for iomeprol (3.9%) and iopromide (3.5%).

Trust comment: Large prospective dataset across consecutive CT patients with clear outcome measurement; strong external validity for acute reaction rates.

Study Details

PMID:20033176
Participants:8931
Impact:iomeprol 3.9% and iopromide 3.5% (higher than others)
Trust score:4/5

age-related difference in reactions

1 evidences

Prospective recording of acute adverse reactions to five iodinated contrast agents in 8,931 CT patients; overall reaction rate 2.7% with higher rates for iomeprol (3.9%) and iopromide (3.5%).

Trust comment: Large prospective dataset across consecutive CT patients with clear outcome measurement; strong external validity for acute reaction rates.

Study Details

PMID:20033176
Participants:8931
Impact:higher in patients ≤59 years (4.5%) vs ≥60 years (1.9%)
Trust score:4/5

POC eGFR accuracy (Nova StatSensor)

1 evidences

Assessed point-of-care devices versus laboratory eGFR before IV iodinated contrast; POC devices were moderately accurate, did not miss high-risk patients but underreported some eGFR values.

Trust comment: Moderate-size diagnostic comparison with clear metrics (R², CV); single-center and limited sample for high-risk strata.

Study Details

PMID:32725604
Participants:186
Impact:R² = 0.77; coefficient of variation 10.65%
Trust score:3/5

POC eGFR accuracy (Abbott iSTAT)

1 evidences

Assessed point-of-care devices versus laboratory eGFR before IV iodinated contrast; POC devices were moderately accurate, did not miss high-risk patients but underreported some eGFR values.

Trust comment: Moderate-size diagnostic comparison with clear metrics (R², CV); single-center and limited sample for high-risk strata.

Study Details

PMID:32725604
Participants:186
Impact:R² = 0.83; coefficient of variation 7.36%
Trust score:3/5

detection of high-risk renal impairment

1 evidences

Assessed point-of-care devices versus laboratory eGFR before IV iodinated contrast; POC devices were moderately accurate, did not miss high-risk patients but underreported some eGFR values.

Trust comment: Moderate-size diagnostic comparison with clear metrics (R², CV); single-center and limited sample for high-risk strata.

Study Details

PMID:32725604
Participants:186
Impact:no high-risk patients (eGFR <30) missed by POC devices; some underreporting of eGFR values occurred
Trust score:3/5

primary molar caries lesion increment (1 year)

1 evidences

Topical varnish containing 10% povidone-iodine + fluoride applied every 3 months reduced new caries in primary molars compared with fluoride alone; no harms reported.

Trust comment: Randomized, double-blind RCT with adequate sample size and appropriate analyses; single-center but well conducted.

Study Details

PMID:32437626
Participants:262
Impact:−50% (adjusted rate ratio 0.50; P = .005)
Trust score:4/5

primary molar caries lesion increment (2 years)

1 evidences

Topical varnish containing 10% povidone-iodine + fluoride applied every 3 months reduced new caries in primary molars compared with fluoride alone; no harms reported.

Trust comment: Randomized, double-blind RCT with adequate sample size and appropriate analyses; single-center but well conducted.

Study Details

PMID:32437626
Participants:262
Impact:−26% (adjusted rate ratio 0.74; P = .073; not statistically significant)
Trust score:4/5

newborn thyroglobulin (iodine status indicator)

1 evidences

Cord-blood substudy (n=333) of a large cluster-randomized trial comparing antenatal multiple micronutrient (MM) supplementation (includes vitamin D) versus iron–folic acid (IFA); MM increased newborn vitamin D, ferritin, and zinc vs IFA.

Trust comment: Large, cluster-randomized, double-blind trial substudy with well-validated biomarker assays and adequate sample for biomarker comparisons.

Study Details

PMID:32844185
Participants:333
Impact:−0.4% (−0.2 µg/L); P = .96 (no difference)
Trust score:4/5

newborn free thyroxine (fT4)

1 evidences

Cord-blood substudy (n=333) of a large cluster-randomized trial comparing antenatal multiple micronutrient (MM) supplementation (includes vitamin D) versus iron–folic acid (IFA); MM increased newborn vitamin D, ferritin, and zinc vs IFA.

Trust comment: Large, cluster-randomized, double-blind trial substudy with well-validated biomarker assays and adequate sample for biomarker comparisons.

Study Details

PMID:32844185
Participants:333
Impact:−1.1% (−0.2 pmol/L); P = .40 (no difference)
Trust score:4/5

cord ferritin (newborn iron stores)

1 evidences

Cord-blood substudy (n=333) of a large cluster-randomized trial comparing antenatal multiple micronutrient (MM) supplementation (includes vitamin D) versus iron–folic acid (IFA); MM increased newborn vitamin D, ferritin, and zinc vs IFA.

Trust comment: Large, cluster-randomized, double-blind trial substudy with well-validated biomarker assays and adequate sample for biomarker comparisons.

Study Details

PMID:32844185
Participants:333
Impact:+12.4% (+18 µg/L); P = .03
Trust score:4/5

conjunctival culture positivity after levofloxacin (T1)

1 evidences

Topical levofloxacin for 1 or 3 days reduced conjunctival culture positivity similarly; subsequent application of 5% povidone‑iodine further reduced positive cultures to 20%.

Trust comment: Randomized trial of antibiotic duration; povidone‑iodine was applied to all participants (non-randomized) but produced additional reduction in conjunctival flora.

Study Details

PMID:17932841
Participants:100
Impact:1-day: reduced from 82% to 46% (P = 0.0004); 3-day: reduced from 74% to 34% (P = 0.0001)
Trust score:3/5

conjunctival culture positivity after povidone‑iodine (T3)

1 evidences

Topical levofloxacin for 1 or 3 days reduced conjunctival culture positivity similarly; subsequent application of 5% povidone‑iodine further reduced positive cultures to 20%.

Trust comment: Randomized trial of antibiotic duration; povidone‑iodine was applied to all participants (non-randomized) but produced additional reduction in conjunctival flora.

Study Details

PMID:17932841
Participants:100
Impact:reduced to 20% (10 eyes per group) after two drops of 5% povidone‑iodine
Trust score:3/5

clinical resolution at day 5 (study eye)

1 evidences

Phase 3 randomized trial: combination PVP‑I/DEX did not show statistically significant clinical or bacteriologic superiority to placebo at day 5 and had higher rates of treatment‑emergent adverse events.

Trust comment: Large, multicenter, double-masked, randomized phase 3 trial with robust design; negative primary efficacy result but high internal validity.

Study Details

PMID:32222367
Participants:526
Impact:PVP‑I/DEX 50.5% vs placebo 42.8%; difference +7.7 percentage points; P = .127 (not significant)
Trust score:4/5

bacterial eradication at day 5

1 evidences

Phase 3 randomized trial: combination PVP‑I/DEX did not show statistically significant clinical or bacteriologic superiority to placebo at day 5 and had higher rates of treatment‑emergent adverse events.

Trust comment: Large, multicenter, double-masked, randomized phase 3 trial with robust design; negative primary efficacy result but high internal validity.

Study Details

PMID:32222367
Participants:526
Impact:PVP‑I/DEX 43.3% vs placebo 46.8%; P = .500 (no significant difference)
Trust score:4/5

treatment‑emergent adverse events (safety)

1 evidences

Phase 3 randomized trial: combination PVP‑I/DEX did not show statistically significant clinical or bacteriologic superiority to placebo at day 5 and had higher rates of treatment‑emergent adverse events.

Trust comment: Large, multicenter, double-masked, randomized phase 3 trial with robust design; negative primary efficacy result but high internal validity.

Study Details

PMID:32222367
Participants:526
Impact:PVP‑I/DEX 32.8% vs placebo 19.0% (more AEs with active treatment)
Trust score:4/5

disease-free survival (early childhood caries prevention)

1 evidences

Applying 10% povidone-iodine to teeth of high-risk toddlers markedly reduced early childhood caries over 12 months compared with placebo.

Trust comment: Randomized controlled trial in 83 children with a large and statistically significant effect on caries prevention, though sample size is modest.

Study Details

PMID:12064491
Participants:83
Impact:12-month disease-free survival 91% (±5%) vs 54% (±9%) in control (absolute difference +37 percentage points; P=0.0013)
Trust score:4/5

oral bacterial flora

1 evidences

Improved oral care using 0.1% povidone-iodine (plus toothbrush and suction) reduced oral bacteria and lowered ventilator-associated pneumonia compared with routine saline care.

Trust comment: Human randomized groups with clear positive clinical signals, but single-center design and limited methodological detail reduce confidence.

Study Details

PMID:36158118
Participants:100
Impact:significantly lower counts at 8 h, 16 h, and 24 h after intubation in the iodine group (P < 0.05)
Trust score:3/5

incidence of ventilator-associated pneumonia

1 evidences

Improved oral care using 0.1% povidone-iodine (plus toothbrush and suction) reduced oral bacteria and lowered ventilator-associated pneumonia compared with routine saline care.

Trust comment: Human randomized groups with clear positive clinical signals, but single-center design and limited methodological detail reduce confidence.

Study Details

PMID:36158118
Participants:100
Impact:8% in observation (iodine) group vs 14% in control (absolute difference -6 percentage points; P < 0.05)
Trust score:3/5

oral cleanliness score

1 evidences

Improved oral care using 0.1% povidone-iodine (plus toothbrush and suction) reduced oral bacteria and lowered ventilator-associated pneumonia compared with routine saline care.

Trust comment: Human randomized groups with clear positive clinical signals, but single-center design and limited methodological detail reduce confidence.

Study Details

PMID:36158118
Participants:100
Impact:significantly improved in the observation group (P < 0.05)
Trust score:3/5

pleurodesis success rate (complete or partial response)

1 evidences

Iodopovidone used for chemical pleurodesis in malignant pleural effusion achieved high overall success (88.4%), with similar results using small or large tubes.

Trust comment: Prospective clinical series with direct use of iodopovidone showing high success but small sample and some complications limit certainty.

Study Details

PMID:18594928
Participants:41
Impact:overall success 88.4% (complete 60.5%, partial 27.9%)
Trust score:3/5

procedure complication rate

1 evidences

Iodopovidone used for chemical pleurodesis in malignant pleural effusion achieved high overall success (88.4%), with similar results using small or large tubes.

Trust comment: Prospective clinical series with direct use of iodopovidone showing high success but small sample and some complications limit certainty.

Study Details

PMID:18594928
Participants:41
Impact:complications in 32.5% of procedures (most common pain 16.2%)
Trust score:3/5

image quality (good or excellent)

1 evidences

Using a lower-iodine concentration contrast agent produced image quality similar to a higher-iodine agent and had slightly fewer adverse events.

Trust comment: Randomized, double-blind multicentre trial with clear endpoints and 98 patients supports moderate-to-high trust.

Study Details

PMID:20821930
Participants:98
Impact:no difference (87.8% vs 89.8%)
Trust score:4/5

bacterial count reduction (log10)

2 evidences

Different scrub protocols were compared; alcohol-based antiseptics and some antiseptic scrubs produced greater bacterial reductions and were not more damaging to skin.

Trust comment: Small randomized crossover sample (n=23) with objective microbiologic measures but limited size.

Study Details

PMID:9172045
Participants:23
Impact:PI-3 1.13 log10; ABH 1.40 log10 (ABH and antiseptic scrubs > non-antiseptic)
Trust score:3/5

Antiseptic soaps (including povidone iodine) and alcohol-based handrub reduced fingertip bacterial counts more than non-antiseptic soap; alcohol rub had the largest reduction.

Trust comment: Randomized clinical design with objective microbial measures but modest sample size limits precision.

Study Details

PMID:12014900
Participants:43
Impact:ABH 1.40; AS30 1.14; AS60 1.21; PI- (antiseptic) ~1.13
Trust score:3/5

post-week colony counts

1 evidences

Different scrub protocols were compared; alcohol-based antiseptics and some antiseptic scrubs produced greater bacterial reductions and were not more damaging to skin.

Trust comment: Small randomized crossover sample (n=23) with objective microbiologic measures but limited size.

Study Details

PMID:9172045
Participants:23
Impact:alcohol-based antiseptics had significantly lower cfu in 2/3 post-scrub samples (p=0.003, p=0.035)
Trust score:3/5

skin condition (subjective drying)

1 evidences

Different scrub protocols were compared; alcohol-based antiseptics and some antiseptic scrubs produced greater bacterial reductions and were not more damaging to skin.

Trust comment: Small randomized crossover sample (n=23) with objective microbiologic measures but limited size.

Study Details

PMID:9172045
Participants:23
Impact:alcohol-based reported less drying (no statistically significant objective differences)
Trust score:3/5

iodine dose

1 evidences

Lower tube voltage plus iterative reconstruction allowed a ~26% lower iodine load and ~35% lower radiation dose while keeping image quality similar.

Trust comment: Prospective multicenter randomized trial with 231 patients and objective imaging/radiation measurements supports good reliability.

Study Details

PMID:25843243
Participants:231
Impact:-26.5% (18.3 g vs 24.9 g)
Trust score:4/5

Safety/adverse effects

1 evidences

In high-risk PCI patients given iodinated contrast, IV prostaglandin E1 reduced the incidence of contrast-induced nephropathy versus control hydration alone.

Trust comment: Randomized trial with clinically relevant endpoint but moderate sample size and limited detail on blinding and follow-up.

Study Details

PMID:24570327
Participants:163
Impact:no serious adverse effects reported
Trust score:3/5

pathogen persistence after hand hygiene

1 evidences

Antiseptic soaps (including povidone iodine) and alcohol-based handrub reduced fingertip bacterial counts more than non-antiseptic soap; alcohol rub had the largest reduction.

Trust comment: Randomized clinical design with objective microbial measures but modest sample size limits precision.

Study Details

PMID:12014900
Participants:43
Impact:2 of 11 pre-HH pathogenic samples remained positive after HH
Trust score:3/5

relative performance of techniques

1 evidences

Antiseptic soaps (including povidone iodine) and alcohol-based handrub reduced fingertip bacterial counts more than non-antiseptic soap; alcohol rub had the largest reduction.

Trust comment: Randomized clinical design with objective microbial measures but modest sample size limits precision.

Study Details

PMID:12014900
Participants:43
Impact:antiseptic soaps and ABH > non-antiseptic soap
Trust score:3/5

coronary intravascular enhancement

1 evidences

Different iodine-containing CT contrast protocols were compared; high flow prewarmed contrast was safe and comfortable.

Trust comment: Double-blind randomized trial of 200 patients with objective imaging measures and reported P-values; moderate risk from single-centre design.

Study Details

PMID:27164459
Participants:200
Impact:no significant difference (437–448 HU across groups; P≥0.18)
Trust score:4/5

patient comfort / pain / stress

1 evidences

Different iodine-containing CT contrast protocols were compared; high flow prewarmed contrast was safe and comfortable.

Trust comment: Double-blind randomized trial of 200 patients with objective imaging measures and reported P-values; moderate risk from single-centre design.

Study Details

PMID:27164459
Participants:200
Impact:no change (comfort median 4/5; pain median 0/10; stress median 1/5; P≥0.68)
Trust score:4/5

injection extravasation (safety)

1 evidences

Different iodine-containing CT contrast protocols were compared; high flow prewarmed contrast was safe and comfortable.

Trust comment: Double-blind randomized trial of 200 patients with objective imaging measures and reported P-values; moderate risk from single-centre design.

Study Details

PMID:27164459
Participants:200
Impact:none observed (0 events)
Trust score:4/5

total diet quality (DHD-P)

1 evidences

A cluster RCT in 342 pregnant women showed the P4HP empowerment programme modestly improved overall diet quality and some nutrient components by the third trimester.

Trust comment: Cluster RCT (342 enrolled, 209 with follow-up) with appropriate mixed-model analysis but substantial loss to follow-up reducing certainty.

Study Details

PMID:39871233
Participants:342
Impact:+4.28 units (intervention vs control; 95% CI 1.00 to 7.56; p=0.011; LOCF +2.75 units)
Trust score:4/5

iodine intake (DHD-P iodine subscore)

1 evidences

A cluster RCT in 342 pregnant women showed the P4HP empowerment programme modestly improved overall diet quality and some nutrient components by the third trimester.

Trust comment: Cluster RCT (342 enrolled, 209 with follow-up) with appropriate mixed-model analysis but substantial loss to follow-up reducing certainty.

Study Details

PMID:39871233
Participants:342
Impact:+0.40 score units (95% CI 0.20 to 0.61; p<0.001)
Trust score:4/5

empowerment (PRES total score)

1 evidences

A cluster RCT in 342 pregnant women showed the P4HP empowerment programme modestly improved overall diet quality and some nutrient components by the third trimester.

Trust comment: Cluster RCT (342 enrolled, 209 with follow-up) with appropriate mixed-model analysis but substantial loss to follow-up reducing certainty.

Study Details

PMID:39871233
Participants:342
Impact:no significant change (difference 0.178; p=0.824)
Trust score:4/5

urinary iodine excretion (iodine status)

1 evidences

Daily consumption of yoghurt fortified with multiple micronutrients (including iodine) for 12 months reduced declines in iodine status and improved hemoglobin and linear growth in schoolchildren.

Trust comment: Double-blind RCT with high compliance and biologic endpoints (urinary iodine, Hb), but ~22% dropout and baseline adequacy for some nutrients limit generalisability.

Study Details

PMID:23714325
Participants:571
Impact:less decline in FY vs NFY; mean difference +39.87 μg/L (95% CI 20.39 to 59.35; p=0.001)
Trust score:4/5

hemoglobin (Hb)

1 evidences

Daily consumption of yoghurt fortified with multiple micronutrients (including iodine) for 12 months reduced declines in iodine status and improved hemoglobin and linear growth in schoolchildren.

Trust comment: Double-blind RCT with high compliance and biologic endpoints (urinary iodine, Hb), but ~22% dropout and baseline adequacy for some nutrients limit generalisability.

Study Details

PMID:23714325
Participants:571
Impact:+1.5 g/L mean difference (95% CI 0.4 to 2.5; p=0.006)
Trust score:4/5

height velocity / linear growth

1 evidences

Daily consumption of yoghurt fortified with multiple micronutrients (including iodine) for 12 months reduced declines in iodine status and improved hemoglobin and linear growth in schoolchildren.

Trust comment: Double-blind RCT with high compliance and biologic endpoints (urinary iodine, Hb), but ~22% dropout and baseline adequacy for some nutrients limit generalisability.

Study Details

PMID:23714325
Participants:571
Impact:+0.32 cm/yr (mean difference; 95% CI 0.05 to 0.60; p=0.02) and HAZ +0.18 (p=0.03)
Trust score:4/5

hepatic enhancement (peak and AUC)

1 evidences

Four iodinated CT contrast agents were compared for liver enhancement; enhancement profiles differed between agents.

Trust comment: Prospective randomized study but small sample (n=53) and differences partly explained by differing administered volumes/concentrations.

Study Details

PMID:7650078
Participants:53
Impact:significant differences between agents; iopromide showed lower late enhancement and lower AUC (P<0.05) when given as 75 mL
Trust score:3/5

time to hepatic peak enhancement

1 evidences

Four iodinated CT contrast agents were compared for liver enhancement; enhancement profiles differed between agents.

Trust comment: Prospective randomized study but small sample (n=53) and differences partly explained by differing administered volumes/concentrations.

Study Details

PMID:7650078
Participants:53
Impact:iopromide peaked earlier but at lower amplitude compared with others
Trust score:3/5

coronary lumen attenuation (opacification)

1 evidences

In 306 patients randomized to iodixanol or iopromide for coronary CTA, lumen opacification and image quality were comparable and cardiovascular effects were monitored without major differences.

Trust comment: Large randomized trial (n=306) with objective imaging endpoints and monitoring of cardiac safety; results reported with appropriate statistics.

Study Details

PMID:28809582
Participants:306
Impact:comparable between iodixanol 270 and iopromide 300 (469 HU vs 447 HU; P=0.241)
Trust score:4/5

heart rhythm / arrhythmia and adverse events

1 evidences

In 306 patients randomized to iodixanol or iopromide for coronary CTA, lumen opacification and image quality were comparable and cardiovascular effects were monitored without major differences.

Trust comment: Large randomized trial (n=306) with objective imaging endpoints and monitoring of cardiac safety; results reported with appropriate statistics.

Study Details

PMID:28809582
Participants:306
Impact:no major differences reported between groups on monitored cardiovascular effects
Trust score:4/5

Diagnostic efficacy (optimal exams)

1 evidences

Prospective double-blind randomized multicenter trial comparing two low-osmolar iodinated contrast agents for abdominal CT focusing on adverse events and diagnostic efficacy.

Trust comment: Large randomized, double-blind multicenter trial with clear adverse event data and statistical testing.

