Thyroid problems are common and the symptoms are often very nonspecific. This is especially true with hypothyroidism. There are many different tests available to evaluate the function of the thyroid gland. However, many tests are over utilized and/or may not be appropriate for the type of thyroid problem suspected. Over the past few decades, there has been a steady increase in the number of thyroid tests ordered and the estimated cost for the most commonly ordered tests (TSH and free T4) totals $1.6 billion per year.
The objectives of this study were to compare patterns of thyroid testing ordered between different institutions, to assess the appropriateness of such testing, and to evaluate whether laboratory utilization protocols showed improvements in thyroid testing.
THE FULL ARTICLE TITLE:
Lin DC et al and the Thyroid Benchmarking Group. Multicenter Benchmark Study Reveals Significant Variation in Thyroid Testing in the United States. Thyroid 2017;27:1232-45.
SUMMARY OF THE STUDY
This study was done with data obtained from 82 laboratories associated with 24 unique US healthcare organizations, of which 13 were academic medical centers. The sites were selected from a voluntary web-based survey. The volume of serum thyroid tests over the 2015 calendar year was determined for the following tests: TSH, free T4, total T4, free T3, Total T3, T3 uptake and reverse T3. Then, that volume was standardized against the frequency of complete blood count (CBC) testing, probably the most common blood test ordered. The prevalence of CBC testing was also used to determine the total testing volume of each laboratory so that comparisons regarding overall volume across health care centers could be done. Researchers divided data by inpatient vs. outpatient patient settings. The investigators also collected data related to health care utilization management initiatives at each center.