నైరూప్య

Thyroid Function Test Ordering Pattern in a Tertiary Care Hospital in Western Uttar Pradesh, India.

Rajni Dawar Mahajan, Tabassum Yasmin, and Anoop Kumar

Disorders of the thyroid gland are amongst the most common endocrine disorders encountered in clinical practice. Thyroid function tests are used to evaluate the thyroid’s functioning and to diagnose cause of thyroid diseases. The diagnosis of thyroid disease consists of a history and clinical examination, followed by specific confirmatory investigations. These investigations are an important diagnostic tool in thyroid disease. Also they are amongst the most common investigations ordered in clinical laboratories. These tests are relatively inexpensive individually but they account for a disproportionately large amount of health care expenditure for diagnostic testing. American thyroid association and American Association of Clinical Endocrinologists recommend serum TSH measurement as the single most reliable test to diagnose all common forms of hypothyroidism and hyperthyroidism particularly in the ambulatory setting. The aim of this study was to analyze the ordering pattern for thyroid function tests by physicians in Rama super speciality hospital. Total of 483 samples were received during study period of 1st January to 15th July 2013. Outpatients accounted for 86.7% of total samples with maximum requisitions from medicine followed by obstetrics and gynaecology. 46% of requisitions were for thyroid function test and approximately equal 46.7% for TSH only. While analysing the results it was seen that percentage of samples with normal results was around 77% in both thyroid profile and only TSH. Therefore we conclude that there is need for appropriate test ordering in a rational and cost effective manner and an optimal approach to identify patients of thyroid dysfunction.