Study Details

PMID:9204351
Participants:518
Impact:Similar between agents: 87.1% (iopentol) vs 90.5% (iopromide), p=0.34
Trust score:4/5

Radiation dose (CTDIvol/DLP/SSDE)

1 evidences

Randomized study in obese patients comparing conventional CT protocol vs a 'double-low' protocol (lower kVp and lower-concentration iodine) plus AIIR reconstruction, assessing image quality, radiation dose, and iodine intake.

Trust comment: Randomized prospective human study (n=150) with detailed quantitative image quality, dose, and iodine-intake results; single-center and moderate sample size.

Study Details

PMID:40634847
Participants:150
Impact:Reduced ~56–58% in arterial and portal-venous phases (e.g., CTDIvol reduced from 8.00 to 3.46 mGy; P<0.001)
Trust score:4/5

Image quality (SNR, CNR, FOM)

1 evidences

Randomized study in obese patients comparing conventional CT protocol vs a 'double-low' protocol (lower kVp and lower-concentration iodine) plus AIIR reconstruction, assessing image quality, radiation dose, and iodine intake.

Trust comment: Randomized prospective human study (n=150) with detailed quantitative image quality, dose, and iodine-intake results; single-center and moderate sample size.

Study Details

PMID:40634847
Participants:150
Impact:AIIR level 4 improved arterial-phase liver SNR +18.84%, CNR +16.34%, FOM +114.89% (all p<0.001) and similar portal-phase improvements
Trust score:4/5

Endophthalmitis incidence after ranibizumab injections

1 evidences

Large prospective randomized trials reporting endophthalmitis rates after intravitreal injections using a standardized protocol that included topical povidone-iodine but did not require topical antibiotics.

Trust comment: Large multicenter randomized clinical trials with thousands of injections and clear incidence reporting; protocol included povidone-iodine antisepsis.

Study Details

PMID:20008710
Participants:3838
Impact:3 cases in 3226 injections (0.09%)
Trust score:5/5

Endophthalmitis incidence after triamcinolone injections

1 evidences

Large prospective randomized trials reporting endophthalmitis rates after intravitreal injections using a standardized protocol that included topical povidone-iodine but did not require topical antibiotics.

Trust comment: Large multicenter randomized clinical trials with thousands of injections and clear incidence reporting; protocol included povidone-iodine antisepsis.

Study Details

PMID:20008710
Participants:3838
Impact:0 cases in 612 injections (0%)
Trust score:5/5

post-contrast nephropathy incidence

1 evidences

Neurosurgical patients given intra-arterial iodinated contrast had a high rate of kidney injury (~23%) with no difference between low- and iso-osmolar agents.

Trust comment: Prospective randomized double‑blind trial in 92 patients with objective renal measures and clear endpoints, moderate sample size.

Study Details

PMID:21498279
Participants:92
Impact:22.8% overall; LOCM 27.1% vs IOCM 18.2% (no significant difference)
Trust score:4/5

renal function (SCr, NAG, creatinine clearance)

1 evidences

Neurosurgical patients given intra-arterial iodinated contrast had a high rate of kidney injury (~23%) with no difference between low- and iso-osmolar agents.

Trust comment: Prospective randomized double‑blind trial in 92 patients with objective renal measures and clear endpoints, moderate sample size.

Study Details

PMID:21498279
Participants:92
Impact:No significant difference between LOCM and IOCM on days 1 and 3 after procedure
Trust score:4/5

wound healing (nanocrystalline silver vs cadexomer iodine)

1 evidences

In a randomized trial of leg ulcer dressings, silver dressings improved early (first 2 weeks) healing compared with cadexomer iodine under certain low-burden bacterial conditions.

Trust comment: Randomized controlled trial with 281 participants and objective wound-healing endpoints, though effect was context-specific and details on longer-term outcomes are limited.

Study Details

PMID:21078131
Participants:281
Impact:Nanocrystalline silver showed significantly better healing than cadexomer iodine in first 2 weeks when bacterial/leukocyte levels were nil or low
Trust score:4/5

relationship clinical assessment vs swab bacterial burden

1 evidences

In a randomized trial of leg ulcer dressings, silver dressings improved early (first 2 weeks) healing compared with cadexomer iodine under certain low-burden bacterial conditions.

Trust comment: Randomized controlled trial with 281 participants and objective wound-healing endpoints, though effect was context-specific and details on longer-term outcomes are limited.

Study Details

PMID:21078131
Participants:281
Impact:No relationship between nurses' clinical assessment of critical colonisation and bacterial burden from swabs
Trust score:4/5

contrast volume used

1 evidences

Using fusion imaging guidance did not significantly change radiation exposure or the volume of iodinated contrast used during lower extremity endovascular procedures.

Trust comment: Prospective randomized pilot single-operator trial with objective imaging metrics but limited size and single-center design.

Study Details

PMID:35735195
Participants:64
Impact:Median 60 ml (fusion) vs 50 ml (control); p=0.10 (no significant difference)
Trust score:3/5

radiation exposure (DAP)

1 evidences

Using fusion imaging guidance did not significantly change radiation exposure or the volume of iodinated contrast used during lower extremity endovascular procedures.

Trust comment: Prospective randomized pilot single-operator trial with objective imaging metrics but limited size and single-center design.

Study Details

PMID:35735195
Participants:64
Impact:No significant difference in DAP between fusion and control groups (31.6 vs 25.6 Gy·cm²; p=0.07)
Trust score:3/5

pain relief (>50% at 6 months)

1 evidences

Increasing injectate volume (4, 6, 8 mL) did not change pain relief or disability outcomes, and the pattern of iodinated contrast spread was similar across volumes.

Trust comment: Randomized double‑blind trial in 60 patients with clear clinical endpoints; moderate quality though single-center and not placebo-controlled.

Study Details

PMID:29871368
Participants:60
Impact:No significant difference across volumes (Group A 72.7%, B 75%, C 72.2%; p=0.98)
Trust score:4/5

pattern of iodinated contrast spread

1 evidences

Increasing injectate volume (4, 6, 8 mL) did not change pain relief or disability outcomes, and the pattern of iodinated contrast spread was similar across volumes.

Trust comment: Randomized double‑blind trial in 60 patients with clear clinical endpoints; moderate quality though single-center and not placebo-controlled.

Study Details

PMID:29871368
Participants:60
Impact:No difference in contrast spread pattern between 4, 6, and 8 mL groups
Trust score:4/5

diagnostic acceptability (subjective score)

1 evidences

Using lower-concentration iodine contrast with lower tube voltage reduced radiation and kept acceptable image quality.

Trust comment: Prospective randomized study with objective image metrics and clear endpoints, but modest sample size (n=63).

Study Details

PMID:26388465
Participants:63
Impact:−0.44 points (4.06±0.45 vs 4.50±0.37; P<.001)
Trust score:4/5

objective image quality (SNR/CNR/figure of merit)

1 evidences

Using lower-concentration iodine contrast with lower tube voltage reduced radiation and kept acceptable image quality.

Trust comment: Prospective randomized study with objective image metrics and clear endpoints, but modest sample size (n=63).

Study Details

PMID:26388465
Participants:63
Impact:increased (P<.001)
Trust score:4/5

mutans streptococci counts

1 evidences

Preventive dental protocols (including topical sodium iodide) reduced cariogenic bacteria and candidosis compared with no preventive care, but chlorhexidine worked best.

Trust comment: Randomized clinical groups and microbiological measures but substantial attrition and modest group sizes reduce certainty.

Study Details

PMID:21499649
Participants:39
Impact:reduced by preventive protocols including sodium iodide; sodium iodide not superior to fluoride (P=0.9952)
Trust score:3/5

oral candidosis occurrence

1 evidences

Preventive dental protocols (including topical sodium iodide) reduced cariogenic bacteria and candidosis compared with no preventive care, but chlorhexidine worked best.

Trust comment: Randomized clinical groups and microbiological measures but substantial attrition and modest group sizes reduce certainty.

Study Details

PMID:21499649
Participants:39
Impact:reduced by preventive protocols versus no treatment (no-treatment group had significantly higher candidosis; P=0.031)
Trust score:3/5

xerostomia / mucositis incidence

1 evidences

Preventive dental protocols (including topical sodium iodide) reduced cariogenic bacteria and candidosis compared with no preventive care, but chlorhexidine worked best.

Trust comment: Randomized clinical groups and microbiological measures but substantial attrition and modest group sizes reduce certainty.

Study Details

PMID:21499649
Participants:39
Impact:not prevented by any protocol (no significant differences between groups)
Trust score:3/5

relative creatinine clearance variation

1 evidences

In children with normal renal function, iobitridol was noninferior to iodixanol for creatinine clearance change and rates of contrast-induced nephropathy were not significantly different.

Trust comment: Large, double-blind randomized multicenter pediatric RCT with predefined endpoints and appropriate analysis (high quality).

Study Details

PMID:21713440
Participants:128
Impact:difference −0.12% (iobitridol − iodixanol); noninferior (P=0.042)
Trust score:5/5

wound bacterial burden

1 evidences

Povidone-iodine irrigation during wet-to-moist cleansing significantly reduced wound bacterial burden compared with saline.

Trust comment: Prospective cohort with many patients and quantitative microbiological outcomes, but not randomized across all arms.

Study Details

PMID:30307816
Participants:260
Impact:povidone-iodine: ln RF=2.98 (p=0.001) indicating significant reduction
Trust score:4/5

diagnostic image quality (6 min film)

1 evidences

At lower iodine doses, iodixanol provided higher diagnostic quality and less discomfort than iohexol in intravenous urography.

Trust comment: Large randomized double-blind clinical trial with clear diagnostic endpoints and robust sample size.

Study Details

PMID:10195003
Participants:392
Impact:iodixanol diagnostic in >90% at both 9 and 12 gI; iohexol diagnostic 74% (9 gI) and 81.8% (12 gI); iodixanol 9 gI superior (p=0.0005 and p=0.014)
Trust score:4/5

patient discomfort

1 evidences

At lower iodine doses, iodixanol provided higher diagnostic quality and less discomfort than iohexol in intravenous urography.

Trust comment: Large randomized double-blind clinical trial with clear diagnostic endpoints and robust sample size.

Study Details

PMID:10195003
Participants:392
Impact:iodixanol caused significantly less discomfort than iohexol
Trust score:4/5

bladder distension

1 evidences

At lower iodine doses, iodixanol provided higher diagnostic quality and less discomfort than iohexol in intravenous urography.

Trust comment: Large randomized double-blind clinical trial with clear diagnostic endpoints and robust sample size.

Study Details

PMID:10195003
Participants:392
Impact:iodixanol produced poorer bladder distension than iohexol
Trust score:4/5

Renal pelvis CT density

1 evidences

In healthy volunteers, iodixanol (dimer) at a lower iodine dose produced similar renal enhancement curves to iopromide (monomer), but produced higher renal pelvic density up to 10 minutes.

Trust comment: Human volunteer study with modest sample size and direct imaging measurements, but limited clinical outcome data.

Study Details

PMID:9059403
Participants:36
Impact:significantly higher with iodixanol up to 10 minutes after injection (despite 10% lower iodine dose)
Trust score:3/5

Overall renal time-density curves

1 evidences

In healthy volunteers, iodixanol (dimer) at a lower iodine dose produced similar renal enhancement curves to iopromide (monomer), but produced higher renal pelvic density up to 10 minutes.

Trust comment: Human volunteer study with modest sample size and direct imaging measurements, but limited clinical outcome data.

Study Details

PMID:9059403
Participants:36
Impact:profiles similar between iodixanol (13.5 g I) and iopromide (15.0 g I) for cortex/medulla/aorta/vena cava
Trust score:3/5

Median peak serum creatinine increase (day 0–3)

1 evidences

In patients with chronic renal insufficiency undergoing angiography, iodixanol did not significantly reduce renal deterioration compared with ioxaglate.

Trust comment: Randomized, double-blind multicenter trial in humans with appropriate endpoints but underpowered for definitive differences.

Study Details

PMID:19463464
Participants:146
Impact:iodixanol 0.09 mg/dl vs ioxaglate 0.15 mg/dl (p = 0.07; not statistically significant)
Trust score:4/5

Incidence of serum creatinine increase ≥0.5 mg/dl

1 evidences

In patients with chronic renal insufficiency undergoing angiography, iodixanol did not significantly reduce renal deterioration compared with ioxaglate.

Trust comment: Randomized, double-blind multicenter trial in humans with appropriate endpoints but underpowered for definitive differences.

Study Details

PMID:19463464
Participants:146
Impact:15.9% (iodixanol) vs 18.2% (ioxaglate) (no significant difference)
Trust score:4/5

creatinine-based contrast-induced nephropathy (CIN) incidence

1 evidences

Post-hoc analysis (n=246) of patients receiving iodinated contrast media: MBL deficiency was associated with lower rates of early cystatin-C–based renal injury but not with creatinine-defined CIN.

Trust comment: Well-characterized post-hoc analysis of a randomized trial with 246 patients; outcome definitions and adjustments are appropriate though post-hoc design and surrogate endpoint (cystatin C) limit causal inference.

Study Details

PMID:22938690
Participants:246
Impact:6.5% overall (16/246); no significant difference by MBL status (5.3% vs 6.9%, p=1.0)
Trust score:4/5

cystatin C increase ≥10% after contrast

1 evidences

Post-hoc analysis (n=246) of patients receiving iodinated contrast media: MBL deficiency was associated with lower rates of early cystatin-C–based renal injury but not with creatinine-defined CIN.

Trust comment: Well-characterized post-hoc analysis of a randomized trial with 246 patients; outcome definitions and adjustments are appropriate though post-hoc design and surrogate endpoint (cystatin C) limit causal inference.

Study Details

PMID:22938690
Participants:246
Impact:less frequent with MBL deficiency: 8/56 (14%) vs 50/185 (27%); adjusted OR 0.34 (95% CI 0.15–0.80), p=0.01
Trust score:4/5

MBL level (continuous) as risk factor

1 evidences

Post-hoc analysis (n=246) of patients receiving iodinated contrast media: MBL deficiency was associated with lower rates of early cystatin-C–based renal injury but not with creatinine-defined CIN.

Trust comment: Well-characterized post-hoc analysis of a randomized trial with 246 patients; outcome definitions and adjustments are appropriate though post-hoc design and surrogate endpoint (cystatin C) limit causal inference.

Study Details

PMID:22938690
Participants:246
Impact:higher MBL associated with increased risk: OR 1.32 per 1000 ng/mL (95% CI 1.10–1.58), p=0.003
Trust score:4/5

contrast-induced nephropathy (SCr increase ≥25%)

1 evidences

Compared two iodine-containing contrast agents for safety and image quality; similar efficacy and safety, with fewer cases of contrast-related kidney injury after iosimenol.

Trust comment: Randomized, double-blind phase-2 trial with objective endpoints but relatively small sample size limiting detection of subtle differences.

Study Details

PMID:24938661
Participants:144
Impact:iosimenol 10.8% (8/74) vs iodixanol 17.1% (12/70)
Trust score:4/5

aortic attenuation / image quality

1 evidences

Compared two iodine-containing contrast agents for safety and image quality; similar efficacy and safety, with fewer cases of contrast-related kidney injury after iosimenol.

Trust comment: Randomized, double-blind phase-2 trial with objective endpoints but relatively small sample size limiting detection of subtle differences.

Study Details

PMID:24938661
Participants:144
Impact:iosimenol ~5–7% higher mean Hounsfield units (not statistically significant); diagnostic quality ≥97% for both
Trust score:4/5

radiocontrast nephropathy (SCr increase ≥25%)

1 evidences

In patients with chronic kidney disease undergoing procedures with iodinated contrast, adding systemic hypothermia did not reduce risk of contrast-induced kidney injury.

Trust comment: Multicenter randomized trial in at-risk patients with centralized lab measurements; moderate sample size limits precision of subgroup effects.

Study Details

PMID:21676368
Participants:128
Impact:normothermia 18.6% vs hypothermia 22.4% (OR 1.27, 95% CI 0.53–3.00, p=0.59)
Trust score:4/5

30-day composite major adverse events

1 evidences

In patients with chronic kidney disease undergoing procedures with iodinated contrast, adding systemic hypothermia did not reduce risk of contrast-induced kidney injury.

Trust comment: Multicenter randomized trial in at-risk patients with centralized lab measurements; moderate sample size limits precision of subgroup effects.

Study Details

PMID:21676368
Participants:128
Impact:normothermia 37.1% vs hypothermia 37.9% (OR 0.97, 95% CI 0.47–1.98, p=0.93)
Trust score:4/5

dietary iron intake

1 evidences

Providing salt fortified with both iron and iodine increased dietary iron intake compared with iodine-only salt but did not change energy, other nutrient intakes, or anthropometric measures.

Trust comment: Randomized, double-masked trial with 245 participants and multiple dietary assessments, though outcomes limited to dietary/anthropometric measures.

Study Details

PMID:28760007
Participants:245
Impact:double-fortified salt increased iron intake vs iodine-only salt (P < .001)
Trust score:4/5

energy and other nutrient intakes

1 evidences

Providing salt fortified with both iron and iodine increased dietary iron intake compared with iodine-only salt but did not change energy, other nutrient intakes, or anthropometric measures.

Trust comment: Randomized, double-masked trial with 245 participants and multiple dietary assessments, though outcomes limited to dietary/anthropometric measures.

Study Details

PMID:28760007
Participants:245
Impact:no significant change attributable to double-fortified salt
Trust score:4/5

anthropometric/nutritional status indicators

1 evidences

Providing salt fortified with both iron and iodine increased dietary iron intake compared with iodine-only salt but did not change energy, other nutrient intakes, or anthropometric measures.

Trust comment: Randomized, double-masked trial with 245 participants and multiple dietary assessments, though outcomes limited to dietary/anthropometric measures.

Study Details

PMID:28760007
Participants:245
Impact:no significant change attributable to double-fortified salt
Trust score:4/5

contrast agent cost

1 evidences

In a small randomized study, CO2 contrast produced comparable angiographic images and clinical outcomes to iodine contrast without worsening kidney function and reduced contrast costs.

Trust comment: Prospective randomized study but small sample (n=35) and limited power to detect differences in renal outcomes.

Study Details

PMID:24704050
Participants:35
Impact:CO2 group had significantly lower contrast cost (p < 0.001)
Trust score:3/5

exit-site infection incidence

1 evidences

In peritoneal dialysis patients, daily care with polyhexanide reduced exit-site infections compared with traditional saline plus povidone-iodine care.

Trust comment: Single-center randomized trial with small sample and open-label design; results suggest benefit but generalizability is limited.

Study Details

PMID:24497599
Participants:46
Impact:traditional (saline + PVI) 20.0% vs polyhexanide 6.7% (p=0.032)
Trust score:3/5

total infection episodes

1 evidences

In peritoneal dialysis patients, daily care with polyhexanide reduced exit-site infections compared with traditional saline plus povidone-iodine care.

Trust comment: Single-center randomized trial with small sample and open-label design; results suggest benefit but generalizability is limited.

Study Details

PMID:24497599
Participants:46
Impact:traditional 9 infections vs polyhexanide 3 infections (p=0.037)
Trust score:3/5

infection rate per patient-months

1 evidences

In peritoneal dialysis patients, daily care with polyhexanide reduced exit-site infections compared with traditional saline plus povidone-iodine care.

Trust comment: Single-center randomized trial with small sample and open-label design; results suggest benefit but generalizability is limited.

Study Details

PMID:24497599
Participants:46
Impact:traditional 1/36.6 patient-months vs polyhexanide 1/102.7 patient-months (p=0.017)
Trust score:3/5

mean CFU count after disinfection

1 evidences

Povidone-iodine hand scrub left more bacteria after surgical disinfection than chlorhexidine scrub or a waterless hand rub.

Trust comment: Randomized controlled trial with objective microbiologic outcomes and large per-arm sample sizes supports moderate-high trust.

Study Details

PMID:27995837
Participants:240
Impact:Povidone: 4.3 vs chlorhexidine: 0.5 (higher by 3.8 CFU) and vs waterless: 1.4 (higher by 2.9 CFU); P<0.01 vs chlorhexidine
Trust score:4/5

mean CFU count after surgery

1 evidences

Povidone-iodine hand scrub left more bacteria after surgical disinfection than chlorhexidine scrub or a waterless hand rub.

Trust comment: Randomized controlled trial with objective microbiologic outcomes and large per-arm sample sizes supports moderate-high trust.

Study Details

PMID:27995837
Participants:240
Impact:No significant difference among groups
Trust score:4/5

procedure-related pain and movement

1 evidences

Different iodinated contrast agents produced different pain and image quality during lower-limb angiography.

Trust comment: Prospective study of 100 procedures but with subjective endpoints and limited detail on blinding.

