Diagnosis of Thyroid Disease-Reply

To the Editor:—  In spite of the current multitude of thyroid function tests, we have yet to see any single test prove to be completely specific and reliable. To allow the Achilles reflex test, a relative newcomer in the field of diagnostic procedures, to displace clinical judgment in diagnosing thyroid dysfunction is contrary to sound medical practice, and is certainly overly enthusiastic. Lawson, who devised the kinemometer, has tended to be conservative in his estimate of its diagnostic accuracy. In 1959, he reported that the test was 95.9 per cent accurate in diagnosing euthyroidism, 94.1 per cent accurate in hypothyroidism, and 71.4 per cent accurate in hyperthyroidism. Also in 1959, he stated that the test appears "promising in diagnosis of thyroid dysfunction, but its prime value is in following the effects of therapy once the diagnosis has been established, using all available diagnostic means at hand." He did not think