通过基准测试改善实验室管理:专注于订购甲状腺功能测试
Ka Keung Chan1, Suhhyun Kim2, Patrick C Mathias3
1Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA 98195, United States; Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY 14642, United States.
Clinical biochemistry
|May 28, 2025
概括
通过TSH-first反射算法提高了甲状腺功能测试效率,稳定了测试比率. 然而,甲状腺刺激激素 (TSH) 和自由甲状腺素 (fT4) 测试的专业特定的排序模式表明存在持久的差异.
科学领域:
- 内分泌学 在内分泌学.
- 实验室医学 实验室医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 甲状腺功能测试,包括TSH和FT4,经常被订购.
- 了解利用趋势和优化订单模式对于高效的医疗保健至关重要.
研究的目的:
- 评估甲状腺检测利用的纵向趋势 (2009-2023年).
- 评估TSH-first反射测试算法对FT4排序的影响.
- 根据PLUGS指南,检查甲状腺测试订购的专业特异性差异.
主要方法:
- 从2009年到2023年对TSH和FT4测试量进行分析.
- 评估TSH/fT4比率和与异常TSH相关的FT4测试.
- 评估专业特定的订购模式和遵守反射测试.
主要成果:
- 观察到TSH和FT4测试量显著增加.
- 实施TSH-first反射算法使TSH/fT4比率稳定在3.7左右.
- fT4测试中异常TSH的百分比从26%增加到39%;初级保健显示了更高的坚持.
结论:
- 反射测试提高了甲状腺测试利用效率,与PLUGS基准保持一致.
- 甲状腺检测的专业特异性变化仍然存在,需要量身定制的方法.
- 实验室管理和共识基准提高了适当的甲状腺功能测试.
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