Study Details

PMID:8944120
Participants:100
Impact:More pain and movement with iopamidol 370 vs ionic contrast media (p < 0.005)
Trust score:3/5

contrast image quality

1 evidences

Different iodinated contrast agents produced different pain and image quality during lower-limb angiography.

Trust comment: Prospective study of 100 procedures but with subjective endpoints and limited detail on blinding.

Study Details

PMID:8944120
Participants:100
Impact:Ioxaglate 350 had better contrast quality than others (p = 0.05)
Trust score:3/5

contrast (iodine) dose

1 evidences

Low-voltage CT angiography using a lower iodine dose provided reliable diagnostic images with less iodine exposure.

Trust comment: Randomized allocation to scanning protocols in 200 patients with objective image quantification gives good reliability.

Study Details

PMID:27903345
Participants:200
Impact:70 kV protocol used 53.5 ml (18.7 g iodine) vs 100 ml (35 g iodine) for 120 kV
Trust score:4/5

subjective image quality (crural segment)

1 evidences

Low-voltage CT angiography using a lower iodine dose provided reliable diagnostic images with less iodine exposure.

Trust comment: Randomized allocation to scanning protocols in 200 patients with objective image quantification gives good reliability.

Study Details

PMID:27903345
Participants:200
Impact:Higher for 70 kV vs 120 kV (2.20±0.36 vs 1.72±0.34; P = 0.001)
Trust score:4/5

hepatic enhancement (HU)

1 evidences

Longer delay after contrast injection (60 s) increased liver enhancement; iodine dose and volume affected vascular attenuation.

Trust comment: Well-sized clinical imaging study with clear quantitative endpoints but older and focused on technical parameters.

Study Details

PMID:7839963
Participants:169
Impact:60-sec delay > 45-sec delay for all three media (e.g., iohexol 300: 43 vs 32 HU; p ≤ 0.0001)
Trust score:3/5

portal vein attenuation

1 evidences

Longer delay after contrast injection (60 s) increased liver enhancement; iodine dose and volume affected vascular attenuation.

Trust comment: Well-sized clinical imaging study with clear quantitative endpoints but older and focused on technical parameters.

Study Details

PMID:7839963
Participants:169
Impact:Greater with 60-sec delay vs 45-sec delay (p = 0.0051)
Trust score:3/5

endogenous thrombin potential (ETP)

1 evidences

Both ionic and non-ionic iodinated contrast agents reduced thrombin generation after diagnostic angiography with no differential effects between agents.

Trust comment: Blinded-endpoint randomized trial with objective coagulation measures provides reliable evidence.

Study Details

PMID:26773574
Participants:100
Impact:Significant decrease after diagnostic angiography in both groups (ioxaglate baseline 1810 to 649 nM*min; iodixanol 1682 to 681 nM*min; p < 0.001), no difference between agents
Trust score:4/5

fibrinolytic markers and platelet activity

1 evidences

Both ionic and non-ionic iodinated contrast agents reduced thrombin generation after diagnostic angiography with no differential effects between agents.

Trust comment: Blinded-endpoint randomized trial with objective coagulation measures provides reliable evidence.

Study Details

PMID:26773574
Participants:100
Impact:No significant changes or differences between contrast media
Trust score:4/5

glans scabbing rate

1 evidences

In children after circumcision, application of wound induction gel resulted in fewer glans scabs and slightly faster wound healing than povidone-iodine application.

Trust comment: Small randomized pediatric trial that used povidone iodine as the control; outcomes are clear but sample size is limited.

Study Details

PMID:27172664
Participants:48
Impact:Gel 12.0% (3/25) vs povidone iodine 73.9% (17/23), P<0.05
Trust score:3/5

postoperative biliary tract infection rate

1 evidences

Randomized trial comparing radioactive I-125 seed-loaded biliary stents versus conventional stents found higher early postoperative biliary tract infection with the I-125 stent.

Trust comment: Randomized single-center RCT directly involving radioactive iodine (I-125) with well-defined infection endpoints and adequate reporting, though single-center and sample-size limitations noted.

Study Details

PMID:36468897
Participants:196
Impact:Radioactive I-125 stent 23.7% (23/97) vs conventional stent 11.1% (11/99), P=0.020 (higher with I-125)
Trust score:4/5

time to 50% bilirubin decrease

1 evidences

Randomized trial comparing radioactive I-125 seed-loaded biliary stents versus conventional stents found higher early postoperative biliary tract infection with the I-125 stent.

Trust comment: Randomized single-center RCT directly involving radioactive iodine (I-125) with well-defined infection endpoints and adequate reporting, though single-center and sample-size limitations noted.

Study Details

PMID:36468897
Participants:196
Impact:Infected patients 9.03 ± 1.53 days vs uninfected 3.94 ± 1.04 days, P<0.0001
Trust score:4/5

iodine intake adequacy

1 evidences

Observational analysis of diet in women with gestational diabetes found many had inadequate intakes of several nutrients including vitamin D.

Trust comment: Cross-sectional dietary-record study with moderate sample size and self-reported intake limits causal inference but findings on nutrient shortfalls are plausible.

Study Details

PMID:23602242
Participants:82
Impact:majority did not meet NRV for iodine (within reported 66%–99% range of inadequate nutrients)
Trust score:3/5

surgical site infection (planned primary outcome)

1 evidences

Statistical analysis plan for a planned randomized cluster-crossover trial comparing 10% povidone-iodine versus 4% chlorhexidine for preventing surgical site infections in open fractures.

Trust comment: Well-described multicenter randomized cluster-crossover protocol directly comparing povidone-iodine to chlorhexidine, but this SAP reports no outcome data yet.

Study Details

PMID:36096826
Participants:1540
Impact:No results reported (statistical analysis plan/protocol)
Trust score:3/5

all-cause mortality

1 evidences

Twice‑RDA multiple micronutrient supplement (including iodine) for six months did not change 12‑month mortality, growth, or CD4 counts versus standard multivitamins.

Trust comment: Large, double-blind randomized trial including iodine within a multi-nutrient intervention; high methodological quality but cannot isolate iodine-specific effects.

Study Details

PMID:20525230
Participants:847
Impact:25/426 (5.9%) intervention vs 28/421 (6.7%) comparative; absolute -0.8 percentage points, not significant (RR 0.9, 95% CI 0.5–1.5)
Trust score:4/5

plasma contrast reduction

1 evidences

In patients with moderately reduced renal function, post-angiography hemodialysis removed plasma contrast but did not reduce contrast-induced nephrotoxicity or change renal clearance outcomes.

Trust comment: Randomized study with objective renal endpoints but very small sample (n=32), limiting precision and generalizability.

Study Details

PMID:11186472
Participants:32
Impact:≈80% reduction in plasma contrast levels after hemodialysis
Trust score:3/5

renal iohexol clearance / GFR

1 evidences

In patients with moderately reduced renal function, post-angiography hemodialysis removed plasma contrast but did not reduce contrast-induced nephrotoxicity or change renal clearance outcomes.

Trust comment: Randomized study with objective renal endpoints but very small sample (n=32), limiting precision and generalizability.

Study Details

PMID:11186472
Participants:32
Impact:no significant difference between hemodialysis and control groups (measured day before vs 1 week after)
Trust score:3/5

contrast-induced nephrotoxicity incidence

1 evidences

In patients with moderately reduced renal function, post-angiography hemodialysis removed plasma contrast but did not reduce contrast-induced nephrotoxicity or change renal clearance outcomes.

Trust comment: Randomized study with objective renal endpoints but very small sample (n=32), limiting precision and generalizability.

Study Details

PMID:11186472
Participants:32
Impact:no reduction in incidence with post-procedure hemodialysis in GFR 10–25 mL/min
Trust score:3/5

Plaque index

2 evidences

In poorly controlled T2D patients, nonsurgical periodontal therapy including subgingival irrigation with 10% povidone-iodine significantly improved periodontal status and reduced HbA1c versus control.

Trust comment: Randomized, single-blind RCT with objective biological endpoints but small sample size limiting precision and generalizability.

Study Details

PMID:29482543
Participants:30
Impact:Treatment group PI reduced from 80.5% to 18.1% (Δ −56.5%, p<0.0001)
Trust score:4/5

Minocycline ointment produced greater improvement than the control treatment (10% iodine applied around teeth) in plaque index, probing depth, and sulcus bleeding index for early peri-implantitis.

Trust comment: Controlled clinical comparison with clear outcomes but limited methodological detail in abstract; iodine was the control topical agent rather than the primary intervention under study.

Study Details

PMID:31894045
Participants:180
Impact:Improvement with minocycline greater than 10% iodine control (p<0.05)
Trust score:3/5

Sulcus bleeding index

1 evidences

Minocycline ointment produced greater improvement than the control treatment (10% iodine applied around teeth) in plaque index, probing depth, and sulcus bleeding index for early peri-implantitis.

Trust comment: Controlled clinical comparison with clear outcomes but limited methodological detail in abstract; iodine was the control topical agent rather than the primary intervention under study.

Study Details

PMID:31894045
Participants:180
Impact:Minocycline group significantly superior to 10% iodine control (p<0.05)
Trust score:3/5

thyroid hormone normalization

1 evidences

Adding potassium bromide to methimazole produced faster symptom relief and normalized thyroid hormone levels more rapidly than methimazole alone.

Trust comment: Randomized trial (n=60) with clear biochemical and clinical endpoints but short (1 month) follow-up and small sample size.

Study Details

PMID:22186223
Participants:60
Impact:93% (combined) vs 37% (methimazole alone)
Trust score:3/5

time to clinical improvement

1 evidences

Adding potassium bromide to methimazole produced faster symptom relief and normalized thyroid hormone levels more rapidly than methimazole alone.

Trust comment: Randomized trial (n=60) with clear biochemical and clinical endpoints but short (1 month) follow-up and small sample size.

Study Details

PMID:22186223
Participants:60
Impact:~10 days earlier with combined therapy
Trust score:3/5

iodine contrast dose

2 evidences

Spectral CT at 60 keV with ASiR allowed about 25% less iodine contrast while maintaining or improving portal-venous image quality.

Trust comment: Prospective randomized imaging study (n=50) with objective image-quality metrics and statistically significant results; modest sample size.

Study Details

PMID:27031376
Participants:50
Impact:−25% (23.1 ± 3.2 g vs 30.5 ± 5.0 g)
Trust score:4/5

127 patients randomized to standard vs BMI-based individualized DECT CTPA: individualized protocol substantially reduced radiation and iodine doses (about 34% and ~57% respectively), improved SNR/CNR and reduced superior vena cava artifacts while maintaining or improving diagnostic image quality.

Trust comment: Prospective randomized study with objective and subjective image quality metrics and clear reductions in radiation/iodine dose; methods and endpoints are appropriate and well reported.

Study Details

PMID:37113033
Participants:127
Impact:Iodine intake reduced by ~56.95% (mean 9.04±1.40 gI vs 21 gI standard)
Trust score:4/5

intrahepatic portal vein contrast-to-noise ratio (CNR)

1 evidences

Spectral CT at 60 keV with ASiR allowed about 25% less iodine contrast while maintaining or improving portal-venous image quality.

Trust comment: Prospective randomized imaging study (n=50) with objective image-quality metrics and statistically significant results; modest sample size.

Study Details

PMID:27031376
Participants:50
Impact:4.2 ± 1.1 vs 3.0 ± 2.1 (60-keV spectral vs 120-kVp); p=0.03 (improved)
Trust score:4/5

overall visualization (VAS)

1 evidences

Iodixanol and iohexol provided similar radiographic quality in children, but iodixanol caused fewer adverse events (mainly diarrhea).

Trust comment: Randomized, double-blind, multicenter phase III trial in children with defined efficacy and safety endpoints.

Study Details

PMID:11893636
Participants:147
Impact:86 mm vs 82 mm (iodixanol vs iohexol); no significant difference
Trust score:4/5

adverse-event rate (diarrhea)

1 evidences

Iodixanol and iohexol provided similar radiographic quality in children, but iodixanol caused fewer adverse events (mainly diarrhea).

Trust comment: Randomized, double-blind, multicenter phase III trial in children with defined efficacy and safety endpoints.

Study Details

PMID:11893636
Participants:147
Impact:16.2% (iodixanol) vs 35.9% (iohexol); p=0.006 (fewer with iodixanol)
Trust score:4/5

infection-related hospital transfer risk

1 evidences

Universal decolonization with chlorhexidine bathing plus nasal povidone-iodine reduced infection-related and all-cause hospital transfers among nursing home residents.

Trust comment: Large cluster-randomized trial across 28 nursing homes (n=28,956) with significant and clinically important reductions in hospital transfers including use of nasal povidone-iodine.

Study Details

PMID:37815935
Participants:28956
Impact:difference in risk ratio vs routine care: 16.6% reduction (95% CI, 11.0 to 21.8)
Trust score:5/5

transfer to hospital for any reason

1 evidences

Universal decolonization with chlorhexidine bathing plus nasal povidone-iodine reduced infection-related and all-cause hospital transfers among nursing home residents.

Trust comment: Large cluster-randomized trial across 28 nursing homes (n=28,956) with significant and clinically important reductions in hospital transfers including use of nasal povidone-iodine.

Study Details

PMID:37815935
Participants:28956
Impact:difference in risk ratio vs routine care: 14.6% reduction (95% CI, 9.7 to 19.2); NNT 8.9 for one hospitalization prevented
Trust score:5/5

incisional surgical site infection (ISSI)

1 evidences

Randomized trial testing extra preoperative umbilicus preparation (in addition to standard povidone-iodine skin disinfection) versus control for incision infection and healing after TU-LESS.

Trust comment: Large randomized controlled trial with clear outcome reporting directly involving povidone-iodine use.

Study Details

PMID:36314980
Participants:400
Impact:no significant difference: 2.5% (prep) vs 1.5% (control), P=0.479
Trust score:4/5

excessive scarring

1 evidences

Randomized trial testing extra preoperative umbilicus preparation (in addition to standard povidone-iodine skin disinfection) versus control for incision infection and healing after TU-LESS.

Trust comment: Large randomized controlled trial with clear outcome reporting directly involving povidone-iodine use.

Study Details

PMID:36314980
Participants:400
Impact:higher in prep group: 3.1% vs 0.5% (trend), P=0.067
Trust score:4/5

umbilical hernia

1 evidences

Randomized trial testing extra preoperative umbilicus preparation (in addition to standard povidone-iodine skin disinfection) versus control for incision infection and healing after TU-LESS.

Trust comment: Large randomized controlled trial with clear outcome reporting directly involving povidone-iodine use.

Study Details

PMID:36314980
Participants:400
Impact:no events at 3 months (0%)
Trust score:4/5

coronary artery attenuation (HU)

1 evidences

Prospective randomized study testing different volumes of iodine-containing contrast medium for high-pitch CT coronary angiography and effects on vessel attenuation and image quality.

Trust comment: Prospective randomized clinical imaging study with direct measurements of iodine-based contrast effects on image quality.

Study Details

PMID:23949727
Participants:100
Impact:increased with higher contrast volume (mean ranges: G30 ~345–399 HU to G70 ~478–572 HU)
Trust score:4/5

segments ≥300 HU

1 evidences

Prospective randomized study testing different volumes of iodine-containing contrast medium for high-pitch CT coronary angiography and effects on vessel attenuation and image quality.

Trust comment: Prospective randomized clinical imaging study with direct measurements of iodine-based contrast effects on image quality.

Study Details

PMID:23949727
Participants:100
Impact:proportion rose with volume: 89% (30 mL), 95% (40 mL), 98% (50–60 mL), 99% (70 mL)
Trust score:4/5

sex effect on enhancement

1 evidences

Prospective randomized study testing different volumes of iodine-containing contrast medium for high-pitch CT coronary angiography and effects on vessel attenuation and image quality.

Trust comment: Prospective randomized clinical imaging study with direct measurements of iodine-based contrast effects on image quality.

Study Details

PMID:23949727
Participants:100
Impact:women had higher attenuation than men (P<0.0001)
Trust score:4/5

global cognitive performance (WPPSI-III scale scores)

1 evidences

Eating farmed Atlantic salmon three times weekly for 16 weeks increased EPA/DHA biomarkers and modestly improved two raw cognitive subtest scores but did not change global IQ scores in preschool children.

Trust comment: Randomized trial in 205 children with objective cognitive tests and biomarkers; results reported and statistically analyzed.

Study Details

PMID:30598384
Participants:205
Impact:no significant difference between salmon and meat groups
Trust score:4/5

symbol search subtest raw score

1 evidences

Eating farmed Atlantic salmon three times weekly for 16 weeks increased EPA/DHA biomarkers and modestly improved two raw cognitive subtest scores but did not change global IQ scores in preschool children.

Trust comment: Randomized trial in 205 children with objective cognitive tests and biomarkers; results reported and statistically analyzed.

Study Details

PMID:30598384
Participants:205
Impact:increased (salmon vs meat; p=0.038)
Trust score:4/5

Heart rate

1 evidences

Two double-blind randomized studies (216 patients) found no significant effects of different iodinated contrast media on heart rate or arterial/LV pressures, though non-serious adverse events were reported more often with iodixanol in coronary angiography.

Trust comment: Double-blind randomized studies with clear hemodynamic measurements in 216 patients; results directly relevant to effects of iodinated contrast on cardiovascular parameters.

Study Details

PMID:17376548
Participants:216
Impact:no significant difference between contrast agents (no change)
Trust score:4/5

left ventricular / arterial pressures

1 evidences

Two double-blind randomized studies (216 patients) found no significant effects of different iodinated contrast media on heart rate or arterial/LV pressures, though non-serious adverse events were reported more often with iodixanol in coronary angiography.

Trust comment: Double-blind randomized studies with clear hemodynamic measurements in 216 patients; results directly relevant to effects of iodinated contrast on cardiovascular parameters.

Study Details

PMID:17376548
Participants:216
Impact:no significant difference between contrast agents (no change)
Trust score:4/5

non-serious adverse events (possibly contrast-related)

1 evidences

Two double-blind randomized studies (216 patients) found no significant effects of different iodinated contrast media on heart rate or arterial/LV pressures, though non-serious adverse events were reported more often with iodixanol in coronary angiography.

Trust comment: Double-blind randomized studies with clear hemodynamic measurements in 216 patients; results directly relevant to effects of iodinated contrast on cardiovascular parameters.

Study Details

PMID:17376548
Participants:216
Impact:higher with iodixanol in coronary angiography (+6.6 percentage points vs iomeprol in CA; 23.3% vs 16.7%)
Trust score:4/5

vessel opacification

1 evidences

In a double-blind crossover study of 50 patients, two iodinated contrast agents produced similar angiographic image quality; iodixanol caused a tendency toward less warmth on injection.

Trust comment: Well-designed double-blind cross-over clinical study with objective and subjective measures; moderate sample size.

Study Details

PMID:10335967
Participants:50
Impact:no significant difference in densitometric measurements (p=0.14)
Trust score:4/5

subjective image quality

2 evidences

In a double-blind crossover study of 50 patients, two iodinated contrast agents produced similar angiographic image quality; iodixanol caused a tendency toward less warmth on injection.

Trust comment: Well-designed double-blind cross-over clinical study with objective and subjective measures; moderate sample size.

Study Details

PMID:10335967
Participants:50
Impact:no significant difference between agents (p=0.74)
Trust score:4/5

Gadolinium-based contrast with dual-energy reconstructions can yield good pulmonary CT angiography; iodine-based iohexol gave highest attenuation but more SVC artifacts.

Trust comment: Randomized feasibility study comparing iodine and gadolinium techniques; clinically relevant but technical and comparatively small.

Study Details

PMID:36190598
Participants:66
Impact:dual-energy Gd 40 keV had higher subjective image quality score than iohexol and other Gd scans
Trust score:3/5

injection warmth

1 evidences

In a double-blind crossover study of 50 patients, two iodinated contrast agents produced similar angiographic image quality; iodixanol caused a tendency toward less warmth on injection.

Trust comment: Well-designed double-blind cross-over clinical study with objective and subjective measures; moderate sample size.

Study Details

PMID:10335967
Participants:50
Impact:tendency toward lower warmth with iodixanol (trend)
Trust score:4/5

positive culture rate (all germs)

1 evidences

Adding subcutaneous povidone-iodine disinfection during shoulder surgery significantly reduced positive cultures for C. acnes and overall microbial contamination.

Trust comment: Prospective randomized single-blind clinical trial with clear microbial endpoints and adequate sample size.

Study Details

PMID:33421560
Participants:108
Impact:significantly reduced (p=0.036)
Trust score:4/5

Cutibacterium acnes culture rate

1 evidences

Adding subcutaneous povidone-iodine disinfection during shoulder surgery significantly reduced positive cultures for C. acnes and overall microbial contamination.

