Effectiveness of interventions to reduce ordering of thyroid function tests: a systematic review

Area of Science:

• Endocrinology
• Health Services Research
• Clinical Practice Guidelines

Background:

• Thyroid function tests are frequently ordered.
• Optimizing the ordering of these tests is crucial for efficient healthcare resource allocation.
• Behaviour change interventions are increasingly explored to influence clinical practice.

Purpose of the Study:

• To systematically review the effectiveness of interventions designed to modify the ordering of thyroid function tests.
• To identify which types of interventions are most successful in reducing test ordering.

Main Methods:

• A systematic review of literature was conducted, searching MEDLINE, EMBASE, and Cochrane Database up to May 2015.
• Included studies were randomized controlled trials (RCTs), non-randomized controlled studies, and before and after studies.
• Two independent reviewers screened studies, extracted data, and assessed methodological quality.

Main Results:

• Twenty-seven studies evaluated various interventions like guidelines, policy changes, education, and audit/feedback.
• Interventions showed effectiveness in reducing the volume of thyroid function tests ordered.
• The majority of studies had poor or moderate methodological quality, with variable and poorly reported interventions.

Conclusions:

• Behaviour change interventions appear effective in reducing thyroid function test volume.
• Poor study quality, reporting, and potential publication bias limit strong conclusions.
• Further high-quality research is needed to guide the implementation of specific interventions.