Wayne Index (Clinical Diagnosis of Thyrotoxicosis)

The Wayne index (Crooks, Murray and Wayne 1959) for the clinical diagnosis of thyrotoxicosis.

Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

Symptom: Dyspnea on effort
Yes
Symptom: Palpitations
Yes
Symptom: Tiredness
Yes
Symptom: Temperature preference
Prefers cold
Symptom: Excessive sweating
Yes
Symptom: Nervousness
Yes
Symptom: Appetite
Increased
Symptom: Weight
Decreased
Sign: Palpable thyroid
Yes
Sign: Bruit over the thyroid
Yes
The other 8 values
Sign: Exophthalmos
Yes
Sign: Lid retraction
Yes
Sign: Lid lag
Yes
Sign: Hyperkinesis
Yes
Sign: Hands hot
Yes
Sign: Hands moist
Yes
Sign: Atrial fibrillation
No
Sign: Casual pulse rate
Above 90/min

Result: Wayne index 41: toxic range.

The tool opens with these values already filled in. Replace them with your own.

What the result means

Signed weights
Several weights are negative: preferring heat -5, an absent palpable thyroid -3, absent hyperkinesis -2, a pulse below 80 -3. An exam with nothing found scores -10, not 0.
Above 19
Toxic range.
11 to 19
Equivocal.
Below 11
Euthyroid.
Not a lab test
Published in 1959, before sensitive TSH assays. Not a substitute for TSH and free T4, and it does not identify the cause.

What you enter

  • Symptom: Dyspnea on effort
  • Symptom: Palpitations
  • Symptom: Tiredness
  • Symptom: Temperature preference
  • Symptom: Excessive sweating
  • Symptom: Nervousness
  • Symptom: Appetite
  • Symptom: Weight
  • Sign: Palpable thyroid
  • Sign: Bruit over the thyroid
The other 8 fields
  • Symptom: Dyspnea on effort [no = No, 0; yes = Yes, +1]
  • Symptom: Palpitations [no = No, 0; yes = Yes, +2]
  • Symptom: Tiredness [no = No, 0; yes = Yes, +2]
  • Symptom: Temperature preference [heat = Prefers heat, -5; neither = Neither, 0; cold = Prefers cold, +5]
  • Symptom: Excessive sweating [no = No, 0; yes = Yes, +3]
  • Symptom: Nervousness [no = No, 0; yes = Yes, +2]
  • Symptom: Appetite [decreased = Decreased, -3; unchanged = Unchanged, 0; increased = Increased, +3]
  • Symptom: Weight [increased = Increased, -3; unchanged = Unchanged, 0; decreased = Decreased, +3]
  • Sign: Palpable thyroid [no = Absent, -3; yes = Present, +3]
  • Sign: Bruit over the thyroid [no = Absent, -2; yes = Present, +2]
  • Sign: Exophthalmos [no = Absent, 0; yes = Present, +2]
  • Sign: Lid retraction [no = Absent, 0; yes = Present, +2]
  • Sign: Lid lag [no = Absent, 0; yes = Present, +1]
  • Sign: Hyperkinesis [no = Absent, -2; yes = Present, +4]
  • Sign: Hands hot [no = Absent, -2; yes = Present, +2]
  • Sign: Hands moist [no = Absent, -1; yes = Present, +1]
  • Sign: Atrial fibrillation [no = Absent, 0; yes = Present, +4]
  • Sign: Casual pulse rate [under80 = Below 80/min, -3; 80to90 = 80 to 90/min, 0; over90 = Above 90/min, +3]
How this is calculated

Crooks J, Murray IPC, Wayne EJ. Statistical methods applied to the clinical diagnosis of thyrotoxicosis. Q J Med. 1959;28(110):211-234. Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

Browse all tools

Built by Clay Good. Source on GitHub.