What is it about?
Blood tests for thyroid function are increasingly being ordered by physicians. Abnormal blood tests often lead to a specialist referral and likely more testing. However the vast majority of these patients do NOT require treatment (80% in this study). Also more than 1/3rd of the patients referred to the pediatric endocrinologist in this study did NOT require any follow-up thyroid tests. Hence, thyroid tests may be unnecessary in patients who are not at high risk/ have no abnormal findings on physical exam. There is a need to formulate better guidelines to reduce unnecessary thyroid testing and referrals.
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Why is it important?
With rising healthcare cost, it is essential to evaluate each aspect of medical practice to ensure we minimize wasteful practices. Blood tests should preferably be ordered only when a medical condition is strongly suspected and a decision may be made based on the test results, rather than as a "routine practice". This study shows how the current trend of checking thyroid function tests for a variety of symptoms often lead to potentially avoidable expense and specialist referrals.
Perspectives
As an endocrinologist, I frequently see patients with thyroid disorders. However a large proportion of them have minor abnormalities in their test results picked up on a "routine test". The families are often distraught and anxious about the unclear nature of these findings. Education alone is sufficient in several of these patients to reassure them about the benign nature of the abnormality. Since a large proportion of these referrals do not require treatment or any thyroid follow-up, educating the patients and physicians may help us formulate better guidelines for when is thyroid testing unnecessary and should be avoided.
Amit Lahoti
Read the Original
This page is a summary of: Prevalence and Determinants of True Thyroid Dysfunction Among Pediatric Referrals for Abnormal Thyroid Function Tests, Global Pediatric Health, May 2016, SAGE Publications,
DOI: 10.1177/2333794x16646701.
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