Trust comment: Prospective randomized single-blind clinical trial with clear microbial endpoints and adequate sample size.

Study Details

PMID:33421560
Participants:108
Impact:significantly reduced (p=0.013)
Trust score:4/5

contamination of surgeon's gloves and retractors (C. acnes)

1 evidences

Adding subcutaneous povidone-iodine disinfection during shoulder surgery significantly reduced positive cultures for C. acnes and overall microbial contamination.

Trust comment: Prospective randomized single-blind clinical trial with clear microbial endpoints and adequate sample size.

Study Details

PMID:33421560
Participants:108
Impact:reduced positive swabs (gloves p=0.041; retractors p=0.007)
Trust score:4/5

CT attenuation / image quality

1 evidences

In 120 patients, low-iodine-concentration contrast (iodixanol 270 mgI/ml) with low tube voltage and iterative reconstruction achieved comparable image quality to higher-concentration contrast while substantially reducing radiation dose.

Trust comment: Randomized assignment, objective imaging endpoints, and clear radiation dose measurements support good internal validity.

Study Details

PMID:25391867
Participants:120
Impact:no significant difference between low-concentration iodixanol 270 and higher concentration (no impairment)
Trust score:4/5

tumor-liver contrast (TLC)

1 evidences

In 135 patients, higher total iodine dose per kg improved tumor-liver contrast and lesion conspicuity for hypervascular HCC on dynamic CT; doses ≥525 mg I/kg recommended for best depiction.

Trust comment: Prospective randomized allocation with quantitative and qualitative imaging endpoints; moderate sample size.

Study Details

PMID:18356448
Participants:135
Impact:increased with higher iodine dose (26.5 H at 450 mg I/kg; 38.4 H at 525 mg I/kg; 52.3 H at 600 mg I/kg; significant differences)
Trust score:4/5

tumor conspicuity (qualitative score)

1 evidences

In 135 patients, higher total iodine dose per kg improved tumor-liver contrast and lesion conspicuity for hypervascular HCC on dynamic CT; doses ≥525 mg I/kg recommended for best depiction.

Trust comment: Prospective randomized allocation with quantitative and qualitative imaging endpoints; moderate sample size.

Study Details

PMID:18356448
Participants:135
Impact:improved with higher iodine dose (mean scores 1.6, 2.3, 2.7 for 450, 525, 600 mg I/kg respectively)
Trust score:4/5

mean aortic enhancement

1 evidences

In 97 patients, tailoring iodine dose to estimated lean body weight produced similar mean aortic enhancement as total body weight dosing but reduced interpatient variability.

Trust comment: Clinical CT study with clear quantitative endpoints and reasonable sample size; methods appropriate for question.

Study Details

PMID:19304716
Participants:97
Impact:no significant difference (308.9 HU LBW vs 314.1 HU TBW; p=0.61)
Trust score:4/5

interpatient variability in aortic enhancement

2 evidences

130 patients randomized to patient-specific iodine dose (p-COP) vs standard protocol for hepatic CT; p-COP reduced interpatient variability of aortic enhancement and increased the proportion achieving acceptable aortic enhancement without changing hepatic enhancement mean.

Trust comment: Randomized study with clear endpoints (enhancement values) and adequate sample (n=130); statistically significant reduction in aortic variability supports reliability of findings.

Study Details

PMID:32195801
Participants:130
Impact:Reduced SD for aortic enhancement in p-COP group (39.9 vs 56.5; P=0.006)
Trust score:4/5

In 97 patients, tailoring iodine dose to estimated lean body weight produced similar mean aortic enhancement as total body weight dosing but reduced interpatient variability.

Trust comment: Clinical CT study with clear quantitative endpoints and reasonable sample size; methods appropriate for question.

Study Details

PMID:19304716
Participants:97
Impact:reduced variability with LBW dosing (IQR 52.8 vs 79.1 HU)
Trust score:4/5

wound-healing rate

1 evidences

Compared artificial dermis + rb‑FGF versus standard povidone‑iodine gauze for residual infected burn wounds; artificial dermis + rb‑FGF showed better healing and bacterial clearance.

Trust comment: Randomized clinical study with 56 patients and clear, significant primary outcome differences (P<0.01); moderate-to-high internal validity.

Study Details

PMID:17605253
Participants:56
Impact:64.3% (artificial dermis + rb‑FGF) vs 32.1% (povidone‑iodine gauze); P<0.01
Trust score:4/5

Bacterial clearance rate

1 evidences

Compared artificial dermis + rb‑FGF versus standard povidone‑iodine gauze for residual infected burn wounds; artificial dermis + rb‑FGF showed better healing and bacterial clearance.

Trust comment: Randomized clinical study with 56 patients and clear, significant primary outcome differences (P<0.01); moderate-to-high internal validity.

Study Details

PMID:17605253
Participants:56
Impact:92.3% vs 72.0%; P<0.01
Trust score:4/5

Relative protein intake

1 evidences

A 12‑week dietary intervention to increase protein meals in older adults raised overall protein and several micronutrient intakes, including iodine, driven by more animal‑derived protein foods.

Trust comment: Randomized intervention with 56 older adults and clear nutrient intake changes; moderate quality but dietary self‑reporting limits certainty.

Study Details

PMID:34725773
Participants:56
Impact:NUTR: 0.99→1.43 g/kg; NUTR+EX: 0.90→1.57 g/kg (P<0.001)
Trust score:3/5

Other micronutrients (cholesterol, B vitamins, selenium)

1 evidences

A 12‑week dietary intervention to increase protein meals in older adults raised overall protein and several micronutrient intakes, including iodine, driven by more animal‑derived protein foods.

Trust comment: Randomized intervention with 56 older adults and clear nutrient intake changes; moderate quality but dietary self‑reporting limits certainty.

Study Details

PMID:34725773
Participants:56
Impact:All increased in NUTR and NUTR+EX (P<0.05)
Trust score:3/5

venous attenuation (CT value)

1 evidences

Lower tube voltage (80 kVp) increased venous attenuation and allowed reducing iodine contrast dose to 400 mgI/kg while maintaining image quality comparable to standard 600 mgI/kg at 120 kVp.

Trust comment: Prospective randomized trial directly manipulating iodine (mgI/kg) and imaging parameters; reasonably designed and directly relevant to iodine contrast dose and imaging outcomes.

Study Details

PMID:24887576
Participants:63
Impact:80 kVp images had significantly higher CT values than 120 kVp for all doses
Trust score:4/5

contrast dose reduction equivalence

1 evidences

Lower tube voltage (80 kVp) increased venous attenuation and allowed reducing iodine contrast dose to 400 mgI/kg while maintaining image quality comparable to standard 600 mgI/kg at 120 kVp.

Trust comment: Prospective randomized trial directly manipulating iodine (mgI/kg) and imaging parameters; reasonably designed and directly relevant to iodine contrast dose and imaging outcomes.

Study Details

PMID:24887576
Participants:63
Impact:400 mgI/kg at 80 kVp ≈ 600 mgI/kg at 120 kVp (no significant difference)
Trust score:4/5

opacification

1 evidences

Lower-strength iodine contrast produced diagnostically excellent neck CTs with fewer immediate minor side effects than higher-strength contrast.

Trust comment: Randomized study with blinded image assessment and objective measures but modest sample size.

Study Details

PMID:7834482
Participants:50
Impact:greater with 320 mgI/mL (p=0.0006)
Trust score:4/5

immediate minor complications

1 evidences

Lower-strength iodine contrast produced diagnostically excellent neck CTs with fewer immediate minor side effects than higher-strength contrast.

Trust comment: Randomized study with blinded image assessment and objective measures but modest sample size.

Study Details

PMID:7834482
Participants:50
Impact:+48 percentage points with 320 mgI/mL (92% vs 44%)
Trust score:4/5

maximum hepatic enhancement (MHE) prediction accuracy

1 evidences

Derived and tested a formula to predict liver CT enhancement from iodine dose and patient weight; accuracy similar to an existing formula.

Trust comment: Regression/modeling on 104 patients with measured outcomes; useful predictive work but residual error is notable.

Study Details

PMID:11383646
Participants:104
Impact:AR 1.04±0.20, AD 9.03±6.35 (no significant difference vs Heiken's formula)
Trust score:3/5

proposed predictive formula

1 evidences

Derived and tested a formula to predict liver CT enhancement from iodine dose and patient weight; accuracy similar to an existing formula.

Trust comment: Regression/modeling on 104 patients with measured outcomes; useful predictive work but residual error is notable.

Study Details

PMID:11383646
Participants:104
Impact:MHE = 13.2 · D / W^0.5
Trust score:3/5

average iodine uptake

1 evidences

A personalized diluted contrast protocol with a test bolus produced diagnostic craniocervical CTA while significantly reducing radiation dose and iodine uptake.

Trust comment: Prospective randomized design with objective dose and attenuation measures and diagnostic-quality imaging.

Study Details

PMID:39198109
Participants:86
Impact:significantly lower with the personalized low-concentration protocol (group B)
Trust score:4/5

arterial attenuation (CCA, ICA, MCA)

1 evidences

A personalized diluted contrast protocol with a test bolus produced diagnostic craniocervical CTA while significantly reducing radiation dose and iodine uptake.

Trust comment: Prospective randomized design with objective dose and attenuation measures and diagnostic-quality imaging.

Study Details

PMID:39198109
Participants:86
Impact:significantly lower in group B; ascending aorta and basilar artery densities similar between groups
Trust score:4/5

serum creatinine–defined nephrotoxicity (≥25% increase)

1 evidences

In patients with renal insufficiency receiving iodine contrast for emergency CT, IV NAC was associated with fewer creatinine-defined nephrotoxic events but no change by cystatin C.

Trust comment: Randomized trial in at-risk patients with objective renal biomarkers, though results differ by biomarker raising uncertainty.

Study Details

PMID:17715118
Participants:87
Impact:reduced by 16 percentage points with NAC (5% vs 21%, p=0.026)
Trust score:4/5

serum cystatin C–defined nephrotoxicity (≥25% increase)

1 evidences

In patients with renal insufficiency receiving iodine contrast for emergency CT, IV NAC was associated with fewer creatinine-defined nephrotoxic events but no change by cystatin C.

Trust comment: Randomized trial in at-risk patients with objective renal biomarkers, though results differ by biomarker raising uncertainty.

Study Details

PMID:17715118
Participants:87
Impact:no significant difference (17% vs 22%, p=0.59)
Trust score:4/5

Mucositis severity (WHO score)

1 evidences

Randomized trial in 40 HSCT patients comparing a supersaturated calcium phosphate rinse to routine oral care (control regimen included povidone‑iodine among other agents); SCPR group had less and shorter mucositis and less mouth pain and TPN use.

Trust comment: Randomized human trial but iodine was part of a combined control regimen (salvia/povidone‑iodine/fluconazole) so the specific effect of povidone‑iodine cannot be isolated; single‑center, non‑blinded.

Study Details

PMID:22736463
Participants:40
Impact:SCPR 0.9 vs control (included povidone‑iodine) 1.8 (p=0.02)
Trust score:3/5

Duration of mucositis (days)

1 evidences

Randomized trial in 40 HSCT patients comparing a supersaturated calcium phosphate rinse to routine oral care (control regimen included povidone‑iodine among other agents); SCPR group had less and shorter mucositis and less mouth pain and TPN use.

Trust comment: Randomized human trial but iodine was part of a combined control regimen (salvia/povidone‑iodine/fluconazole) so the specific effect of povidone‑iodine cannot be isolated; single‑center, non‑blinded.

Study Details

PMID:22736463
Participants:40
Impact:SCPR 3.2 d vs control 7.1 d (p=0.02)
Trust score:3/5

Peak mouth pain (VAS 0–10)

1 evidences

Randomized trial in 40 HSCT patients comparing a supersaturated calcium phosphate rinse to routine oral care (control regimen included povidone‑iodine among other agents); SCPR group had less and shorter mucositis and less mouth pain and TPN use.

Trust comment: Randomized human trial but iodine was part of a combined control regimen (salvia/povidone‑iodine/fluconazole) so the specific effect of povidone‑iodine cannot be isolated; single‑center, non‑blinded.

Study Details

PMID:22736463
Participants:40
Impact:SCPR 0.85 vs control 1.75 (p=0.005)
Trust score:3/5

surgical site infection (SSI) incidence

1 evidences

Randomized trial in 70 BPH surgery patients comparing 0.5% povidone‑iodine skin antisepsis to alcohol‑based chlorhexidine; no difference in surgical site infection risk was observed between antiseptics.

Trust comment: Randomized human trial directly testing povidone‑iodine versus chlorhexidine but single‑center with modest sample size, limiting power to detect small differences.

Study Details

PMID:25372452
Participants:70
Impact:No difference between povidone‑iodine and chlorhexidine antisepsis (SSI overall 18%; p=1.00)
Trust score:3/5

Total follicle lesion count change (comparator arm, povidone‑iodine)

1 evidences

Randomized multicenter pilot trial comparing turpentine ointment (verum), placebo, and a comparator disinfectant containing povidone‑iodine in 70 patients with acute folliculitis; primary endpoint differences were not statistically significant for the comparator (povidone‑iodine) vs placebo.

Trust comment: Randomized multicenter human pilot trial but open‑label and small; povidone‑iodine comparator did not show significant benefit versus placebo on the primary endpoint.

Study Details

PMID:38104550
Participants:70
Impact:Mean unweighted change day0–7 −1.3 (comparator) vs +0.4 (placebo); primary endpoint differences not statistically significant
Trust score:3/5

Weighted follicle lesion change (comparator)

1 evidences

Randomized multicenter pilot trial comparing turpentine ointment (verum), placebo, and a comparator disinfectant containing povidone‑iodine in 70 patients with acute folliculitis; primary endpoint differences were not statistically significant for the comparator (povidone‑iodine) vs placebo.

Trust comment: Randomized multicenter human pilot trial but open‑label and small; povidone‑iodine comparator did not show significant benefit versus placebo on the primary endpoint.

Study Details

PMID:38104550
Participants:70
Impact:Weighted mean change −4.2 (comparator) vs −0.1 (placebo); differences not significant for primary endpoint analysis
Trust score:3/5

body mass

1 evidences

Eating the iodine- and chromium-enriched Laminaria jam for 6 months led to larger weight loss, lower blood pressure, and better cholesterol than standard therapy.

Trust comment: Small controlled clinical comparison with statistically significant differences but limited by small sample size and unclear blinding/randomization.

Study Details

PMID:24006749
Participants:50
Impact:-5.0% (main group) vs -3.0% (comparison)
Trust score:3/5

LDL-C

1 evidences

Eating the iodine- and chromium-enriched Laminaria jam for 6 months led to larger weight loss, lower blood pressure, and better cholesterol than standard therapy.

Trust comment: Small controlled clinical comparison with statistically significant differences but limited by small sample size and unclear blinding/randomization.

Study Details

PMID:24006749
Participants:50
Impact:-28.3% (main group) vs -18.3% (comparison)
Trust score:3/5

heat/pain sensation (VAS)

1 evidences

During angiography, iomeprol caused less heat/pain sensation than iopentol by patient VAS scores.

Trust comment: Randomized, double-blind intraindividual study with clear VAS outcome differences (p < 0.01).

Study Details

PMID:8867434
Participants:29
Impact:median VAS 40 vs 70 (iomeprol vs iopentol, first injection); 60 vs 65 (second injection)
Trust score:4/5

patient motion

1 evidences

Nonionic iodine contrast caused less patient motion and improved CT scan quality compared with ionic contrast.

Trust comment: Prospective randomized study with objective motion measurement and consistent subjective quality improvement.

Study Details

PMID:9494478
Participants:98
Impact:0.44 mm/section (nonionic) vs 0.71 mm/section (ionic); reduction ~0.27 mm/section
Trust score:4/5

scan quality

1 evidences

Nonionic iodine contrast caused less patient motion and improved CT scan quality compared with ionic contrast.

Trust comment: Prospective randomized study with objective motion measurement and consistent subjective quality improvement.

Study Details

PMID:9494478
Participants:98
Impact:subjective and objective measures better with nonionic contrast (statistically significant)
Trust score:4/5

offspring low IQ (lowest 10%)

1 evidences

In mothers with borderline thyroid function, high maternal perchlorate in early pregnancy was linked to higher odds of low IQ in their children at age 3.

Trust comment: Retrospective analysis of a large antenatal cohort with biologically plausible findings but observational and limited to thyroid-dysfunctional subgroup.

Study Details

PMID:25057878
Participants:487
Impact:OR = 3.14 (95% CI 1.38–7.13) for highest 10% maternal perchlorate
Trust score:3/5

offspring verbal IQ (lowest 10%)

1 evidences

In mothers with borderline thyroid function, high maternal perchlorate in early pregnancy was linked to higher odds of low IQ in their children at age 3.

Trust comment: Retrospective analysis of a large antenatal cohort with biologically plausible findings but observational and limited to thyroid-dysfunctional subgroup.

Study Details

PMID:25057878
Participants:487
Impact:OR = 3.14 (95% CI 1.42–6.90)
Trust score:3/5

stent image quality (Likert)

1 evidences

Two different iodine contrast concentrations produced similar stent image quality on coronary CT; image quality mainly influenced by stent diameter, heart rate variation, and LAI ratio.

Trust comment: Prospective, double-blind randomized non-inferiority trial with clear endpoints but modest sample size.

Study Details

PMID:32816561
Participants:65
Impact:4.48 ± 0.75 vs 4.54 ± 0.65 (Iopamidol-370 vs Ioversol-320), p = 0.5 (no significant difference)
Trust score:4/5

lumen attenuation increase (LAI) ratio

1 evidences

Two different iodine contrast concentrations produced similar stent image quality on coronary CT; image quality mainly influenced by stent diameter, heart rate variation, and LAI ratio.

Trust comment: Prospective, double-blind randomized non-inferiority trial with clear endpoints but modest sample size.

Study Details

PMID:32816561
Participants:65
Impact:0.39 ± 0.42 vs 0.48 ± 0.44 (I-370 vs I-320), p = 0.08 (no significant difference)
Trust score:4/5

contrast dose

1 evidences

Using lower tube voltage with proportionally lower iodine dose maintained or improved CT image quality while substantially reducing contrast dose and injection rate.

Trust comment: Randomized prospective trial in 90 patients demonstrating preserved or improved image quality with lower iodine flow and tube voltage.

Study Details

PMID:38693081
Participants:90
Impact:-46% (group C vs group A; 42.7 ± 8.6 vs 79.48 ± 12.24 mgI/kg)
Trust score:4/5

contrast injection rate

1 evidences

Using lower tube voltage with proportionally lower iodine dose maintained or improved CT image quality while substantially reducing contrast dose and injection rate.

Trust comment: Randomized prospective trial in 90 patients demonstrating preserved or improved image quality with lower iodine flow and tube voltage.

Study Details

PMID:38693081
Participants:90
Impact:-22% (2.1 ± 0.4 vs 2.7 ± 0.41 ml/s; group C vs A)
Trust score:4/5

image quality and CT metrics

1 evidences

Using lower tube voltage with proportionally lower iodine dose maintained or improved CT image quality while substantially reducing contrast dose and injection rate.

Trust comment: Randomized prospective trial in 90 patients demonstrating preserved or improved image quality with lower iodine flow and tube voltage.

Study Details

PMID:38693081
Participants:90
Impact:group C showed higher CT values, lower noise, and higher SNR/CNR in most regions (P < 0.05); subjective image scores not significantly different
Trust score:4/5

first stimulated thyroglobulin (sTg)

1 evidences

Sentinel lymph node biopsy detected occult lateral metastases but did not change stimulated thyroglobulin after ablation or recurrence rates at median 39-month follow-up.

Trust comment: Randomized controlled trial with adequate sample size and median 39-month follow-up, though some sTg data were missing for subsets.

Study Details

PMID:25633731
Participants:283
Impact:lower in LSLNB group (P = 0.012)
Trust score:4/5

urinary iodine excretion (µg/24 h)

1 evidences

Low-dose iodide (0.2 mg/day) for 12 months reduced thyroid size in adults with endemic goiter but triggered reversible thyroid autoimmunity/dysfunction in a minority.

Trust comment: Randomized, double-blind, placebo-controlled trial with clear clinical outcomes but modest sample size.

Study Details

PMID:9398711
Participants:62
Impact:I group: baseline 32 → 213 at 12 months (P=0.0001); placebo ~34 → 33 (no change)
Trust score:4/5

iodine-induced autoimmunity / thyroid dysfunction

1 evidences

Low-dose iodide (0.2 mg/day) for 12 months reduced thyroid size in adults with endemic goiter but triggered reversible thyroid autoimmunity/dysfunction in a minority.

