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CPE-006 · Safety
HG-11: Testosterone-therapy cautions to review
Testosterone-therapy cautions to review. Evaluates testosterone therapy under consideration.
Active rulePriority 2Testosterone engine v1.0.0
Condition
- testosterone therapy under consideration
- any of: prostate cancer, breast cancer, palpable prostate nodule or induration, PSA > 4 ng/mL, hematocrit > 50%, untreated severe sleep apnea, severe lower urinary tract symptoms, unstable heart failure, myocardial infarction or stroke in the last 6 months, thrombophilia
What it reports
- Endocrine Society cautions or contraindications to testosterone therapy are present
Recommended next steps (for physician review)
- Resolve or evaluate each flag before any decision on therapy
Never outputs
- a recommendation to start testosterone therapy
Diagnostic boundary
- A screen of cautions. It is never an indication.
Evidence
- EV-ES-TRT-2018Bhasin S, Brito JP, Cunningham GR, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103(5):1715-1744.Supports: Diagnose with symptoms plus unequivocally low testosterone on two morning fasting samples Contraindications and cautions to therapy; monitoring of hematocrit and PSA Evaluation of the type of hypogonadism with LH and FSH
- EV-TRAVERSE-2023Lincoff AM, Bhasin S, Flevaris P, et al. Cardiovascular Safety of Testosterone-Replacement Therapy. N Engl J Med. 2023;389(2):107-117.Supports: Cardiovascular safety data in hypogonadal men at increased cardiovascular risk, with higher rates of atrial fibrillation, pulmonary embolism and acute kidney injury
Cases where this rule fires
Open a case to see this rule fire with real inputs, then change the values until it stops.
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