[Diagnosis of thyreopatic diseases by laboratory examinations--possibility for rational economy]

This paper is oriented on the possibility of racional economy of laboratory diagnostical process of thyreopathies. The study was based on analysis of 29,683 examinations made at biochemical department in hospital Trencín. The overuse--mostly of antibodies and also, but less of thyreoidal hormones was discovered, mostly in the group of physicians in general practise and less in hospital and internal practise. The absence of initial algoritmus in thyreoidology is documented. The followed approach was formulated as new proposal: the first step is the examination of TSH (by ultrasensitive method) with possibility for all groups of physicians. Clinical and biochemical department should have responsibility to add fT4 in the case of pathological TSH. The endokerinologist should have responsibility for all other thyreoidal examinations, but in reasonable case also the internists in ambulatory and hospital care, and other relevant hospital physicians could order these examinations. Probability of cost saving was about 34% of expanditures on thyreoidology. To make the recount for Slovak republic the saving cost could be about 42,500,000 Sk.