Chonnam Med J.
2002 Mar;38(1):50-55.
Choice of Thyroid Function Test in Patients with Thyroid Diseases
- Affiliations
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- 1Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea. mychung@chonnam.ac.kr
- 2Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea.
Abstract
- Thyroid function test is essential in diagnostic approach to the patients with suspicious thyroid diseases. Measurements of thyroid stimulating hormone (TSH), total thyroid hormone (total T4, total T3), and free thyroid hormone (free T4, free T3) are widely used in clinical practice. But, there has been no report concerning with the most cost-effective thyroid function test in Korean population. Study subjects were 211 patients who visited The Thyroid Clinic in Chonnam University Hospital for the evaluation of thyroid problems from Jan. 1996 to Dec. 2000. The data were classified to five diagnostic categories: hyperthyroidism, hypothyroidism, euthyroidism, subclinical hypothyroidism and hyperthyroidism. Various combinations of thyroid function tests were analysed to obtain the sensitivity and specificity in each diagnostic category. TSH is the most sensitive screening method of thyroid diseases. And there were no differences in sensitivity and specificity between patient tested with TSH and free T4 and patient tested with 3 or more diagnostic methods. In conclusion, simultaneous measurement of TSH and free T4 is the most cost-effective diagnostic approach method in patients with thyroid diseases. Large amount of medical cost can be saved if we use this simple paradigm in clinical practice.
