Dear Editor,

I have read with great interest the article by Afşin and Çalışkan titled “Quality of Life Outcomes Following Radioactive Iodine-131 Therapy in Hyperthyroid Patients: Insights from the Thyroid Patient-Reported Outcome Questionnaire,” recently published in Molecular Imaging and Radionuclide Therapy (1).

While the topic is undoubtedly relevant and the study presents promising findings regarding the impact of radioactive iodine (RAI) therapy on quality of life (QoL) in hyperthyroid patients, I would like to raise a methodological concern that may impact the interpretability of the results.

The authors have utilized the thyroid patient-reported outcome (ThyPRO) questionnaire to assess QoL changes before and after RAI therapy. However, to the best of my knowledge, no formal validity and reliability study has yet been conducted for the Turkish version of the ThyPRO instrument. The absence of a culturally and linguistically validated version of the tool may introduce bias, limit interpretability, and compromise the internal validity of the results.

Given the importance of using psychometrically robust instruments, especially in studies relying on patient-reported outcomes, this issue should be acknowledged as a limitation in the manuscript. I respectfully suggest that future studies using the ThyPRO in Turkish-speaking populations should ensure proper cross-cultural adaptation and psychometric validation in accordance with established guidelines.

Thank you for considering this comment in the spirit of constructive academic discourse.

Sincerely,