Analysis of Current Thyroid Function Testing Practices

Rationale: Current guidelines recommend thyroid stimulating hormone (TSH) alone as the best test to detect and monitor thyroid dysfunction, yet free thyroxine (FT4) and free triiodothyronine (FT3) are commonly ordered when not clinically indicated. Excessive testing can lead to added economic burden...

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Bibliographic Details
Main Authors: Kluesner, Joseph K, Beckman,Darrick J, Tate,Joshua M, Beauvais,Alexis A, Kravchenko,Maria I, Wardian,Jana L, Graybill,Sky D, Colburn,Jeffrey A, Folaron,Irene, True,Mark W
Format: Report
Language:English
Subjects:
costs
health care
laboratory tests
medical research
Medicine and Medical Research
thyroid diseases
thyroid therapy drugs
Online Access:Request full text
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Summary:Rationale: Current guidelines recommend thyroid stimulating hormone (TSH) alone as the best test to detect and monitor thyroid dysfunction, yet free thyroxine (FT4) and free triiodothyronine (FT3) are commonly ordered when not clinically indicated. Excessive testing can lead to added economic burden in an era of rising healthcare costs, while rarely contributing to the evaluation or management of thyroid disease. Objective: (1) to evaluate our institution's practice in ordering thyroid function tests (TFTs) and (2) to identify strategies to help reduce inappropriate FT4 and FT3 testing. Methods: A record of all TFTs obtained in the San Antonio Military Health System (SAMHS) during a three month period in 2016 was extracted from the electric medical record (EMR). TFTs of interest were: TSH, FT4, thyroid panel )TSH + FT4), FT3, total thyroxine (T$), and total triiodothyronine (T3). These were also categorized based on the presence or absence of hypothyroidism. American Thyroid Association 2017 Meeting , 18 Oct 2017, 22 Oct 2017,