Thyroid function testing in primary care: overused and under-evidenced? A study examining which clinical features correspond to an abnormal thyroid function result

Family Practice
Alexander Werhun, William Hamilton

Abstract

Diagnostic testing is increasing in primary care, including for thyroid disease. This study examined which clinical features were associated with an abnormal thyroid stimulating hormone (TSH) result. This was a cross-sectional study in one general practice of 16,487 patients in Exeter, Devon, UK. We examined the primary care records relating to every TSH test taken in the year from August 2012, and extracted symptoms and/or the indication for testing. Associations with an abnormal result were tested using multivariable logistic regression. A cohort study was then performed of 100 patients newly recorded with each of the six features associated with an abnormal test result in the cross-sectional study, and the proportions tested for TSH and the results of that testing identified. Two thousand thirty-five patients (12% of the practice population) had TSH testing in the year. Of these 35 (1.7%) had a TSH >4.5 mIU/l, suggesting hypothyroidism, and 7 (0.3%) had TSH <0.01 mIu/l suggesting hyperthyroidism. Features associated with an abnormal TSH were: pregnancy, odds ratio 41 (95% confidence interval 9.3-180), constipation 9.7 (2.1-45), palpitations 23 (3.4-150), hair loss, 21 (2.0-230), weight gain, 18 (1.6-190) and diarrhoea, 13 (1...Continue Reading

References

Jan 1, 1983·Hypertension·I SaitoT Saruta
Jul 1, 1995·Diabetic Medicine : a Journal of the British Diabetic Association·P PerrosB M Frier
Mar 1, 1997·Endocrinology and Metabolism Clinics of North America·C Wang, L M Crapo
Jan 22, 2004·Annals of Internal Medicine·UNKNOWN U.S. Preventive Services Task Force
Aug 5, 2004·The Journal of Clinical Endocrinology and Metabolism·R W V FlynnG P Leese
Jan 15, 2005·Treatments in Endocrinology·John H Lazarus
May 20, 2006·Acta Diabetologica·D H AkbarJ Al-Mughales
Apr 7, 2007·Journal of Hypertension·Vasilios KotsisNikos Zakopoulos
Apr 4, 2009·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Hèlen KochPatrick J E Bindels
Aug 26, 2010·BMJ : British Medical Journal·William HamiltonAlison Round
Jun 10, 2011·Therapeutische Umschau. Revue thérapeutique·Henryk Zulewski
May 31, 2012·BMJ : British Medical Journal·Ray MoynihanDavid Henry
Jan 29, 2014·Indian Journal of Dermatology·Ola A BakryWafaa A Shehata

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Citations

Nov 7, 2017·Journal of Evaluation in Clinical Practice·Joseph K KluesnerMark W True
Jul 7, 2017·Thyroid : Official Journal of the American Thyroid Association·David C LinThe Thyroid Benchmarking Group Various
Feb 23, 2020·Annals of Clinical Biochemistry·Tanuka PalitChristopher J Duff
Nov 7, 2019·Frontiers in Endocrinology·Peter N TaylorOnyebuchi Okosieme
Jan 19, 2021·Journal of Endocrinological Investigation·L Dal MasoUNKNOWN DEPTH Working Group

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