Trust comment: Randomized, double-blind, placebo-controlled trial with clear clinical outcomes but modest sample size.

Study Details

PMID:9398711
Participants:62
Impact:3/31 (9.7%) developed high autoantibodies with lymphocytic infiltration; 2 developed hypothyroidism, 1 hyperthyroidism (reversible)
Trust score:4/5

operative bleeding volume (mL)

1 evidences

Compared a sequential thyroid defunctionalization preoperative method to conventional antithyroid drugs plus iodine; the test method reduced bleeding and complications.

Trust comment: Large clinical series with randomized grouping reported benefit in bleeding and complications, but reporting language and methodological detail limit full certainty.

Study Details

PMID:17953380
Participants:476
Impact:Control: 324.76±163.26 mL; Subgroup A: 195.74±57.07 mL; B: 230.00±70.81 mL; C: 240.47±80.29 mL; D: 314.75±96.46 mL (A–C significantly lower vs control, P<0.05)
Trust score:3/5

Total hair mercury (THHg)

1 evidences

Pregnant women randomized to eat 400 g cod/week for 16 weeks had slightly higher hair mercury levels overall, but levels remained generally low.

Trust comment: Randomized controlled trial in pregnant women with objective biomarker measurements and moderate sample size; primary intervention intended to increase iodine status though reported outcomes focus on mercury.

Study Details

PMID:32388274
Participants:137
Impact:Median 554 vs 485 µg/kg (intervention vs control), difference +69 µg/kg; P=0.186 overall; significant increase in subgroup with baseline <534 µg/kg
Trust score:4/5

Proportion exceeding US EPA hair reference (1000 µg/kg)

1 evidences

Pregnant women randomized to eat 400 g cod/week for 16 weeks had slightly higher hair mercury levels overall, but levels remained generally low.

Trust comment: Randomized controlled trial in pregnant women with objective biomarker measurements and moderate sample size; primary intervention intended to increase iodine status though reported outcomes focus on mercury.

Study Details

PMID:32388274
Participants:137
Impact:8% overall exceeded reference (intervention n=6, control n=4)
Trust score:4/5

Maximum pancreatic enhancement (Hounsfield units)

1 evidences

Higher iodine dose and faster injection rate of iodinated contrast produced greater pancreatic enhancement (higher HU) on CT.

Trust comment: Randomized human imaging study with quantitative objective CT measures directly testing effects of iodinated contrast dose and injection rate.

Study Details

PMID:10405745
Participants:126
Impact:Group means: 99±18 (group1) vs 90±18 (group2) vs 86±15 (group3) vs 74±13 (group4); higher iodine dose and faster rate increased enhancement (multiple pairwise significant differences)
Trust score:4/5

hospitalization duration

1 evidences

Randomized trial (MEBO versus standard therapy using povidone iodine plus bepanthenol) in ~211 hospitalized patients with partial-thickness burns: MEBO reduced hospital stay, time to 50% wound healing (superficial burns), and pain/analgesic use compared with the povidone-iodine standard.

Trust comment: Large randomized trial with blinded outcome assessment and clear clinical endpoints; single-centre and some limitations (short follow-up, subgroup power issues) but overall reliable.

Study Details

PMID:22132709
Participants:211
Impact:Standard (povidone iodine) associated with ~1 day longer stay vs MEBO (MEBO reduced stay by ~1 day; p=0.03 total groups)
Trust score:4/5

Time to 50% wound healing (TEWL)

1 evidences

Randomized trial (MEBO versus standard therapy using povidone iodine plus bepanthenol) in ~211 hospitalized patients with partial-thickness burns: MEBO reduced hospital stay, time to 50% wound healing (superficial burns), and pain/analgesic use compared with the povidone-iodine standard.

Trust comment: Large randomized trial with blinded outcome assessment and clear clinical endpoints; single-centre and some limitations (short follow-up, subgroup power issues) but overall reliable.

Study Details

PMID:22132709
Participants:211
Impact:Standard therapy had ~2 days longer time to 50% healing in superficial partial-thickness burns (10.75 vs 8.7 days; p=0.00)
Trust score:4/5

Pain / analgesic use

1 evidences

Randomized trial (MEBO versus standard therapy using povidone iodine plus bepanthenol) in ~211 hospitalized patients with partial-thickness burns: MEBO reduced hospital stay, time to 50% wound healing (superficial burns), and pain/analgesic use compared with the povidone-iodine standard.

Trust comment: Large randomized trial with blinded outcome assessment and clear clinical endpoints; single-centre and some limitations (short follow-up, subgroup power issues) but overall reliable.

Study Details

PMID:22132709
Participants:211
Impact:Higher pain and greater paracetamol (and paracetamol+codeine) use in povidone-iodine group (e.g., paracetamol use higher: 95.3% vs 84.3%)
Trust score:4/5

Rate of acceptable aortic enhancement (250–350 HU)

1 evidences

130 patients randomized to patient-specific iodine dose (p-COP) vs standard protocol for hepatic CT; p-COP reduced interpatient variability of aortic enhancement and increased the proportion achieving acceptable aortic enhancement without changing hepatic enhancement mean.

Trust comment: Randomized study with clear endpoints (enhancement values) and adequate sample (n=130); statistically significant reduction in aortic variability supports reliability of findings.

Study Details

PMID:32195801
Participants:130
Impact:Higher rate in p-COP group (P<0.01)
Trust score:4/5

Hepatic enhancement variability

1 evidences

130 patients randomized to patient-specific iodine dose (p-COP) vs standard protocol for hepatic CT; p-COP reduced interpatient variability of aortic enhancement and increased the proportion achieving acceptable aortic enhancement without changing hepatic enhancement mean.

Trust comment: Randomized study with clear endpoints (enhancement values) and adequate sample (n=130); statistically significant reduction in aortic variability supports reliability of findings.

Study Details

PMID:32195801
Participants:130
Impact:No significant difference between p-COP and standard protocol (P=0.871)
Trust score:4/5

Radiation dose (ED)

1 evidences

127 patients randomized to standard vs BMI-based individualized DECT CTPA: individualized protocol substantially reduced radiation and iodine doses (about 34% and ~57% respectively), improved SNR/CNR and reduced superior vena cava artifacts while maintaining or improving diagnostic image quality.

Trust comment: Prospective randomized study with objective and subjective image quality metrics and clear reductions in radiation/iodine dose; methods and endpoints are appropriate and well reported.

Study Details

PMID:37113033
Participants:127
Impact:Decreased by ~33.9% in individualized group (CTDIvol, DLP and ED all significantly lower; P<0.05)
Trust score:4/5

Image quality / SVC artifacts

1 evidences

127 patients randomized to standard vs BMI-based individualized DECT CTPA: individualized protocol substantially reduced radiation and iodine doses (about 34% and ~57% respectively), improved SNR/CNR and reduced superior vena cava artifacts while maintaining or improving diagnostic image quality.

Trust comment: Prospective randomized study with objective and subjective image quality metrics and clear reductions in radiation/iodine dose; methods and endpoints are appropriate and well reported.

Study Details

PMID:37113033
Participants:127
Impact:Improved image quality (best at 60 keV+80% ASIR-V) and marked reduction in SVC beam-hardening artifacts (69.84%→7.81% affecting diagnosis)
Trust score:4/5

signal-to-noise and contrast-to-noise ratio (SNR/CNR)

1 evidences

Reducing injection rate and contrast dose (iodine-containing agent) in 3D DSA was feasible and produced satisfactory images.

Trust comment: Randomized groups, objective quantitative imaging metrics, moderate sample size and clear outcomes.

Study Details

PMID:26916657
Participants:51
Impact:significant differences between groups (M1 and A1 segments; A vs C significant for all segments)
Trust score:4/5

image quality (physician scores)

1 evidences

Reducing injection rate and contrast dose (iodine-containing agent) in 3D DSA was feasible and produced satisfactory images.

Trust comment: Randomized groups, objective quantitative imaging metrics, moderate sample size and clear outcomes.

Study Details

PMID:26916657
Participants:51
Impact:no significant difference between groups
Trust score:4/5

coronary CT attenuation

1 evidences

Using 80 kVp plus iterative reconstruction allowed reduction of iodine contrast dose while maintaining or improving some image metrics and lowering radiation dose.

Trust comment: Randomized 3-arm human study with objective image and dose metrics and adequate sample size.

Study Details

PMID:25677790
Participants:90
Impact:tended to be higher under protocol B (80 kVp, 25% CM reduction)
Trust score:4/5

optimal arterial-phase scan delay

1 evidences

Timing after iodine contrast threshold (50 H in aorta) of 10–15 s and 45–55 s optimizes arterial and portal venous phases for detecting hypervascular HCCs.

Trust comment: Prospective randomized timing study with objective quantitative enhancement measures in a large patient cohort.

Study Details

PMID:16794136
Participants:171
Impact:10–15 seconds after 50 H aortic threshold (max HCC-to-liver contrast at 10–15 s)
Trust score:4/5

optimal portal-venous-phase scan delay

1 evidences

Timing after iodine contrast threshold (50 H in aorta) of 10–15 s and 45–55 s optimizes arterial and portal venous phases for detecting hypervascular HCCs.

Trust comment: Prospective randomized timing study with objective quantitative enhancement measures in a large patient cohort.

Study Details

PMID:16794136
Participants:171
Impact:45–55 seconds (peak liver parenchyma enhancement)
Trust score:4/5

contrast enhancement index (CEI) timing

1 evidences

Timing after iodine contrast threshold (50 H in aorta) of 10–15 s and 45–55 s optimizes arterial and portal venous phases for detecting hypervascular HCCs.

Trust comment: Prospective randomized timing study with objective quantitative enhancement measures in a large patient cohort.

Study Details

PMID:16794136
Participants:171
Impact:aorta and spleen peak early (10–20 s), liver CEI peaks at 45–55 s
Trust score:4/5

aortic and arterial enhancement

1 evidences

In patients undergoing abdominal MDCT, shorter (25 s) contrast injection increased early aortic/arterial enhancement while longer (35 s) injection increased liver enhancement; pancreas unchanged.

Trust comment: Prospective randomized study in 116 humans with quantitative and qualitative measurements supports reliable imaging comparisons.

Study Details

PMID:20650587
Participants:116
Impact:higher with 25-s injection vs 35-s in first phase (P<0.001)
Trust score:4/5

hepatic enhancement

1 evidences

In patients undergoing abdominal MDCT, shorter (25 s) contrast injection increased early aortic/arterial enhancement while longer (35 s) injection increased liver enhancement; pancreas unchanged.

Trust comment: Prospective randomized study in 116 humans with quantitative and qualitative measurements supports reliable imaging comparisons.

Study Details

PMID:20650587
Participants:116
Impact:higher with 35-s injection vs 25-s in first (P<0.001) and second (P<0.01) phases
Trust score:4/5

pancreatic enhancement

1 evidences

In patients undergoing abdominal MDCT, shorter (25 s) contrast injection increased early aortic/arterial enhancement while longer (35 s) injection increased liver enhancement; pancreas unchanged.

Trust comment: Prospective randomized study in 116 humans with quantitative and qualitative measurements supports reliable imaging comparisons.

Study Details

PMID:20650587
Participants:116
Impact:no difference between 25-s and 35-s protocols
Trust score:4/5

dietary glycemic load effect on nutrient intake

1 evidences

Observational analysis of diet in women with gestational diabetes found many had inadequate intakes of several nutrients including vitamin D.

Trust comment: Cross-sectional dietary-record study with moderate sample size and self-reported intake limits causal inference but findings on nutrient shortfalls are plausible.

Study Details

PMID:23602242
Participants:82
Impact:higher glycemic load associated with lower intakes of total, mono- and polyunsaturated fat, vitamin E, and potassium (all P<0.001)
Trust score:3/5

vascular CT attenuation

1 evidences

In selected patients, 70 kVp CCTA with half the usual contrast volume produced higher vessel attenuation, higher image noise and lower SNR/CNR in some coronary vessels, but achieved substantially lower radiation dose and diagnostic image quality in most cases.

Trust comment: Prospective randomized allocation with objective metrics and clear dose/contrast reductions in a well-defined patient sample supports high reliability for imaging conclusions.

Study Details

PMID:25396334
Participants:150
Impact:higher in 70 and 80 kVp groups vs 100 kVp (P<0.001)
Trust score:4/5

signal-to-noise and contrast-to-noise ratios (image quality)

1 evidences

In selected patients, 70 kVp CCTA with half the usual contrast volume produced higher vessel attenuation, higher image noise and lower SNR/CNR in some coronary vessels, but achieved substantially lower radiation dose and diagnostic image quality in most cases.

Trust comment: Prospective randomized allocation with objective metrics and clear dose/contrast reductions in a well-defined patient sample supports high reliability for imaging conclusions.

Study Details

PMID:25396334
Participants:150
Impact:SNR lower in 70 kVp vs 80/100 (P<0.05); CNR lower in 70 kVp for RCA, LAD, LCX (P<0.05)
Trust score:4/5

radiation dose and contrast volume

1 evidences

In selected patients, 70 kVp CCTA with half the usual contrast volume produced higher vessel attenuation, higher image noise and lower SNR/CNR in some coronary vessels, but achieved substantially lower radiation dose and diagnostic image quality in most cases.

Trust comment: Prospective randomized allocation with objective metrics and clear dose/contrast reductions in a well-defined patient sample supports high reliability for imaging conclusions.

Study Details

PMID:25396334
Participants:150
Impact:70 kVp protocol reduced radiation dose by ~56% vs 80 kVp and ~75% vs 100 kVp and used 30 mL contrast (50% reduction vs 60 mL)
Trust score:4/5

organ misalignment (coregistration)

1 evidences

In randomized PET/CT protocols, single-phase CT during normal expiration (protocol B) produced the best organ coregistration (least misalignment) and, along with protocol D, the best CT image quality compared with multiphase approaches.

Trust comment: Randomized study in 60 patients with objective misalignment and artifact assessments provides reasonably robust technical evidence though sample size is modest.

Study Details

PMID:16513616
Participants:60
Impact:misalignment significantly lower for protocol B (single-phase NormExp) in almost all organs compared with others
Trust score:4/5

CT image quality (artifacts)

1 evidences

In randomized PET/CT protocols, single-phase CT during normal expiration (protocol B) produced the best organ coregistration (least misalignment) and, along with protocol D, the best CT image quality compared with multiphase approaches.

Trust comment: Randomized study in 60 patients with objective misalignment and artifact assessments provides reasonably robust technical evidence though sample size is modest.

Study Details

PMID:16513616
Participants:60
Impact:best CT image quality with lowest occurrence of artifacts in protocols B and D (NormExp)
Trust score:4/5

5-year PSA relapse-free survival (PSA-RFS)

1 evidences

Large cohort study of brachytherapy for localized prostate cancer; Iodine-125 seed monotherapy produced excellent 5-year biochemical control, and higher delivered dose (D90>140 Gy) was associated with better outcomes.

Trust comment: Large patient series with clear outcome measures and strong sample size; observational design (retrospective/prospective registry) limits causal inference but data are robust.

Study Details

PMID:21925957
Participants:1466
Impact:favorable-risk 98%, intermediate-risk 95%, high-risk 80% (5-year PSA-RFS)
Trust score:4/5

D90 dose effect

1 evidences

Large cohort study of brachytherapy for localized prostate cancer; Iodine-125 seed monotherapy produced excellent 5-year biochemical control, and higher delivered dose (D90>140 Gy) was associated with better outcomes.

Trust comment: Large patient series with clear outcome measures and strong sample size; observational design (retrospective/prospective registry) limits causal inference but data are robust.

Study Details

PMID:21925957
Participants:1466
Impact:D90 >140 Gy associated with improved biochemical tumor control vs lower D90
Trust score:4/5

image quality (SNR/CNR in aorta, LV, venous graft)

1 evidences

Using 80 kVp low-iodine contrast protocol with IMR in CABG patients reduced radiation and iodine load and improved image quality for aorta, left ventricle and venous grafts.

Trust comment: Prospective randomized study in 71 CABG patients with objective imaging metrics and clear outcome measures.

Study Details

PMID:30606383
Participants:71
Impact:increased (SNR e.g. ascending aorta 19±5 vs 16±6; CNR 17±4.7 vs 14±5.5; statistically significant)
Trust score:4/5

arterial phase vascular/myocardial enhancement

1 evidences

Iodixanol 320 provided similar arterial vascular/myocardial enhancement to iohexol 350 but produced greater delayed LV myocardial enhancement.

Trust comment: Randomized consecutive enrolment of 72 patients comparing two iodinated contrast agents with objective CT measures.

Study Details

PMID:18094272
Participants:72
Impact:no significant difference (p>0.05)
Trust score:4/5

LV myocardium delayed enhancement

1 evidences

Iodixanol 320 provided similar arterial vascular/myocardial enhancement to iohexol 350 but produced greater delayed LV myocardial enhancement.

Trust comment: Randomized consecutive enrolment of 72 patients comparing two iodinated contrast agents with objective CT measures.

Study Details

PMID:18094272
Participants:72
Impact:+7.7 HU (significant, p<0.05)
Trust score:4/5

conjunctival bacteria elimination after 2.5% PVI irrigation

1 evidences

Topical antibiotics combined with 2.5% povidone-iodine (PVI) irrigation substantially reduced conjunctival bacterial carriage immediately prior to cataract surgery.

Trust comment: Randomized clinical study in 135 patients showing substantial reduction in conjunctival bacteria after standardized PVI irrigation.

Study Details

PMID:20137430
Participants:135
Impact:immediate elimination ~86–90% (varied by group)
Trust score:4/5

antibiotic sensitivity of Gram-positive cocci

1 evidences

Topical antibiotics combined with 2.5% povidone-iodine (PVI) irrigation substantially reduced conjunctival bacterial carriage immediately prior to cataract surgery.

Trust comment: Randomized clinical study in 135 patients showing substantial reduction in conjunctival bacteria after standardized PVI irrigation.

Study Details

PMID:20137430
Participants:135
Impact:levofloxacin 94.8% vs tobramycin 74.1% (P=0.000)
Trust score:4/5

Overall CAUTI cumulative incidence (day 10)

1 evidences

Expanded periurethral cleansing with povidone-iodine reduced catheter-associated urinary infections versus usual cleansing in comatose ICU patients.

Trust comment: Randomized, single-blind RCT with objective microbiological outcomes and adequate completed sample (n=446); monocentric and single-blinded to staff limits generalizability.

Study Details

PMID:38741134
Participants:446
Impact:-11.05 percentage points (10.22% vs 21.27%)
Trust score:4/5

Bacterial CAUTI incidence (day 10)

1 evidences

Expanded periurethral cleansing with povidone-iodine reduced catheter-associated urinary infections versus usual cleansing in comatose ICU patients.

Trust comment: Randomized, single-blind RCT with objective microbiological outcomes and adequate completed sample (n=446); monocentric and single-blinded to staff limits generalizability.

Study Details

PMID:38741134
Participants:446
Impact:-5.97 percentage points (4.89% vs 10.86%)
Trust score:4/5

Polymicrobial CAUTI incidence (day 10)

1 evidences

Expanded periurethral cleansing with povidone-iodine reduced catheter-associated urinary infections versus usual cleansing in comatose ICU patients.

Trust comment: Randomized, single-blind RCT with objective microbiological outcomes and adequate completed sample (n=446); monocentric and single-blinded to staff limits generalizability.

Study Details

PMID:38741134
Participants:446
Impact:-3.18 percentage points (0.89% vs 4.07%)
Trust score:4/5

Salt (sodium) intake

1 evidences

In a small randomized subsample, an 8-week whole-food plant-based diet reduced weight, HbA1c and several cardiometabolic risk factors but decreased intake of some micronutrients including vitamin D and calcium.

Trust comment: Randomized trial with weighed food records but small analyzed subsample (n=37) and potential reporting/selection bias for dietary records.

Study Details

PMID:36364858
Participants:37
Impact:-~1.1 g (significantly lower in PBD vs control, p < 0.001)
Trust score:3/5

Stapler pin contamination

1 evidences

Rectal washout with povidone-iodine reduced rectal mucosa contamination but did not reduce contamination of the stapler pin or postoperative infection rates.

Trust comment: Patient- and assessor-blinded RCT with objective microbiological endpoints; sample moderate and primary endpoint is a surrogate of intraabdominal contamination.

Study Details

PMID:30463785
Participants:69
Impact:No significant change (RW-PI 39.1% vs RW-R 33.3% vs RW 52.0%; P = 0.421)
Trust score:4/5

Rectal mucosa contamination

1 evidences

Rectal washout with povidone-iodine reduced rectal mucosa contamination but did not reduce contamination of the stapler pin or postoperative infection rates.

