[Evaluation of a diagnostic protocol of thyroid dysfunction]

Area of Science:

• Endocrinology
• Clinical Diagnostics
• Health Economics

Background:

• Thyroid dysfunction diagnosis relies on accurate and cost-effective testing protocols.
• Optimizing laboratory testing pathways is crucial for efficient patient management and resource allocation.

Purpose of the Study:

• To evaluate a three-stage diagnostic protocol for thyroid dysfunction in primary care.
• To assess the cost-effectiveness and diagnostic yield of the proposed protocol.
• To identify potential improvements by adjusting testing parameters and cut-off values.

Main Methods:

• A descriptive, retrospective study involving 8,818 non-hospitalized patients with no prior treatment.
• Implemented a three-stage testing protocol: TSH first, followed by FT4 for confirmation, and T3 only when necessary.
• Analyzed cost savings and diagnostic accuracy, exploring variations in TSH cut-off values.

Main Results:

• The protocol demonstrated acceptable analytic sensitivity and specificity.
• An estimated 45.7% of potential FT4 and T3 tests were avoided, leading to significant cost savings.
• Adjusting TSH cut-off values to match reference ranges showed potential for further economic benefits.

Conclusions:

• The three-stage protocol is a suitable method for diagnosing thyroid dysfunction.
• Refining TSH cut-off values within the protocol can enhance its efficiency and cost-effectiveness.
• The study highlights the importance of optimized diagnostic algorithms in managing thyroid disorders.