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Investigating Investigation (Ab)Use: Thyroid Function Test Audit in a Tertiary Care Teaching Institute in Eastern India

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Abstract

An essential component of contemporary health care is laboratory testing. As the utilization of diagnostic tests grow, there is also an increase in the scrutiny of such tests for its effectiveness, balance of cost and over- utilization. Thyroid dysfunction is common across all age groups and is associated with a number of comorbid states. The thyroid function tests (TFTs) are very important for the diagnosis and monitoring of such patients. The guidelines recommend serum thyroid stimulating hormone (TSH) as the single most reliable test to diagnose all common forms of hypothyroidism and hyperthyroidism, except in few cases. This study was conducted to study the investigation requesting pattern of TFTs. Our results showed that TFT panel was ordered in almost equal numbers (35.58%) as single test of TSH (41.27%). Subclinical thyroid disease was diagnosed in 22.1% of cases and the rest were excluded as having any thyroid dysfunction. Over 2/3rd of all requests were for women. An important conclusion from our study was that, the essentiality of lab tests is a decision entirely in the hands of the treating physician keeping in mind the cost and best outcome for patients. Hospitals can develop strategic protocols for ordering laboratory tests keeping resources, need and patient satisfaction and outcomes optimal.

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Data Availability

Yes.

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Acknowledgements

I acknowledge the help rendered by LiveHealth.solutions, Creliant Software Pvt Ltd., Pune for their support in retrieving and classification of TFTs from the Laboratory information system.

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Authors and Affiliations

  1. Department of Biochemistry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India

    Suchanda Sahu

  2. Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India

    Joseph John

Authors
  1. Suchanda Sahu
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  2. Joseph John
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Contributions

Dr. SS contributed in conceptualization, acquisition, analysis, interpretation of data, preparation and editing and Dr. JJ did the interpretation of data, review and editing of this manuscript. Both authors read and approved the final manuscript.

Corresponding author

Correspondence to Suchanda Sahu.

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The authors declare that they have no conflict of interest.

Ethical Approval

IEC approval was obtained from our institute bearing the reference number T/IM-NF/ Biochem/18/ 19 DATED 15. 09. 2018.

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We give consent to IJCB to publish this article.

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Sahu, S., John, J. Investigating Investigation (Ab)Use: Thyroid Function Test Audit in a Tertiary Care Teaching Institute in Eastern India. Ind J Clin Biochem 37, 499–503 (2022). https://doi.org/10.1007/s12291-020-00955-w

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  • DOI: https://doi.org/10.1007/s12291-020-00955-w

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