Multi-Center Benchmark Study Reveals Significant Variation in Thyroid Testing in United States.

Area of Science:

• Clinical Chemistry
• Endocrinology
• Laboratory Medicine

Background:

• Significant laboratory testing is often unnecessary.
• Thyroid tests are frequently ordered, but practice patterns are poorly understood.
• This study aimed to gather data on thyroid testing practices in the U.S.

Purpose of the Study:

• To collect data on practice patterns for thyroid testing in the United States.
• To analyze variations in thyroid test ordering and utilization.
• To identify areas for improvement in thyroid test selection.

Main Methods:

• A survey was conducted across 82 sites in the U.S.
• Collected data on annual test volumes for various thyroid hormones and complete blood counts (CBC).
• Compared thyroid workup rates (TSH/CBC) and test selection patterns.

Main Results:

• Thyroid workup rates were higher in outpatients than inpatients.
• Significant practice variation was observed in the selection of thyroid tests (e.g., FT4 vs. TT4, FT3 vs. TT3).
• Utilization management activities showed a weak correlation with improved thyroid test ordering quality.

Conclusions:

• Considerable practice variation in thyroid testing necessitates better guidance for test selection.
• Opportunities exist to improve the quality of thyroid testing and reduce associated costs.
• Standardizing thyroid testing protocols could lead to more efficient healthcare delivery.