From guidelines to hospital practice: reducing inappropriate ordering of thyroid hormone and antibody tests

Because of major technical improvements and conscious care about cost effectiveness, limiting the inadequate use of thyroid biological tests appears to be a major issue. To (i) estimate the ordering prevalence of each thyroid test, (ii) assess the prevalence of relevant thyroid tests, and (iii) eval...

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Bibliographic Details
Published in:European journal of endocrinology 2000-06, Vol.142 (6), p.605-610
Main Authors: TOUBERT, M.-E, CHEVRET, S, CASSINAT, B, SCHLAGETER, M.-H, BERESSI, J.-P, RAIN, J.-D
Format: Article
Language:English
Subjects:
Autoantibodies - analysis
Biological and medical sciences
Data Collection
Endocrinology
Health Services Misuse
Hospitals
Humans
Investigative techniques, diagnostic techniques (general aspects)
Medical sciences
Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
Practice Guidelines as Topic
Prospective Studies
Thyroid Function Tests
Thyroid Hormones - blood
Thyroid Hormones - immunology
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Summary:Because of major technical improvements and conscious care about cost effectiveness, limiting the inadequate use of thyroid biological tests appears to be a major issue. To (i) estimate the ordering prevalence of each thyroid test, (ii) assess the prevalence of relevant thyroid tests, and (iii) evaluate the impact of expressing justification for tests during a 2-month intervention period on these prevalences. During a prospective 2-month survey (June-July 1997), all the request forms were divided into four groups of prescription: (1) investigation of thyroid function, (2) taking drugs affecting the thyroid, (3) monitoring of nodule and cancer, and (4) investigation of thyroid autoimmunity. Their appropriateness was thus determined according to consensus in our hospital and previously published recommendations. Results were compared with those of retrospective similar 2-month periods in 1996 and 1998. Combinations of thyroid function tests and thyroid antibodies were analyzed during the 1996, 1997 and 1998 periods. The overall estimated rate of appropriate ordering between 1996 and 1997 increased from 42.5% to 72.4% (P
ISSN:0804-4643
1479-683X
DOI:10.1530/eje.0.1420605