Initial evaluation of thyroid dysfunction - Are simultaneous TSH and fT4 tests necessary?

ABSTRACT:

Objective

Guidelines for thyroid function evaluation recommend testing TSH first, then assessing fT4 only if TSH is out of the reference range (two-step), but many clinicians initially request both TSH and fT4 (one-step). Given limitations of previous studies, we aimed to compare the two-step with the one-step approach in an unselected community-dwelling study population, and develop a prediction score based on clinical parameters that could identify at-risk patients for thyroid dysfunction.

Design

Cross-sectional analysis of the population-based Busselton Health Study.

Methods

We compared the two-step with the one-step approach, focusing on cases that would be missed by the two-step approach, i.e. those with normal TSH, but out-of-range fT4. We used likelihood ratio

SUBMITTER: Schneider C 

PROVIDER: S-EPMC5927436 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature