How do I install the Es Tshd Screening Indication skill?

Run npx skillmds@latest add dromlakhani/es-tshd-screening-indication in your terminal (requires Node.js), paste this page's agent-chat prompt into Claude, Cursor, or any MCP-connected agent, or download the SKILL.md file and copy it into your agent's skills directory.

Is Es Tshd Screening Indication safe to use?

This skill has not completed SkillMD's automated safety review yet. Independent scanners report: SkillSpector: PASS, Skill Scanner: PASS. Capability flags: makes network calls. SkillMD never runs a skill's scripts for you; review the SKILL.md before installing.

Which AI agents work with Es Tshd Screening Indication?

This skill is tagged as working with Claude Code, Claude.ai, OpenAI Codex. SKILL.md is an open format, so most agents that read a skills directory can load it too.

Is Es Tshd Screening Indication free to use?

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Who published Es Tshd Screening Indication?

dromlakhani (@dromlakhani) published this skill. Their other Agent Skills are listed on their SkillMD profile.

Es Tshd Screening Indication by dromlakhani

Name: Es Tshd Screening Indication
Rating: 4.2 (5 reviews)
Author: dromlakhani

Es Tshd Screening Indication

This skill identifies childhood cancer survivors who require lifelong annual screening for thyroid-stimulating hormone deficiency (TSHD) based on hypothalamic-pituitary tumor history or radiation exposure ≥30 Gy. It is triggered by clinician questions such as “Does this survivor need yearly TSH testing?” or “Is annual thyroid function monitoring indicated post‑HP radiation?”

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Screen for TSHD indication

STEP 1 — Gather Information

Collect history of tumors or surgery involving the hypothalamic–pituitary (HP) region (e.g., suprasellar/optic pathway) and radiation dose to the HP axis (cranial RT, craniospinal irradiation, total body irradiation). Record whether HP radiation dose is ≥30 Gy.

STEP 2 — Rule In / Rule Out

If the survivor has a history of HP tumor/surgery OR HP radiation ≥30 Gy → proceed to Step 3; otherwise → Document that annual TSH screening is not indicated and stop.

STEP 3 — Classify or Stratify

Classify the patient as requiring lifelong annual screening for TSHD (central hypothyroidism).

STEP 4 — Decide

Order annual serum TSH with free T4 (or fT4) and schedule repeat testing every year for life.

Clinical Guardrails / Mimics / Pitfalls

Do not rely on TSH alone; always pair with free T4 to detect central hypothyroidism. Do not discontinue screening in asymptomatic survivors—TSHD can be subclinical for years. Avoid confusing TSHD with primary hypothyroidism (which shows elevated TSH). Do not use TRH stimulation, TSH surge, or total T4 alone for diagnosis. Remember that screening is lifelong, regardless of age or symptom status.

Concrete Clinical Example

A 12‑year‑old survivor of craniopharyngioma treated with surgical resection and 35 Gy cranial radiation has an HP tumor history and radiation dose ≥30 Gy → classified as needing lifelong annual TSH/fT4 screening.

Source: Hypothalamic Pituitary and Growth Disorders in Survivors of Childhood Cancer: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2018, https://doi.org/10.1210/jc.2018-01175

TODO: consider adding scripts/calc.py for the es-tshd-screening-indication calculator

---name: es-tshd-screening-indicationdescription: This skill identifies childhood cancer survivors who require lifelong annual screening for thyroid-stimulating hormone deficiency (TSHD) based on hypothalamic-pituitary tumor history or radiation exposure ≥30 Gy. It is triggered by clinician questions such as “Does this survivor need yearly TSH testing?” or “Is annual thyroid function monitoring indicated post‑HP radiation?”---# Screen for TSHD indication## STEP 1 — Gather InformationCollect history of tumors or surgery involving the hypothalamic–pituitary (HP) region (e.g., suprasellar/optic pathway) and radiation dose to the HP axis (cranial RT, craniospinal irradiation, total body irradiation). Record whether HP radiation dose is ≥30 Gy.## STEP 2 — Rule In / Rule OutIf the survivor has a history of HP tumor/surgery **OR** HP radiation ≥30 Gy → proceed to Step 3; otherwise → Document that annual TSH screening is **not indicated** and stop.## STEP 3 — Classify or StratifyClassify the patient as requiring **lifelong annual screening for TSHD** (central hypothyroidism).## STEP 4 — DecideOrder annual serum TSH with free T4 (or fT4) and schedule repeat testing every year for life.## Clinical Guardrails / Mimics / PitfallsDo not rely on TSH alone; always pair with free T4 to detect central hypothyroidism. Do not discontinue screening in asymptomatic survivors—TSHD can be subclinical for years. Avoid confusing TSHD with primary hypothyroidism (which shows elevated TSH). Do not use TRH stimulation, TSH surge, or total T4 alone for diagnosis. Remember that screening is lifelong, regardless of age or symptom status.## Concrete Clinical ExampleA 12‑year‑old survivor of craniopharyngioma treated with surgical resection and 35 Gy cranial radiation has an HP tumor history and radiation dose ≥30 Gy → classified as needing lifelong annual TSH/fT4 screening.**Source:** Hypothalamic Pituitary and Growth Disorders in Survivors of Childhood Cancer: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2018, https://doi.org/10.1210/jc.2018-01175> **TODO:** consider adding scripts/calc.py for the es-tshd-screening-indication calculator

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