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Cost-effectiveness of Thyroid Function Tests

Cost-effectiveness of Thyroid Function Tests Abstract • The cost-effectiveness of thyroid function tests (serum thyroxine concentration, triiodothyronine [T3]-resin uptake, free thyroxine index, serum T3, and serum thyrotropin concentration) was assessed in 135 ambulatory patients suspected of hypothyroidism or hyperthyroidism who did not have a history of thyroid disease requiring medication or thyroid surgery within the preceding two years. Of patients with five or more signs and symptoms compatible with thyroid dysfunction, 50.0% had biochemical abnormalities substantiating hypothyroidism or hyperthyroidism, while only 1.5% of patients with fewer than two signs and symptoms had either disease. The cost of thyroid function tests was twice as much per patient evaluated by residents as for those evaluated by faculty physicians. These results suggest that interventions to reduce the number and type of tests in patients without multiple signs and symptoms of thyroid disease could improve the cost-effective use of these tests. (Arch Intern Med 1982;142:1810-1812) References 1. Griner PF, Liptzin B: Use of the laboratory in a teaching hospital. Ann Intern Med 1971;75:157-163.Crossref 2. Eisenberg JM, Williams SV, Garner L, et al: Computer based audit to detect and correct overutilization of laboratory tests. Med Care 1977; 15:915-921.Crossref 3. White GH, Walmsley RN: Can the initial clinical assessment of thyroid function be improved? Lancet 1978;2:933-935.Crossref 4. Brookeman VA, Williams CM: Cost benefit analysis of in vitro screening tests of thyroid function. JNM 1981;14:721-722. 5. Dixon RH, Laszlo J: Utilization of clinical chemistry services by medical housestaff. Arch Intern Med 1974;134:1064-1067.Crossref 6. Hardwick DF, Vertinsky P, Buth RT, et al: Clinical styles and motivation: A study of laboratory test use. Med Care 1975;13:397-408.Crossref 7. Turnbridge WMG, Evered DC, Hall R, et al: The spectrum of thyroid disease in a community: The Whickham survey. Clin Endocrinol 1977; 7:481-493.Crossref 8. Stauffer M, Clayson KG, Roby RJ, et al: A computer-assisted system: Thyroid disease. Am J Clin Pathol 1974;62:766-774. 9. Button KE, Quinn V, Brown BL, et al: A strategy for thyroid function tests. Br Med J 1975;3:350-352.Crossref 10. Rhyne RL, Gehlback SH: Effects of an educational feedback strategy on physician utilization of thyroid function panels. J Fam Pract 1979; 8:1033-1037. 11. Daniels DL, Henry HW: Selective performance of T3 uptake: A practical approach to thyroid function studies. JNM 1981;22:605-609. 12. Vagenakis AG, Braverman LE: Thyroid function tests—which one? Ann Intern Med 1976;84:607-608.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Cost-effectiveness of Thyroid Function Tests

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1982.00340230050010
Publisher site
See Article on Publisher Site

Abstract

Abstract • The cost-effectiveness of thyroid function tests (serum thyroxine concentration, triiodothyronine [T3]-resin uptake, free thyroxine index, serum T3, and serum thyrotropin concentration) was assessed in 135 ambulatory patients suspected of hypothyroidism or hyperthyroidism who did not have a history of thyroid disease requiring medication or thyroid surgery within the preceding two years. Of patients with five or more signs and symptoms compatible with thyroid dysfunction, 50.0% had biochemical abnormalities substantiating hypothyroidism or hyperthyroidism, while only 1.5% of patients with fewer than two signs and symptoms had either disease. The cost of thyroid function tests was twice as much per patient evaluated by residents as for those evaluated by faculty physicians. These results suggest that interventions to reduce the number and type of tests in patients without multiple signs and symptoms of thyroid disease could improve the cost-effective use of these tests. (Arch Intern Med 1982;142:1810-1812) References 1. Griner PF, Liptzin B: Use of the laboratory in a teaching hospital. Ann Intern Med 1971;75:157-163.Crossref 2. Eisenberg JM, Williams SV, Garner L, et al: Computer based audit to detect and correct overutilization of laboratory tests. Med Care 1977; 15:915-921.Crossref 3. White GH, Walmsley RN: Can the initial clinical assessment of thyroid function be improved? Lancet 1978;2:933-935.Crossref 4. Brookeman VA, Williams CM: Cost benefit analysis of in vitro screening tests of thyroid function. JNM 1981;14:721-722. 5. Dixon RH, Laszlo J: Utilization of clinical chemistry services by medical housestaff. Arch Intern Med 1974;134:1064-1067.Crossref 6. Hardwick DF, Vertinsky P, Buth RT, et al: Clinical styles and motivation: A study of laboratory test use. Med Care 1975;13:397-408.Crossref 7. Turnbridge WMG, Evered DC, Hall R, et al: The spectrum of thyroid disease in a community: The Whickham survey. Clin Endocrinol 1977; 7:481-493.Crossref 8. Stauffer M, Clayson KG, Roby RJ, et al: A computer-assisted system: Thyroid disease. Am J Clin Pathol 1974;62:766-774. 9. Button KE, Quinn V, Brown BL, et al: A strategy for thyroid function tests. Br Med J 1975;3:350-352.Crossref 10. Rhyne RL, Gehlback SH: Effects of an educational feedback strategy on physician utilization of thyroid function panels. J Fam Pract 1979; 8:1033-1037. 11. Daniels DL, Henry HW: Selective performance of T3 uptake: A practical approach to thyroid function studies. JNM 1981;22:605-609. 12. Vagenakis AG, Braverman LE: Thyroid function tests—which one? Ann Intern Med 1976;84:607-608.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Oct 1, 1982

References