Trust comment: Patient- and assessor-blinded RCT with objective microbiological endpoints; sample moderate and primary endpoint is a surrogate of intraabdominal contamination.

Study Details

PMID:30463785
Participants:69
Impact:Reduced: 47.8% (RW-PI) vs 95.2% (RW-R) vs 100% (RW); P < 0.001
Trust score:4/5

Peritoneal contamination

1 evidences

Rectal washout with povidone-iodine reduced rectal mucosa contamination but did not reduce contamination of the stapler pin or postoperative infection rates.

Trust comment: Patient- and assessor-blinded RCT with objective microbiological endpoints; sample moderate and primary endpoint is a surrogate of intraabdominal contamination.

Study Details

PMID:30463785
Participants:69
Impact:Trend to reduction with PI (39.1% vs 71.4% vs 60.0%; P = 0.09)
Trust score:4/5

Arterial phase aortic enhancement

1 evidences

Iomeprol-400 produced greater arterial and portal venous enhancement on MDCT than iodixanol-320 with similar safety profiles.

Trust comment: Large comparative study with blinded independent readers and objective HU measures; clinically relevant for iodinated contrast selection.

Study Details

PMID:19064592
Participants:183
Impact:Greater with iomeprol-400: 337.3 HU vs 294.9 HU (Reader1); difference significant (p=0.0004)
Trust score:4/5

Portal venous liver parenchyma enhancement

1 evidences

Iomeprol-400 produced greater arterial and portal venous enhancement on MDCT than iodixanol-320 with similar safety profiles.

Trust comment: Large comparative study with blinded independent readers and objective HU measures; clinically relevant for iodinated contrast selection.

Study Details

PMID:19064592
Participants:183
Impact:Greater with iomeprol-400: 115.1 HU vs 108.6 HU (Reader1); difference significant (p=0.04)
Trust score:4/5

Procedural success / operative metrics

1 evidences

CO2 contrast produced similar procedural outcomes to iodine contrast for EVAR in patients without contraindications to iodine, though many procedures required supplemental iodine contrast.

Trust comment: Prospective randomized study but small (n=36) and high rate of supplemental iodine use limits interpretation of CO2 as sole alternative.

Study Details

PMID:27671460
Participants:36
Impact:Similar between CO2 and iodine groups (duration, fluoroscopy, costs of materials)
Trust score:3/5

Need for supplemental iodine contrast

1 evidences

CO2 contrast produced similar procedural outcomes to iodine contrast for EVAR in patients without contraindications to iodine, though many procedures required supplemental iodine contrast.

Trust comment: Prospective randomized study but small (n=36) and high rate of supplemental iodine use limits interpretation of CO2 as sole alternative.

Study Details

PMID:27671460
Participants:36
Impact:62.5% of CO2 group required additional iodine contrast
Trust score:3/5

Renal function / hypersensitivity

1 evidences

CO2 contrast produced similar procedural outcomes to iodine contrast for EVAR in patients without contraindications to iodine, though many procedures required supplemental iodine contrast.

Trust comment: Prospective randomized study but small (n=36) and high rate of supplemental iodine use limits interpretation of CO2 as sole alternative.

Study Details

PMID:27671460
Participants:36
Impact:No changes in creatinine clearance and no hypersensitivity with CO2
Trust score:3/5

serum selenium

1 evidences

Two long-term dietary patterns affected several serum minerals over 24 months; serum calcium showed no significant change while other minerals (selenium, manganese, magnesium) increased and serum zinc decreased.

Trust comment: Large randomized controlled trial with repeated measures and adequate sample, but mineral status was an incidental (not primary) outcome.

Study Details

PMID:38701651
Participants:368
Impact:increase
Trust score:4/5

diagnostic efficacy (angiogram quality)

1 evidences

Double-blind randomized trial of two iodine-containing contrast agents in cerebral angiography found similar diagnostic efficacy and no significant difference in adverse event rates.

Trust comment: Randomized double-blind phase III trial but small sample size limits precision of adverse event comparisons.

Study Details

PMID:8883527
Participants:49
Impact:comparable between agents
Trust score:3/5

clinical infection incidence

1 evidences

Study of children with minor school injuries comparing topical treatments found the novel gel reduced clinical infections; povidone-iodine was a comparator.

Trust comment: Pragmatic comparative clinical trial in children with clear clinical endpoints, but limited detail on group-level infection rates for povidone-iodine in excerpt.

Study Details

PMID:9161648
Participants:177
Impact:9/177 infections overall; novel gel reduced incidence (statistically significant vs comparator groups)
Trust score:3/5

knife contamination rate

1 evidences

Randomized study in cataract surgery patients found that 3-day preoperative topical antibiotic reduced knife contamination compared with single pre-op dose; all patients also received povidone-iodine perioperatively.

Trust comment: Prospective randomized controlled design with objective microbiologic outcomes, moderate sample size.

Study Details

PMID:15234136
Participants:75
Impact:26% (control) vs 5% (3-day ofloxacin); P=0.028
Trust score:4/5

serious contrast-related adverse reactions (including acute renal failure)

1 evidences

Economic analysis based on a randomized study found iodixanol (isosmolar, iodine-based) was associated with fewer serious adverse reactions (notably acute renal failure) and lower costs than iohexol in high-risk patients.

Trust comment: Analysis uses randomized clinical trial data and real-world cost inputs; moderate sample and clear differences in serious adverse events favor iodixanol.

Study Details

PMID:15846268
Participants:125
Impact:6 patients with serious reactions (iohexol) vs 0 serious reactions reported for iodixanol in excerpt; iodixanol had 2 nonserious reactions
Trust score:4/5

hospitalization and ADR treatment costs

1 evidences

Economic analysis based on a randomized study found iodixanol (isosmolar, iodine-based) was associated with fewer serious adverse reactions (notably acute renal failure) and lower costs than iohexol in high-risk patients.

Trust comment: Analysis uses randomized clinical trial data and real-world cost inputs; moderate sample and clear differences in serious adverse events favor iodixanol.

Study Details

PMID:15846268
Participants:125
Impact:lower costs with iodixanol (examples: €489, €573, €393 lower depending on country prices)
Trust score:4/5

ferritin concentration

1 evidences

Double-blind randomized trial in pregnant women showed that a micronutrient-fortified beverage (including iodine) increased hemoglobin and ferritin and reduced risk of anemia and iron deficiency.

Trust comment: Randomized double-blind design with adequate sample size and clear hematologic outcome measures, though iodine-specific effects are not isolated.

Study Details

PMID:12730420
Participants:259
Impact:increase +3 µg/L
Trust score:4/5

risk of anemia / iron deficiency anemia

1 evidences

Double-blind randomized trial in pregnant women showed that a micronutrient-fortified beverage (including iodine) increased hemoglobin and ferritin and reduced risk of anemia and iron deficiency.

Trust comment: Randomized double-blind design with adequate sample size and clear hematologic outcome measures, though iodine-specific effects are not isolated.

Study Details

PMID:12730420
Participants:259
Impact:risk reduced by 51% (anemia) and 56% (iron deficiency anemia)
Trust score:4/5

respiratory illness incidence

1 evidences

School lunch seasoning fortified with multiple micronutrients (including 50 μg iodine per serving) reduced respiratory and diarrheal morbidity and slightly improved a visual recall test, but did not change growth.

Trust comment: Well-powered RCT showing benefits of a multinutrient supplement that included iodine, but effects cannot be attributed to iodine alone.

Study Details

PMID:18541560
Participants:569
Impact:RR 0.83 (17% reduction)
Trust score:3/5

visual recall test

1 evidences

School lunch seasoning fortified with multiple micronutrients (including 50 μg iodine per serving) reduced respiratory and diarrheal morbidity and slightly improved a visual recall test, but did not change growth.

Trust comment: Well-powered RCT showing benefits of a multinutrient supplement that included iodine, but effects cannot be attributed to iodine alone.

Study Details

PMID:18541560
Participants:569
Impact:+0.5 items recalled
Trust score:3/5

sensitivity for ≥CIN2 (VIA-nurse)

1 evidences

Study evaluated visual inspection with Lugol's iodine (VILI) and acetic acid (VIA) versus Pap cytology for cervical cancer screening in 1,528 women in Kinshasa.

Trust comment: Large, well-conducted screening study with independent cytology/histology reference; diagnostic accuracy endpoints clearly reported.

Study Details

PMID:16619217
Participants:1528
Impact:55.5%
Trust score:4/5

specificity for ≥CIN2 (VILI-nurse)

1 evidences

Study evaluated visual inspection with Lugol's iodine (VILI) and acetic acid (VIA) versus Pap cytology for cervical cancer screening in 1,528 women in Kinshasa.

Trust comment: Large, well-conducted screening study with independent cytology/histology reference; diagnostic accuracy endpoints clearly reported.

Study Details

PMID:16619217
Participants:1528
Impact:74.6%
Trust score:4/5

negative predictive value for ≥CIN2 (physician VIA)

1 evidences

Study evaluated visual inspection with Lugol's iodine (VILI) and acetic acid (VIA) versus Pap cytology for cervical cancer screening in 1,528 women in Kinshasa.

Trust comment: Large, well-conducted screening study with independent cytology/histology reference; diagnostic accuracy endpoints clearly reported.

Study Details

PMID:16619217
Participants:1528
Impact:98.6%
Trust score:4/5

waist circumference

1 evidences

Four-week randomized diet trial in women showing the Paleolithic diet led to greater short-term weight and fat loss and reduced dietary calcium intake compared to guidelines-based diet.

Trust comment: Small, short-duration randomized trial with objective biochemical measures but limited power and short follow-up.

Study Details

PMID:27223304
Participants:39
Impact:−3.8% (Paleolithic group)
Trust score:3/5

protein intake (E%)

1 evidences

Individualized dietary counseling in older caregivers increased protein intake, raised calcium intake modestly, and greatly increased use of vitamin D supplementation over 6 months.

Trust comment: Randomized, population-based trial with validated dietary assessment and appropriate statistical analysis; some COVID-19–related visit changes noted.

Study Details

PMID:35622137
Participants:113
Impact:+1.3 E% (16.3→17.6 E%, p<0.001)
Trust score:4/5

Protein intake (g/kg BW/day)

1 evidences

Individualized dietary counseling in older caregivers increased protein intake, raised calcium intake modestly, and greatly increased use of vitamin D supplementation over 6 months.

Trust comment: Randomized, population-based trial with validated dietary assessment and appropriate statistical analysis; some COVID-19–related visit changes noted.

Study Details

PMID:35622137
Participants:113
Impact:+0.10 g/kg BW/day (0.95→1.05 g/kg BW/day, p=0.002)
Trust score:4/5

CIAKI occurrence

1 evidences

Single-center randomized trial in patients with renal dysfunction receiving iodinated contrast showed N-acetylcysteine (NAC) reduced occurrence of contrast-induced acute kidney injury (CIAKI).

Trust comment: Randomized single-center trial with clear outcome and multivariate analysis but limited size and single-center design.

Study Details

PMID:23138396
Participants:123
Impact:24/123 (19.5%) overall; 15/42 (35.7%) B0 vs 9/81 (11.1%) with NAC (p<0.01)
Trust score:3/5

NAC association with CIAKI

1 evidences

Single-center randomized trial in patients with renal dysfunction receiving iodinated contrast showed N-acetylcysteine (NAC) reduced occurrence of contrast-induced acute kidney injury (CIAKI).

Trust comment: Randomized single-center trial with clear outcome and multivariate analysis but limited size and single-center design.

Study Details

PMID:23138396
Participants:123
Impact:OR 0.18 (95% CI 0.04–0.72, p=0.016)
Trust score:3/5

BMI-SDS

1 evidences

An 8-week intensive lifestyle program in children with abdominal obesity increased diet quality and improved some micronutrient intakes including calcium and vitamin D, and reduced BMI-SDS.

Trust comment: Randomized, multidisciplinary intervention with objective measures and validated dietary assessment; moderate sample and short term.

Study Details

PMID:30322156
Participants:107
Impact:−0.5 units (both groups)
Trust score:4/5

diet quality indices

1 evidences

An 8-week intensive lifestyle program in children with abdominal obesity increased diet quality and improved some micronutrient intakes including calcium and vitamin D, and reduced BMI-SDS.

Trust comment: Randomized, multidisciplinary intervention with objective measures and validated dietary assessment; moderate sample and short term.

Study Details

PMID:30322156
Participants:107
Impact:DQI-A, HDL-I and KIDMED scores increased (greater improvement in intensive group)
Trust score:4/5

extravasation rate

1 evidences

Randomized study in 180 patients (174 analyzed) comparing 24G side-hole vs 22G end-hole catheters for MDCT contrast (iodine) administration found similar safety and contrast enhancement but higher injection pressure with 24G.

Trust comment: Prospective randomized study with adequate sample size for safety endpoints and direct relevance to iodinated contrast administration.

Study Details

PMID:28065379
Participants:174
Impact:1.1% overall (2/174), no difference between groups
Trust score:4/5

maximum injection pressure

1 evidences

Randomized study in 180 patients (174 analyzed) comparing 24G side-hole vs 22G end-hole catheters for MDCT contrast (iodine) administration found similar safety and contrast enhancement but higher injection pressure with 24G.

Trust comment: Prospective randomized study with adequate sample size for safety endpoints and direct relevance to iodinated contrast administration.

Study Details

PMID:28065379
Participants:174
Impact:higher with 24G side-holes (8.16±0.95 vs 4.79±0.63 kg/cm², p<0.001)
Trust score:4/5

contrast enhancement

1 evidences

Randomized study in 180 patients (174 analyzed) comparing 24G side-hole vs 22G end-hole catheters for MDCT contrast (iodine) administration found similar safety and contrast enhancement but higher injection pressure with 24G.

Trust comment: Prospective randomized study with adequate sample size for safety endpoints and direct relevance to iodinated contrast administration.

Study Details

PMID:28065379
Participants:174
Impact:no significant difference between catheter types
Trust score:4/5

global arterial-phase vessel attenuation

1 evidences

Compared two timing methods for iodinated contrast injection in CT angiography; bolus-tracking gave slightly higher vessel contrast but no significant difference.

Trust comment: Randomized clinical imaging trial with clear quantitative endpoints but modest sample size and imaging-focused (not clinical) outcomes.

Study Details

PMID:14610711
Participants:71
Impact:+23 HU (372 vs 349 HU); not significant (p=0.143)
Trust score:3/5

aortic attenuation

1 evidences

Compared two timing methods for iodinated contrast injection in CT angiography; bolus-tracking gave slightly higher vessel contrast but no significant difference.

Trust comment: Randomized clinical imaging trial with clear quantitative endpoints but modest sample size and imaging-focused (not clinical) outcomes.

Study Details

PMID:14610711
Participants:71
Impact:+25 HU (353 vs 328 HU); trend higher with bolus tracking
Trust score:3/5

iliac artery attenuation

1 evidences

Compared two timing methods for iodinated contrast injection in CT angiography; bolus-tracking gave slightly higher vessel contrast but no significant difference.

Trust comment: Randomized clinical imaging trial with clear quantitative endpoints but modest sample size and imaging-focused (not clinical) outcomes.

Study Details

PMID:14610711
Participants:71
Impact:+26 HU (387 vs 361 HU); trend higher with bolus tracking
Trust score:3/5

infant caries prevalence at age 2

1 evidences

Pregnant women received additional antimicrobial care including topical iodine; their children had lower caries prevalence by age 2.

Trust comment: Prospective randomized study with clear clinical endpoints but relatively small sample size limits precision.

Study Details

PMID:12964648
Participants:81
Impact:-18.6 percentage points (33.3% control vs 14.7% experimental)
Trust score:4/5

mean number of carious tooth surfaces in children

1 evidences

Pregnant women received additional antimicrobial care including topical iodine; their children had lower caries prevalence by age 2.

Trust comment: Prospective randomized study with clear clinical endpoints but relatively small sample size limits precision.

Study Details

PMID:12964648
Participants:81
Impact:Control higher (mean 6.3 vs 3.2 in experimental); difference not statistically significant
Trust score:4/5

duration of sufficient vessel attenuation

1 evidences

Tested different iodinated contrast injection rates for head/neck CT; 2 mL/s provided the longest duration of adequate vessel enhancement.

Trust comment: Well-controlled randomized allocation with objective quantitative imaging measures and adequate sample size for imaging endpoints.

Study Details

PMID:10543650
Participants:97
Impact:Longest with 2 mL/s: 27 ± 4 s (P ≤ 0.008)
Trust score:4/5

muscle (sternocleidomastoid) enhancement

1 evidences

Tested different iodinated contrast injection rates for head/neck CT; 2 mL/s provided the longest duration of adequate vessel enhancement.

Trust comment: Well-controlled randomized allocation with objective quantitative imaging measures and adequate sample size for imaging endpoints.

Study Details

PMID:10543650
Participants:97
Impact:No significant change with injection flow rate (mean enhancement 9 ± 7 HU)
Trust score:4/5

submandibular and thyroid gland attenuation

1 evidences

Tested different iodinated contrast injection rates for head/neck CT; 2 mL/s provided the longest duration of adequate vessel enhancement.

Trust comment: Well-controlled randomized allocation with objective quantitative imaging measures and adequate sample size for imaging endpoints.

Study Details

PMID:10543650
Participants:97
Impact:1.5 mL/s: submandibular 81 ± 12 HU (lowest) and thyroid 164 ± 22 HU (highest); thyroid not significantly different from 2 mL/s
Trust score:4/5

thyroid parenchymal blood flow

1 evidences

Power-Doppler ultrasound showed high thyroid blood flow in Graves' disease and that preoperative Lugol's iodine reduced thyroid parenchymal blood flow.

Trust comment: Small clinical observational series with objective Doppler measures showing plausible effect of preoperative Lugol's iodine but limited sample and quantitative detail.

Study Details

PMID:11339007
Participants:46
Impact:decrease after preoperative Lugol's iodine (magnitude not quantified)
Trust score:3/5

overall thyroid blood flow in Graves' disease versus control

1 evidences

Power-Doppler ultrasound showed high thyroid blood flow in Graves' disease and that preoperative Lugol's iodine reduced thyroid parenchymal blood flow.

Trust comment: Small clinical observational series with objective Doppler measures showing plausible effect of preoperative Lugol's iodine but limited sample and quantitative detail.

Study Details

PMID:11339007
Participants:46
Impact:significantly higher in Graves' patients (measured by power-Doppler)
Trust score:3/5

coronary CT attenuation (HU)

1 evidences

A weight- and concentration-adjusted iodine-dose protocol for CT produced more consistent vessel enhancement and reduced total contrast volume versus a fixed protocol.

Trust comment: Prospective randomized human trial (n=160) directly manipulating iodine contrast dose with clear imaging and dose outcomes; moderate sample and randomized design.

Study Details

PMID:26167680
Participants:160
Impact:consistent across concentrations (≈317–392 HU) with individualized protocol; no significant differences between concentrations
Trust score:4/5

coefficient of variation (CT attenuation)

1 evidences

A weight- and concentration-adjusted iodine-dose protocol for CT produced more consistent vessel enhancement and reduced total contrast volume versus a fixed protocol.

Trust comment: Prospective randomized human trial (n=160) directly manipulating iodine contrast dose with clear imaging and dose outcomes; moderate sample and randomized design.

Study Details

PMID:26167680
Participants:160
Impact:lower (improved uniformity) with individualized protocol vs fixed protocol
Trust score:4/5

total contrast medium dose / flow rate

1 evidences

A weight- and concentration-adjusted iodine-dose protocol for CT produced more consistent vessel enhancement and reduced total contrast volume versus a fixed protocol.

Trust comment: Prospective randomized human trial (n=160) directly manipulating iodine contrast dose with clear imaging and dose outcomes; moderate sample and randomized design.

Study Details

PMID:26167680
Participants:160
Impact:reduced (mean 62.96 ml and 5.24 ml/s vs 80 ml and 5.50 ml/s; P<0.001)
Trust score:4/5

CD4+ cell count

1 evidences

Twice‑RDA multiple micronutrient supplement (including iodine) for six months did not change 12‑month mortality, growth, or CD4 counts versus standard multivitamins.

Trust comment: Large, double-blind randomized trial including iodine within a multi-nutrient intervention; high methodological quality but cannot isolate iodine-specific effects.

Study Details

PMID:20525230
Participants:847
Impact:no significant difference at 12 months (mean ~1024 vs 1060 cells; p=0.53)
Trust score:4/5

anthropometry (WHZ/HAZ/WAZ)

1 evidences

Twice‑RDA multiple micronutrient supplement (including iodine) for six months did not change 12‑month mortality, growth, or CD4 counts versus standard multivitamins.

Trust comment: Large, double-blind randomized trial including iodine within a multi-nutrient intervention; high methodological quality but cannot isolate iodine-specific effects.

