Evaluation of using thyroid function test follow to The Endocrine Society Of Thailand recommendation 2013 to screening and diagnosis thyrotoxicosis/hyperthyroidism in Wangsapung hospital.
Keywords:
Hyperthyroidsim, Thyrotoxicosis, diagnosis, Thyroid function testAbstract
The thyroid function test is used to diagnosis abnormal thyroid functions and to evaluate the treatment for many thyroid diseases such as thyrotoxicosis and hyperthyroidism (in the majority), endemic goiter, hypothyroid, thyroiditis and cancer of thyroid. Many types of testing pattern cause the expense in the hospital. Medical staffs in Wangsapung hospital use the testing protocol for diagnosis thyrotoxicosis and hyperthyroidism follow to The Endocrine Society of Thailand recommendation 2013 to reduce the excessive test prescribed that thyroid stimulation hormone level (TSH) blood test performed in case of no objective evidence or signs of hyperthyroidism, and TSH & free thyroxine (FT4) in case of 1 or more signs of hyperthyroidism. This aimed to reduce the use TSH FT4 and triiodothyronine (T3) or free T3 (FT3) protocol and may reduce the cost of investigation.
This retrospective research was done on November 2020, aimed to study result of using thyroid function test following implementation of The Endocrine Society of Thailand recommendation 2013 to screening and diagnosis thyrotoxicosis/hyperthyroidism in Wangsapung hospital. Collected data from Wangsapung hospital database in 2013 – 2019 to analyse the pattern of usage the thyroid function test (TSH, FT4 and FT3 /or T3) compared to all type of the pattern of screening & evaluation in serial of time sequence of use the clinical practice guideline implemention in 2015, and thyroid clinic unit was founded in 2017. Data were analyzed by descriptive statistic.
Result show that the study include 12,167 times of test, in 4,749 people; within 7 years. The frequency of “TSH + FT4 + FT3 or T3” testing pattern in 2013-2014 (before implement the clinical practice guideline) was 36.80%, in 2015-2016 (after the implement) was 22.79%, in 2017-2019 (after Thyroid clinic unit was founded) was 20.88%. The average expense of test in 2013-2014 was 350.23 Baht/blood test, in 2015-2016 was 314.40 Baht/blood test, and 288.60 Baht/blood test in 2017-2019. The total cost was increased due to the frequency of test (1,356 times/year in 2013-2014 to 2,087 times/year in 2017-2019). This concluded that the implementation of clinical practice guideline for diagnosis thyroxicosis and hyperthyroidism according to The Endocrine Society of Thailand recommendation 2013 can reduce the use of excessive screening pattern, but the expense was increased from the frequency of follow up and blood test.
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การละเมิดลิขสิทธิ์ถือเป็นความรับผิดชอบของผู้ส่งบทความโดยตรง
ผลงานที่ได้รับการตีพิมพ์ถือเป็นลิขสิทธิ์ของผู้นิพนธ์ ขอสงวนสิทธิ์มิให้นำเนื้อหา ทัศนะ หรือข้อคิดเห็นใด ๆ ของบทความในวารสารไปเผยแพร่ทางการค้าก่อนได้รับอนุญาตจากกองบรรณาธิการ อย่างเป็นลายลักษณ์อักษร
