Intraoperative parathyroid hormone testing: survey of testing program characteristics.

Area of Science:

• Clinical Chemistry
• Surgical Pathology
• Laboratory Medicine

Background:

• Intraoperative intact parathyroid hormone (PTH) testing has become a valuable tool in parathyroid surgery.
• The adoption and practice patterns of this assay have not been extensively documented.

Purpose of the Study:

• To determine the prevalence and characteristics of laboratories offering intraoperative intact PTH testing.
• To analyze testing methodologies and service delivery models for intraoperative intact PTH assays.

Main Methods:

• A survey was distributed to 355 laboratories participating in the College of American Pathologists Special Ligand Survey in 2001.
• The survey focused on the performance of intraoperative intact PTH testing, including frequency, methodology, and location of testing.

Main Results:

• Of 320 responding laboratories, 92 (29%) offered intraoperative intact PTH testing.
• Testing was performed for all (40%), most (31%), or less than half (30%) of parathyroidectomies, often at low monthly frequencies (≤5 cases/month for two-thirds of labs).
• Contrary to the initial point-of-care approach, 71% of testing occurred in central laboratories, 6% in satellite labs, and 23% in operating suites. Common assays included manual QuiCk-Intraoperative (33%), automated Immulite Turbo intact PTH (47%), and others (20%).

Conclusions:

• Intraoperative intact PTH testing is widely adopted in parathyroid surgery.
• The service delivery model has shifted from point-of-care to a central laboratory-based approach.
• This evolution illustrates broader trends in laboratory test utilization and logistics.