Study Details

PMID:20525230
Participants:847
Impact:no significant differences between arms at 12 months
Trust score:4/5

superior vena cava (SVC) enhancement

1 evidences

Biphasic contrast injection provided better liver and infrarenal IVC enhancement and fewer SVC artifacts than a uniphasic protocol in whole-body CT screening.

Trust comment: Randomized imaging study in humans (n=60) directly comparing iodine-contrast injection profiles; small sample size limits generalizability.

Study Details

PMID:15553010
Participants:60
Impact:better with uniphasic protocol A (p=0.04)
Trust score:3/5

infrarenal IVC and liver enhancement

1 evidences

Biphasic contrast injection provided better liver and infrarenal IVC enhancement and fewer SVC artifacts than a uniphasic protocol in whole-body CT screening.

Trust comment: Randomized imaging study in humans (n=60) directly comparing iodine-contrast injection profiles; small sample size limits generalizability.

Study Details

PMID:15553010
Participants:60
Impact:better with biphasic protocol B (p<0.01)
Trust score:3/5

artifacts in SVC

1 evidences

Biphasic contrast injection provided better liver and infrarenal IVC enhancement and fewer SVC artifacts than a uniphasic protocol in whole-body CT screening.

Trust comment: Randomized imaging study in humans (n=60) directly comparing iodine-contrast injection profiles; small sample size limits generalizability.

Study Details

PMID:15553010
Participants:60
Impact:fewer artifacts with protocol B (p<0.01)
Trust score:3/5

thyroglobulin (iodine status)

1 evidences

In this randomized substudy, antenatal multiple micronutrients (including vitamin D) improved maternal micronutrient biomarkers in late pregnancy but many deficiencies persisted.

Trust comment: Large, randomized, double-masked cluster trial substudy with robust biochemical assays and appropriate adjustments — high-quality evidence.

Study Details

PMID:31006806
Participants:1526
Impact:−1.4 µg/L (MM vs IFA; P<0.0001)
Trust score:5/5

cobalamin (vitamin B-12)

1 evidences

In this randomized substudy, antenatal multiple micronutrients (including vitamin D) improved maternal micronutrient biomarkers in late pregnancy but many deficiencies persisted.

Trust comment: Large, randomized, double-masked cluster trial substudy with robust biochemical assays and appropriate adjustments — high-quality evidence.

Study Details

PMID:31006806
Participants:1526
Impact:+14% (MM vs IFA; P<0.0001)
Trust score:5/5

25-hydroxyvitamin D

1 evidences

In this randomized substudy, antenatal multiple micronutrients (including vitamin D) improved maternal micronutrient biomarkers in late pregnancy but many deficiencies persisted.

Trust comment: Large, randomized, double-masked cluster trial substudy with robust biochemical assays and appropriate adjustments — high-quality evidence.

Study Details

PMID:31006806
Participants:1526
Impact:+6.6% (MM vs IFA; P<0.0001)
Trust score:5/5

Schistosoma mansoni reinfection intensity

1 evidences

Multimicronutrient tablets (which included 5 µg vitamin D) modestly reduced Schistosoma mansoni reinfection intensity but did not affect other helminth reinfections.

Trust comment: Randomized, double-blind trial with reasonable design but low compliance (~46%) and some borderline significance — moderate trustworthiness.

Study Details

PMID:12886816
Participants:977
Impact:reinfected at 69% of control intensity (≈−31% intensity; 5.5 epg vs 7.7 epg; P=0.047)
Trust score:3/5

S. mansoni reinfection rate (odds)

1 evidences

Multimicronutrient tablets (which included 5 µg vitamin D) modestly reduced Schistosoma mansoni reinfection intensity but did not affect other helminth reinfections.

Trust comment: Randomized, double-blind trial with reasonable design but low compliance (~46%) and some borderline significance — moderate trustworthiness.

Study Details

PMID:12886816
Participants:977
Impact:OR≈0.7 (borderline significance, P≈0.09)
Trust score:3/5

salivary SARS-CoV-2 viral load (qPCR)

1 evidences

Tested four mouthwashes (including povidone-iodine) in hospitalized COVID-19 patients and found no significant overall reduction in salivary viral RNA compared with baseline or control.

Trust comment: Multicentre, randomized, double-blind placebo-controlled trial but limited sample size per arm and high inter-individual variability.

Study Details

PMID:34937855
Participants:67
Impact:No significant change vs baseline overall; mean reductions ~30% at 120 min in PVP-I and CPC groups (not significant versus control)
Trust score:4/5

proportion with ≥50% viral load decrease

1 evidences

Tested four mouthwashes (including povidone-iodine) in hospitalized COVID-19 patients and found no significant overall reduction in salivary viral RNA compared with baseline or control.

Trust comment: Multicentre, randomized, double-blind placebo-controlled trial but limited sample size per arm and high inter-individual variability.

Study Details

PMID:34937855
Participants:67
Impact:PVP-I 65% and CPC 59% at 120 min (many control patients also showed decreases)
Trust score:4/5

proportion with ≥90% viral load decrease

1 evidences

Tested four mouthwashes (including povidone-iodine) in hospitalized COVID-19 patients and found no significant overall reduction in salivary viral RNA compared with baseline or control.

Trust comment: Multicentre, randomized, double-blind placebo-controlled trial but limited sample size per arm and high inter-individual variability.

Study Details

PMID:34937855
Participants:67
Impact:Pattern similar to ≥50% responders but low and variable between individuals
Trust score:4/5

CI-AKI incidence (Cys-C ≥10% at 24h)

1 evidences

In high-risk patients undergoing coronary angiography/PCI, short peri-procedural low-dose tolvaptan plus hydration reduced early cystatin-C–based CI-AKI incidence and renal medullary contrast retention measured by iodine concentration on spectral CT.

Trust comment: Prospective randomized controlled trial with adequate sample size and objective imaging endpoints, but unblinded and single-trial limitations.

Study Details

PMID:40321050
Participants:232
Impact:Tolvaptan 10.3% (12/116) vs control 23.3% (27/116); p = 0.008 (reduced incidence)
Trust score:4/5

renal medullary iodine concentration (spectral CT at 24h)

1 evidences

In high-risk patients undergoing coronary angiography/PCI, short peri-procedural low-dose tolvaptan plus hydration reduced early cystatin-C–based CI-AKI incidence and renal medullary contrast retention measured by iodine concentration on spectral CT.

Trust comment: Prospective randomized controlled trial with adequate sample size and objective imaging endpoints, but unblinded and single-trial limitations.

Study Details

PMID:40321050
Participants:232
Impact:Total renal medulla: 2.67 mg/mL (TOL) vs 5.00 mg/mL (control); p = 0.006 (less contrast retention)
Trust score:4/5

change in renal biomarkers (ΔSCr, ΔCys-C, ΔeGFR)

1 evidences

In high-risk patients undergoing coronary angiography/PCI, short peri-procedural low-dose tolvaptan plus hydration reduced early cystatin-C–based CI-AKI incidence and renal medullary contrast retention measured by iodine concentration on spectral CT.

Trust comment: Prospective randomized controlled trial with adequate sample size and objective imaging endpoints, but unblinded and single-trial limitations.

Study Details

PMID:40321050
Participants:232
Impact:ΔSCr 6.6 vs 10.6 μmol/L (p=0.046); ΔCys-C 0.02 vs 0.06 mg/L (p=0.048); ΔeGFR decline 3.8 vs 7.1 mL/min/1.73m2 (p=0.010)
Trust score:4/5

bacterial culture positive rate — hallux (after prep)

1 evidences

Compared three skin-prep solutions; chlorhexidine plus alcohol (ChloraPrep) eliminated bacteria from the forefoot more effectively than povidone-iodine–containing DuraPrep or chloroxylenol.

Trust comment: Prospective randomized preparation comparison with clear microbiological endpoints but single-centre and focused on surgical prep rather than systemic iodine exposure.

Study Details

PMID:15866959
Participants:125
Impact:DuraPrep (iodine): 65% positive; Techni-Care 95%; ChloraPrep 30% (ChloraPrep best, p < 0.0001)
Trust score:3/5

bacterial culture positive rate — toe web spaces (after prep)

1 evidences

Compared three skin-prep solutions; chlorhexidine plus alcohol (ChloraPrep) eliminated bacteria from the forefoot more effectively than povidone-iodine–containing DuraPrep or chloroxylenol.

Trust comment: Prospective randomized preparation comparison with clear microbiological endpoints but single-centre and focused on surgical prep rather than systemic iodine exposure.

Study Details

PMID:15866959
Participants:125
Impact:DuraPrep: 45% positive; Techni-Care 98%; ChloraPrep 23% (ChloraPrep best)
Trust score:3/5

bacterial culture positive rate — control site (anterior tibia)

1 evidences

Compared three skin-prep solutions; chlorhexidine plus alcohol (ChloraPrep) eliminated bacteria from the forefoot more effectively than povidone-iodine–containing DuraPrep or chloroxylenol.

Trust comment: Prospective randomized preparation comparison with clear microbiological endpoints but single-centre and focused on surgical prep rather than systemic iodine exposure.

Study Details

PMID:15866959
Participants:125
Impact:DuraPrep: 23% positive; Techni-Care 35%; ChloraPrep 10%
Trust score:3/5

testosterone pellet extrusion rate

1 evidences

In 186 men undergoing testosterone pellet implantation, soaking pellets in gentamicin did not significantly reduce extrusion rates; povidone-iodine skin disinfectant was associated with fewer extrusions than mixed alcohol.

Trust comment: Well-powered randomized trial (186 participants) with clear outcome measurement; finding on povidone-iodine is observational within the trial but plausible and statistically supported.

Study Details

PMID:11916619
Participants:186
Impact:Control 11.2% vs antibiotic-soak 9.2% (P = 0.42; no significant reduction)
Trust score:4/5

povidone-iodine skin disinfectant effect

1 evidences

In 186 men undergoing testosterone pellet implantation, soaking pellets in gentamicin did not significantly reduce extrusion rates; povidone-iodine skin disinfectant was associated with fewer extrusions than mixed alcohol.

Trust comment: Well-powered randomized trial (186 participants) with clear outcome measurement; finding on povidone-iodine is observational within the trial but plausible and statistically supported.

Study Details

PMID:11916619
Participants:186
Impact:Povidone-iodine associated with statistically fewer extrusions than mixed alcohol solution (significant)
Trust score:4/5

myocardial hyperemia

1 evidences

Iodinated contrast boluses produce short-lived increases in myocardial blood flow and contrast-derived indices can predict adenosine test results, reducing adenosine use.

Trust comment: Prospective clinical study with 93 patients and objective wire-based measurements; reasonable methodology though specific device/center factors may limit generalizability.

Study Details

PMID:40308206
Participants:93
Impact:transient, submaximal hyperemia after 8-mL iohexol bolus
Trust score:4/5

contrast-derived coronary flow reserve (CFR) accuracy

1 evidences

Iodinated contrast boluses produce short-lived increases in myocardial blood flow and contrast-derived indices can predict adenosine test results, reducing adenosine use.

Trust comment: Prospective clinical study with 93 patients and objective wire-based measurements; reasonable methodology though specific device/center factors may limit generalizability.

Study Details

PMID:40308206
Participants:93
Impact:AUC 0.82 for detecting abnormal adenosine-derived CFR
Trust score:4/5

adenosine use

1 evidences

Iodinated contrast boluses produce short-lived increases in myocardial blood flow and contrast-derived indices can predict adenosine test results, reducing adenosine use.

Trust comment: Prospective clinical study with 93 patients and objective wire-based measurements; reasonable methodology though specific device/center factors may limit generalizability.

Study Details

PMID:40308206
Participants:93
Impact:reduced by 40% using a hybrid approach
Trust score:4/5

serum creatinine change (48–72 h)

1 evidences

Remote ischemic preconditioning did not change creatinine overall after iodinated contrast exposure, but in very high-risk patients (Mehran ≥11) it was associated with a smaller rise in creatinine.

Trust comment: Multicenter randomized controlled trial but small overall sample; objective renal endpoints measured.

Study Details

PMID:26015372
Participants:76
Impact:no significant difference overall; CIN occurred in 4 patients (2 sham, 2 RIPC)
Trust score:4/5

serum creatinine change in high-risk (Mehran ≥11) subgroup

1 evidences

Remote ischemic preconditioning did not change creatinine overall after iodinated contrast exposure, but in very high-risk patients (Mehran ≥11) it was associated with a smaller rise in creatinine.

Trust comment: Multicenter randomized controlled trial but small overall sample; objective renal endpoints measured.

Study Details

PMID:26015372
Participants:76
Impact:Δ creatinine −3.3 ± 9.8 μmol/L (RIPC) vs +17.8 ± 20.1 μmol/L (sham)
Trust score:4/5

CIN incidence

1 evidences

Remote ischemic preconditioning did not change creatinine overall after iodinated contrast exposure, but in very high-risk patients (Mehran ≥11) it was associated with a smaller rise in creatinine.

Trust comment: Multicenter randomized controlled trial but small overall sample; objective renal endpoints measured.

Study Details

PMID:26015372
Participants:76
Impact:4 of 76 patients developed CIN (2 per arm)
Trust score:4/5

correlation of iodine load with creatinine change

1 evidences

Dose-dependent nephrotoxic effects of two iodinated contrast agents were quantified; iobitridol showed a steeper load-to-damage slope than iodixanol, and diabetics had much higher slopes.

Trust comment: Randomized comparison with quantitative modeling of iodine load versus renal change; moderate sample and appropriate analyses.

Study Details

PMID:23811842
Participants:113
Impact:iobitridol R=0.29 (P<0.0001); iodixanol R=0.15 (P=0.00028)
Trust score:4/5

load-to-damage slope (intrinsic nephrotoxicity)

1 evidences

Dose-dependent nephrotoxic effects of two iodinated contrast agents were quantified; iobitridol showed a steeper load-to-damage slope than iodixanol, and diabetics had much higher slopes.

Trust comment: Randomized comparison with quantitative modeling of iodine load versus renal change; moderate sample and appropriate analyses.

Study Details

PMID:23811842
Participants:113
Impact:iobitridol 19.03 ± 4.02 vs iodixanol 14.50 ± 4.63 (P<0.001)
Trust score:4/5

effect of diabetes on nephrotoxicity

1 evidences

Dose-dependent nephrotoxic effects of two iodinated contrast agents were quantified; iobitridol showed a steeper load-to-damage slope than iodixanol, and diabetics had much higher slopes.

Trust comment: Randomized comparison with quantitative modeling of iodine load versus renal change; moderate sample and appropriate analyses.

Study Details

PMID:23811842
Participants:113
Impact:slope in diabetics 24.35 ± 4.96 vs non-diabetics 4.59 ± 3.25 (P<0.001)
Trust score:4/5

ulcer healing rate at 24 weeks

1 evidences

Iodine-impregnated dressing (Inadine) showed no advantage over non-iodine dressings for ulcer healing at 24 weeks; costs differed between products.

Trust comment: Large multicenter randomized trial with 317 randomized and 229 evaluable participants; robust design for dressing comparison.

Study Details

PMID:19922726
Participants:229
Impact:no difference between dressings; Inadine 44.4% (intention-to-treat)
Trust score:4/5

pain with dressing changes

1 evidences

Iodine-impregnated dressing (Inadine) showed no advantage over non-iodine dressings for ulcer healing at 24 weeks; costs differed between products.

Trust comment: Large multicenter randomized trial with 317 randomized and 229 evaluable participants; robust design for dressing comparison.

Study Details

PMID:19922726
Participants:229
Impact:non-adherent dressings associated with less pain; Inadine not superior
Trust score:4/5

cancer detection rate (per 1000 exams)

1 evidences

Large randomised trial comparing supplemental breast imaging in women with dense breasts; contrast-enhanced mammography (iodinated contrast) and abbreviated MRI detected more cancers than ABUS but iodinated contrast caused allergic/reaction events.

Trust comment: Large multicenter randomized trial with thousands of completed imaging exams; interim results reported and adverse events for iodinated contrast are directly measured.

Study Details

PMID:40412427
Participants:6305
Impact:abbreviated MRI 17.4/1000; ABUS 4.2/1000; contrast-enhanced mammography 19.2/1000
Trust score:4/5

invasive cancer detection rate (per 1000 exams)

1 evidences

Large randomised trial comparing supplemental breast imaging in women with dense breasts; contrast-enhanced mammography (iodinated contrast) and abbreviated MRI detected more cancers than ABUS but iodinated contrast caused allergic/reaction events.

Trust comment: Large multicenter randomized trial with thousands of completed imaging exams; interim results reported and adverse events for iodinated contrast are directly measured.

Study Details

PMID:40412427
Participants:6305
Impact:abbreviated MRI 15.0/1000; ABUS 4.2/1000; contrast-enhanced mammography 15.7/1000
Trust score:4/5

iodinated contrast reactions

1 evidences

Large randomised trial comparing supplemental breast imaging in women with dense breasts; contrast-enhanced mammography (iodinated contrast) and abbreviated MRI detected more cancers than ABUS but iodinated contrast caused allergic/reaction events.

Trust comment: Large multicenter randomized trial with thousands of completed imaging exams; interim results reported and adverse events for iodinated contrast are directly measured.

Study Details

PMID:40412427
Participants:6305
Impact:24 reactions in CEM arm: 17 minor (8.4/1000), 6 moderate (2.9/1000), 1 severe (0.5/1000)
Trust score:4/5

Contrast‑induced nephropathy (≥25% creatinine rise)

1 evidences

In patients receiving iodinated contrast, peri‑procedure hydration with sodium bicarbonate reduced occurrence of contrast‑induced nephropathy compared with sodium chloride.

Trust comment: Randomized controlled single‑center trial (n=119) with clear clinical endpoint and statistically significant result; moderate quality.

Study Details

PMID:15150204
Participants:119
Impact:Reduced by 11.9 percentage points (1.7% vs 13.6%)
Trust score:4/5

Serum creatinine (short term)

1 evidences

In patients receiving iodinated contrast, peri‑procedure hydration with sodium bicarbonate reduced occurrence of contrast‑induced nephropathy compared with sodium chloride.

Trust comment: Randomized controlled single‑center trial (n=119) with clear clinical endpoint and statistically significant result; moderate quality.

Study Details

PMID:15150204
Participants:119
Impact:Fewer creatinine rises at day 1–2 with bicarbonate (1/60 vs 8/59)
Trust score:4/5

Contrast‑to‑noise ratio (CNR) of abdominal arteries

1 evidences

Using spectral CT with a lower‑concentration iodinated contrast reduced total iodine dose by ~28% while achieving equal or better vascular image quality than conventional CTA.

Trust comment: Small randomized feasibility study (n=70) showing reduced iodinated contrast dose with maintained/better image quality; moderate risk of limited generalizability.

Study Details

PMID:26036793
Participants:70
Impact:Higher at optimal mono‑energy (improved image quality)
Trust score:3/5

Image quality (reader scores)

1 evidences

Using spectral CT with a lower‑concentration iodinated contrast reduced total iodine dose by ~28% while achieving equal or better vascular image quality than conventional CTA.

Trust comment: Small randomized feasibility study (n=70) showing reduced iodinated contrast dose with maintained/better image quality; moderate risk of limited generalizability.

Study Details

PMID:26036793
Participants:70
Impact:Improved with spectral imaging despite lower iodine concentration (statistically significant)
Trust score:3/5

treatment failure (development of white spot lesion/ECC)

1 evidences

In high-risk toddlers, topical 10% povidone-iodine applied to teeth reduced the development of early childhood caries compared with placebo.

Trust comment: Randomized, double-blind, placebo-controlled pilot trial in humans with statistically significant reduction in caries; small sample size limits generalizability.

Study Details

PMID:10029961
Participants:31
Impact:-31 percentage points (0/15 experimental vs 5/16 control; P=0.04)
Trust score:4/5

absolute serum creatinine increase ≥0.5 mg/dL

1 evidences

In CKD patients undergoing contrast CT, rates of contrast-induced nephropathy were low and similar between iodixanol-320 and iopamidol-370, with small numeric differences.

Trust comment: Multicenter, double-blind randomized trial in humans with adequate follow-up for renal outcomes; sample size moderate.

Study Details

PMID:17035872
Participants:153
Impact:iodixanol 2.6% (2/76) vs iopamidol 0% (0/77)
Trust score:4/5

relative serum creatinine increase ≥25%

1 evidences

In CKD patients undergoing contrast CT, rates of contrast-induced nephropathy were low and similar between iodixanol-320 and iopamidol-370, with small numeric differences.

Trust comment: Multicenter, double-blind randomized trial in humans with adequate follow-up for renal outcomes; sample size moderate.

