Document Detail

Sensitivity, specificity, and cost-effectiveness of the sensitive thyrotropin assay in the diagnosis of thyroid disease in ambulatory patients.
MedLine Citation:
PMID:  2493228     Owner:  NLM     Status:  MEDLINE    
The sensitivity and specificity of two sensitive thyrotropin assays were compared with those of other standard thyroid function tests in 544 ambulatory subjects who were clinically euthyroid, thyrotoxic, or hypothyroid. Both sensitive thyrotropin assays had the highest sensitivity and specificity (95%/89% and 92%/95%), following by estimated free thyroxine (T4) level (82% and 94%), calculated free T4 index (78% and 93%), and free triiodothyronine index (86% and 88%). Sensitivity of the two thyrotropin assay kits in the diagnosis of thyrotoxicosis was 86% and 95%, and that in the diagnosis of hypothyroidism was 92% and 94%. Other tests were nearly as sensitive in the diagnosis of thyrotoxicosis but not hypothyroidism. A cost analysis of a testing strategy that used either total T4, free T4 index, or sensitive thyrotropin assay alone as the first-line thyroid test disclosed that to establish the patient's thyroid metabolic status would have cost $11,093, $14,536, and $24,902, respectively, using each test first. We suggest that, at current prices, routine use of the thyrotropin assay as a first-line test in ambulatory patients is not as cost-effective as the free T4 index.
E T de los Santos; G H Starich; E L Mazzaferri
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Archives of internal medicine     Volume:  149     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  1989 Mar 
Date Detail:
Created Date:  1989-04-06     Completed Date:  1989-04-06     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  526-32     Citation Subset:  AIM; IM    
Department of Internal Medicine-Endocrinology, Ohio State University, Columbus.
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MeSH Terms
Cost-Benefit Analysis
Costs and Cost Analysis
Middle Aged
Reference Values
Thyroid Diseases / diagnosis*
Thyroid Function Tests*
Thyrotropin / blood*
Grant Support
Reg. No./Substance:

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