Study Details

PMID:17035872
Participants:153
Impact:4% in both groups (3/76 vs 3/77)
Trust score:4/5

incidence of contrast-induced nephropathy (SCr increase ≥0.5 mg/dL)

1 evidences

In CKD patients, intravenous iodixanol-320 was associated with a higher incidence of contrast-induced nephropathy and a greater mean rise in serum creatinine than iomeprol-400.

Trust comment: Randomized, double-blind, multicenter study in humans with significant differences reported and adjudicated renal safety review.

Study Details

PMID:18301313
Participants:148
Impact:iodixanol 6.9% (5/72) vs iomeprol 0% (0/76); P=0.025
Trust score:4/5

mean serum creatinine change from baseline

1 evidences

In CKD patients, intravenous iodixanol-320 was associated with a higher incidence of contrast-induced nephropathy and a greater mean rise in serum creatinine than iomeprol-400.

Trust comment: Randomized, double-blind, multicenter study in humans with significant differences reported and adjudicated renal safety review.

Study Details

PMID:18301313
Participants:148
Impact:iodixanol +0.06 mg/dL vs iomeprol -0.04 mg/dL (difference ~+0.10 mg/dL; P=0.017)
Trust score:4/5

iodine contrast-agent dosage

1 evidences

A one-stop-shop CT protocol reduced the required iodinated contrast volume, scan time, and radiation dose while preserving image quality compared with the traditional separate-protocol approach in suspected acute ischemic stroke patients.

Trust comment: Prospective randomized allocation with clear quantitative differences in contrast use and radiation, but single-center/smaller sample and limited blinding reduce overall strength.

Study Details

PMID:39198108
Participants:100
Impact:-20 ml (80 ml vs 100 ml; P<0.001)
Trust score:3/5

scan time

1 evidences

A one-stop-shop CT protocol reduced the required iodinated contrast volume, scan time, and radiation dose while preserving image quality compared with the traditional separate-protocol approach in suspected acute ischemic stroke patients.

Trust comment: Prospective randomized allocation with clear quantitative differences in contrast use and radiation, but single-center/smaller sample and limited blinding reduce overall strength.

Study Details

PMID:39198108
Participants:100
Impact:-0.91 min (2.32 vs 3.23 min; P<0.001)
Trust score:3/5

radiation dose (CT dose-length product)

1 evidences

A one-stop-shop CT protocol reduced the required iodinated contrast volume, scan time, and radiation dose while preserving image quality compared with the traditional separate-protocol approach in suspected acute ischemic stroke patients.

Trust comment: Prospective randomized allocation with clear quantitative differences in contrast use and radiation, but single-center/smaller sample and limited blinding reduce overall strength.

Study Details

PMID:39198108
Participants:100
Impact:-447.65 mGy·cm (4681.35 vs 5129.00 mGy·cm; P<0.001)
Trust score:3/5

2-year progression-free survival

1 evidences

Phase III RCT comparing R-BEAM vs B-BEAM (with I-131 tositumomab) before autologous transplant; similar 2-year PFS and OS, higher mucositis with radioimmunotherapy arm.

Trust comment: Large randomized phase III trial with clear endpoints and reported CIs/P values supporting results.

Study Details

PMID:23478060
Participants:224
Impact:48.6% (R-BEAM) vs 47.9% (B-BEAM); P = .94
Trust score:4/5

2-year overall survival

1 evidences

Phase III RCT comparing R-BEAM vs B-BEAM (with I-131 tositumomab) before autologous transplant; similar 2-year PFS and OS, higher mucositis with radioimmunotherapy arm.

Trust comment: Large randomized phase III trial with clear endpoints and reported CIs/P values supporting results.

Study Details

PMID:23478060
Participants:224
Impact:65.6% (R-BEAM) vs 61.0% (B-BEAM); P = .38
Trust score:4/5

Maximum mucositis score

1 evidences

Phase III RCT comparing R-BEAM vs B-BEAM (with I-131 tositumomab) before autologous transplant; similar 2-year PFS and OS, higher mucositis with radioimmunotherapy arm.

Trust comment: Large randomized phase III trial with clear endpoints and reported CIs/P values supporting results.

Study Details

PMID:23478060
Participants:224
Impact:Higher with B-BEAM: 0.72 vs 0.31; P < .001
Trust score:4/5

Coronary artery CT attenuation

1 evidences

Randomized study: using higher iodine concentration contrast plus reduced tube current cut radiation dose ~42% while maintaining image quality.

Trust comment: Prospective randomized two-center study with objective and subjective IQ metrics and clear dose measurements.

Study Details

PMID:28800951
Participants:81
Impact:Group B 507.5–548.1 HU vs Group A 407.5–444.5 HU (P ≤ 0.0166)
Trust score:4/5

Radiation dose (CTDIvol and DLP)

1 evidences

Randomized study: using higher iodine concentration contrast plus reduced tube current cut radiation dose ~42% while maintaining image quality.

Trust comment: Prospective randomized two-center study with objective and subjective IQ metrics and clear dose measurements.

Study Details

PMID:28800951
Participants:81
Impact:Group B = 58% of Group A (42% dose reduction)
Trust score:4/5

Signal-to-noise & contrast-to-noise ratio

1 evidences

Randomized study: using higher iodine concentration contrast plus reduced tube current cut radiation dose ~42% while maintaining image quality.

Trust comment: Prospective randomized two-center study with objective and subjective IQ metrics and clear dose measurements.

Study Details

PMID:28800951
Participants:81
Impact:No significant difference between groups (P ≥ 0.1859)
Trust score:4/5

PSA nadir

1 evidences

Small randomized pilot comparing single-fraction HDR vs I-125 LDR brachytherapy: LDR produced lower PSA nadir and more patients reached PSA <0.4 ng/mL; toxicity similar.

Trust comment: Randomized pilot with very small sample size limiting power and generalizability.

Study Details

PMID:34238688
Participants:31
Impact:HDRB 1.02 ± 0.66 vs LDRB 0.25 ± 0.39; P < 0.0001
Trust score:3/5

Proportion with PSA <0.4 ng/mL

1 evidences

Small randomized pilot comparing single-fraction HDR vs I-125 LDR brachytherapy: LDR produced lower PSA nadir and more patients reached PSA <0.4 ng/mL; toxicity similar.

Trust comment: Randomized pilot with very small sample size limiting power and generalizability.

Study Details

PMID:34238688
Participants:31
Impact:LDRB 13/15 vs HDRB 2/16; P < 0.0001
Trust score:3/5

Late GU/GI/sexual toxicity

1 evidences

Small randomized pilot comparing single-fraction HDR vs I-125 LDR brachytherapy: LDR produced lower PSA nadir and more patients reached PSA <0.4 ng/mL; toxicity similar.

Trust comment: Randomized pilot with very small sample size limiting power and generalizability.

Study Details

PMID:34238688
Participants:31
Impact:No significant difference at 24 and 36 months
Trust score:3/5

5-year freedom from progression (Phoenix)

1 evidences

Large RCT comparing EBRT+BT vs BT alone: addition of EBRT did not improve 5‑year freedom from progression but increased late GU/GI toxicity.

Trust comment: Large multicenter randomized clinical trial with robust sample size and clinically relevant endpoints.

Study Details

PMID:37315297
Participants:579
Impact:88.0% (COMBO) vs 85.5% (BT); P = .19
Trust score:5/5

5-year cumulative late GU/GI grade ≥2 toxicity

1 evidences

Large RCT comparing EBRT+BT vs BT alone: addition of EBRT did not improve 5‑year freedom from progression but increased late GU/GI toxicity.

Trust comment: Large multicenter randomized clinical trial with robust sample size and clinically relevant endpoints.

Study Details

PMID:37315297
Participants:579
Impact:COMBO 42.8% vs BT 25.8%; P = .006
Trust score:5/5

Hospital length of stay

1 evidences

Compared ciNPWT versus standard sterile gauze with an iodine disinfectant after ventral hernia repair; ciNPWT reduced infections numerically but increased hospital stay.

Trust comment: Randomized clinical study with clear outcomes but limited by relatively small size and some design ambiguities (described as retrospective/observational yet randomized).

Study Details

PMID:39336589
Participants:100
Impact:Mean: sterile gauze 5.6 days vs ciNPWT 8.2 days (ciNPWT +2.6 days, p<0.001)
Trust score:3/5

hernia size interaction with SSI

1 evidences

Compared ciNPWT versus standard sterile gauze with an iodine disinfectant after ventral hernia repair; ciNPWT reduced infections numerically but increased hospital stay.

Trust comment: Randomized clinical study with clear outcomes but limited by relatively small size and some design ambiguities (described as retrospective/observational yet randomized).

Study Details

PMID:39336589
Participants:100
Impact:ciNPWT associated with lower SSI risk for larger hernias (statistically significant subgroup interaction, p<0.001)
Trust score:3/5

gingival bleeding index / pocket depth / clinical attachment loss

1 evidences

In poorly controlled T2D patients, nonsurgical periodontal therapy including subgingival irrigation with 10% povidone-iodine significantly improved periodontal status and reduced HbA1c versus control.

Trust comment: Randomized, single-blind RCT with objective biological endpoints but small sample size limiting precision and generalizability.

Study Details

PMID:29482543
Participants:30
Impact:GBI reduced −34.1% (p<0.0001); PD decreased ~1.1 mm; CAL improved ~1.3 mm (all p<0.0001)
Trust score:4/5

rinse acceptability

1 evidences

Two double-blind RCTs tested multiple antiseptic rinses including povidone iodine; only the CPC-containing rinse significantly reduced salivary SARS-CoV-2 viral load at 30 min, while povidone iodine did not show a significant effect in these trials.

Trust comment: Well-powered, double-blind randomized controlled trials with standardized qPCR viral load outcomes and appropriate analyses; high internal validity for short-term effects.

Study Details

PMID:39651628
Participants:247
Impact:Povidone iodine had less favorable appearance ratings; overall willingness to use rinses was high in clinical settings (no major difference among rinses)
Trust score:5/5

urinary cadmium correlation with iodine

1 evidences

Cross-sectional study showing long-term environmental cadmium exposure alters urinary mineral balance, including increased urinary calcium.

Trust comment: Observational cross-sectional study with reasonable sample size showing associations but limited by potential confounding and environmental exposure assessment constraints.

Study Details

PMID:27029362
Participants:298
Impact:Urinary cadmium positively correlated with urinary iodine (r=0.25, P<0.05); cadmium was a significant predictor in regression (standardized β=0.24, P<0.001)
Trust score:3/5

protocol tolerance and compliance

1 evidences

Large randomized equivalence trial found hand-rubbing with 75% aqueous alcohol was as effective as traditional hand-scrubbing with antiseptic soap containing 4% povidone iodine or 4% chlorhexidine in preventing 30-day surgical site infections, with better tolerance and compliance for hand-rubbing.

Trust comment: Large, multicenter randomized equivalence trial with robust sample size and clinically meaningful endpoints; high external validity for surgical settings.

Study Details

PMID:12169076
Participants:4387
Impact:Hand-rubbing had better compliance (44% vs 28%, p=0.008) and less skin irritation than povidone-iodine hand-scrubbing
Trust score:5/5

Hair mercury concentration

1 evidences

Preschool children given fatty fish 3×/week for 16 weeks had higher urinary iodine, higher n‑3 fatty acids, and higher hair mercury than children given meat.

Trust comment: Randomized controlled trial with objective biomarker measurements and adequate sample size; exploratory multiple outcomes limit certainty.

Study Details

PMID:33978160
Participants:222
Impact:+0.83 SMD
Trust score:4/5

RBC total n‑3 PUFAs (EPA/DHA)

1 evidences

Preschool children given fatty fish 3×/week for 16 weeks had higher urinary iodine, higher n‑3 fatty acids, and higher hair mercury than children given meat.

Trust comment: Randomized controlled trial with objective biomarker measurements and adequate sample size; exploratory multiple outcomes limit certainty.

Study Details

PMID:33978160
Participants:222
Impact:+0.41 SMD (EPA +0.61; DHA +0.43)
Trust score:4/5

Mean relative increase in serum creatinine (2–5 days)

1 evidences

In patients with stage 3 CKD undergoing iodinated contrast CT, withholding prehydration was noninferior for mean relative creatinine change and had similar low rates of postcontrast AKI.

Trust comment: Large multicentre randomized noninferiority trial with high follow-up and clinically relevant endpoints related to iodinated contrast safety.

Study Details

PMID:32065601
Participants:523
Impact:No prehydration 3.0% vs prehydration 3.5% (mean difference 0.5%; noninferior)
Trust score:5/5

Postcontrast acute kidney injury (2–5 days) incidence

1 evidences

In patients with stage 3 CKD undergoing iodinated contrast CT, withholding prehydration was noninferior for mean relative creatinine change and had similar low rates of postcontrast AKI.

Trust comment: Large multicentre randomized noninferiority trial with high follow-up and clinically relevant endpoints related to iodinated contrast safety.

Study Details

PMID:32065601
Participants:523
Impact:2.7% (no prehydration) vs 1.5% (prehydration)
Trust score:5/5

ascending aorta attenuation (HU)

1 evidences

Phase-3 randomized trial in healthy volunteers comparing two iodinated contrast agents found iohexol-380 increased ascending aorta enhancement but had similar coronary enhancement and similar mild adverse reaction rates.

Trust comment: Multicenter, randomized, double-blind phase-3 trial with predefined efficacy and safety endpoints and adequate sample size for imaging measures.

Study Details

PMID:27134522
Participants:224
Impact:mean higher with iohexol-380 vs iohexol-350 (p=0.030)
Trust score:4/5

adverse drug reaction rate

1 evidences

Phase-3 randomized trial in healthy volunteers comparing two iodinated contrast agents found iohexol-380 increased ascending aorta enhancement but had similar coronary enhancement and similar mild adverse reaction rates.

Trust comment: Multicenter, randomized, double-blind phase-3 trial with predefined efficacy and safety endpoints and adequate sample size for imaging measures.

Study Details

PMID:27134522
Participants:224
Impact:no significant difference: 48.7% (iohexol-380) vs 46.4% (iohexol-350); p=0.69
Trust score:4/5

Peak serum creatinine increase (day 0–3)

1 evidences

Randomized double-blind multicenter trial comparing iodixanol (iso-osmolar iodinated contrast) vs iohexol (low-osmolar iodinated contrast) in diabetic patients with impaired renal function; iodixanol produced smaller rises in serum creatinine and fewer clinically significant creatinine increases.

Trust comment: Prospective double-blind randomized multicenter trial with clear, significant renal outcome differences favoring iodixanol in high-risk patients; moderate sample size limits precision but design is strong.

Study Details

PMID:12571256
Participants:129
Impact:Iodixanol +0.13 mg/dL vs Iohexol +0.55 mg/dL (difference −0.42 mg/dL, P=0.001)
Trust score:4/5

Increase ≥0.5 mg/dL

1 evidences

Randomized double-blind multicenter trial comparing iodixanol (iso-osmolar iodinated contrast) vs iohexol (low-osmolar iodinated contrast) in diabetic patients with impaired renal function; iodixanol produced smaller rises in serum creatinine and fewer clinically significant creatinine increases.

Trust comment: Prospective double-blind randomized multicenter trial with clear, significant renal outcome differences favoring iodixanol in high-risk patients; moderate sample size limits precision but design is strong.

Study Details

PMID:12571256
Participants:129
Impact:Iodixanol 3% (2/64) vs Iohexol 26% (17/65) (P=0.002; OR 0.09)
Trust score:4/5

Mean change in creatinine (day 0–7)

1 evidences

Randomized double-blind multicenter trial comparing iodixanol (iso-osmolar iodinated contrast) vs iohexol (low-osmolar iodinated contrast) in diabetic patients with impaired renal function; iodixanol produced smaller rises in serum creatinine and fewer clinically significant creatinine increases.

Trust comment: Prospective double-blind randomized multicenter trial with clear, significant renal outcome differences favoring iodixanol in high-risk patients; moderate sample size limits precision but design is strong.

Study Details

PMID:12571256
Participants:129
Impact:Iodixanol +0.07 mg/dL vs Iohexol +0.24 mg/dL (difference −0.17 mg/dL, P=0.003)
Trust score:4/5

time to symptomatic progression

1 evidences

Randomized trial found that placing an iodine-125 seed-loaded irradiation stent before TACE improved survival and reduced liver failure versus sorafenib+TACE.

Trust comment: Multicentre randomized controlled trial with clear endpoints and statistically significant interim differences, but early stopping and smaller-than-planned sample reduce precision.

Study Details

PMID:37038986
Participants:105
Impact:+2.4 months (6.6 vs 4.2 mo); HR=0.60 (40% reduced hazard)
Trust score:4/5

post-TACE liver failure

1 evidences

Randomized trial found that placing an iodine-125 seed-loaded irradiation stent before TACE improved survival and reduced liver failure versus sorafenib+TACE.

Trust comment: Multicentre randomized controlled trial with clear endpoints and statistically significant interim differences, but early stopping and smaller-than-planned sample reduce precision.

Study Details

PMID:37038986
Participants:105
Impact:reduced from 20% to 6% (−14 percentage points)
Trust score:4/5

radiation-associated biomarker modulation

1 evidences

Phase II randomized biomarker study showed that 131I-MIBG therapy alters peripheral radiation biomarkers and that radiosensitizers modify the extent of biomarker changes; some biomarker changes associated with hematologic toxicity.

Trust comment: Randomized phase II biomarker-focused trial with moderate sample size; findings are exploratory and primarily associative.

Study Details

PMID:36526235
Participants:99
Impact:significant modulation of most biomarkers at 72–96 hours after 131I-MIBG
Trust score:3/5

overall response (association)

1 evidences

Phase II randomized biomarker study showed that 131I-MIBG therapy alters peripheral radiation biomarkers and that radiosensitizers modify the extent of biomarker changes; some biomarker changes associated with hematologic toxicity.

Trust comment: Randomized phase II biomarker-focused trial with moderate sample size; findings are exploratory and primarily associative.

Study Details

PMID:36526235
Participants:99
Impact:lower baseline BCL2 transcript associated with higher overall response
Trust score:3/5

grade 4 hematologic toxicity (thrombocytopenia)

1 evidences

Phase II randomized biomarker study showed that 131I-MIBG therapy alters peripheral radiation biomarkers and that radiosensitizers modify the extent of biomarker changes; some biomarker changes associated with hematologic toxicity.

Trust comment: Randomized phase II biomarker-focused trial with moderate sample size; findings are exploratory and primarily associative.

Study Details

PMID:36526235
Participants:99
Impact:greater FLT3 ligand increase at 96 h associated with higher risk of grade 4 thrombocytopenia
Trust score:3/5

iodine intake (dietary)

1 evidences

Cross-sectional analysis found that participants with highest metabolic syndrome severity had higher iodine (and sodium) intake compared with those with lowest severity.

Trust comment: Large cross-sectional observational analysis showing association between higher iodine intake and greater MetS severity; cannot infer causality.

Study Details

PMID:32272653
Participants:5739
Impact:higher dietary iodine intake observed in highest MetS severity tertile (T3) versus lowest (T1) — association noted
Trust score:3/5

10-year progression-free survival

1 evidences

Long-term follow-up of SWOG S0016 showed improved 10-year PFS with CHOP plus I-131 tositumomab consolidation but no overall survival benefit; increased MDS/AML incidence with RIT.

Trust comment: Well-conducted randomized intergroup trial with long (10+ year) follow-up providing robust long-term outcome data including late adverse events.

Study Details

PMID:29356608
Participants:531
Impact:PFS 56% (CHOP-RIT) vs 42% (R-CHOP); +14 percentage points, P=0.01
Trust score:5/5

10-year overall survival

1 evidences

Long-term follow-up of SWOG S0016 showed improved 10-year PFS with CHOP plus I-131 tositumomab consolidation but no overall survival benefit; increased MDS/AML incidence with RIT.

Trust comment: Well-conducted randomized intergroup trial with long (10+ year) follow-up providing robust long-term outcome data including late adverse events.

Study Details

PMID:29356608
Participants:531
Impact:OS 75% (CHOP-RIT) vs 81% (R-CHOP); no significant difference, P=0.13
Trust score:5/5

myelodysplastic syndrome/acute myeloid leukemia (MDS/AML)

1 evidences

Long-term follow-up of SWOG S0016 showed improved 10-year PFS with CHOP plus I-131 tositumomab consolidation but no overall survival benefit; increased MDS/AML incidence with RIT.

Trust comment: Well-conducted randomized intergroup trial with long (10+ year) follow-up providing robust long-term outcome data including late adverse events.

Study Details

PMID:29356608
Participants:531
Impact:higher cumulative incidence of death from MDS/AML with CHOP-RIT (4% vs 0.9%), P=0.02
Trust score:5/5