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Journals / Türk Klinik Biyokimya Dergisi / 2017 / Cilt: 15 - Sayı: 2

"Reflex Test" Implementation on Thyroid Function Test Requests and Examination of the Effect on Health Expenditures

Tiroid Fonksiyon Test İstemlerinde “Refleks Test” Uygulaması ve Sağlık Harcamalarına Etkisinin İncelenmesi

Can DUMAN
İnanç KARAKOYUN
Defne ÖZBEK
Ferhat DEMİRCİ
Fatma Demet ARSLAN
Dilek KALENCİ
Pages
67–74
Publication Date
2022-11-05
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Results: After the implementation, unnecessary test for all outpatient clinics decreased from 40,65% to 1,19% (p

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objective: Thyroid function tests (TFT) are the most frequently requested endocrine tests from clinical laboratories.
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Key Findings & Data:The change in unnecessary test request rates was assessed by the "significance test of the difference between the two percent".
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Conclusion & Impact:Results: After the implementation, unnecessary test for all outpatient clinics decreased from 40,65% to 1,19% (p
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objective: Thyroid function tests (TFT) are the most frequently requested endocrine tests from clinical laboratories. Although the guidelines published by the American and British Thyroid Associations suggest the use of thyroid stimulating hormone (TSH) as a first step test for thyroid diseases, algorithms for these tests are not considered. In our study, we aimed to investigate the effect of health expenditure of the TFT reflex test application which we initiated in our hospital. Material and Methods: The request of at least one of the free triiodothyronine or free tetraiodothyronine tests in addition to the TSH test in euthyroid patients was also considered unnecessary test. Cost analysis of unnecessary tests was performed six months before and six months after the reflex test application. The change in unnecessary test request rates was assessed by the "significance test of the difference between the two percent". Results: After the implementation, unnecessary test for all outpatient clinics decreased from 40,65% to 1,19% (p

Özet

Amaç: Tiroid fonksiyon testleri (TFT) klinik laboratuvarlardan en sık istenen endokrin testlerdir. Amerikan ve İngiliz Tiroid Dernekleri tarafından yayınlanan kılavuzlar, tiroid uyarıcı hormonun (TSH) tiroid hastalıkları için ilk adım testi olarak kullanılmasını önerse de, bu testler için algoritmalar dikkate alınmamaktadır. Çalışmamızda hastanemizde başlattığımız TFT refleks testi uygulamasının sağlık harcamasının etkisini araştırmayı amaçladık. Gereç ve Yöntem: Ötiroid hastalarda TSH testine ek olarak serbest triiodotironin veya serbest tetraiyodotironin testlerinden en az birinin istemi gereksiz test olarak değerlendirildi. Gereksiz testlerin maliyet analizi, refleks testi uygulamasından altı ay önce ve altı ay sonra şeklinde gerçekleştirildi. Gereksiz test istem oranlarındaki değişim "iki yüzde arasındaki farkın anlamlılık testi" ile değerlendirildi. Bulgular: Uygulama sonrasında tüm poliklinikler için gereksiz test oranı %40,65'den %1,19'a düştü (p (p

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Cite This Article

DUMAN, C., KARAKOYUN, İ., ÖZBEK, D., DEMİRCİ, F., ARSLAN, F. D., KALENCİ, D. (2022). "Reflex Test" Implementation on Thyroid Function Test Requests and Examination of the Effect on Health Expenditures. Türk Klinik Biyokimya Dergisi, Cilt: 15 - Sayı: 2, 67–74. https://ajindex.com/articles/634405

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References (13)

  1. Koulouri O, Moran C, Halsall D, Chatterjee K, Gurnell M. Pitfalls in the measurement and interpretation of thyroid function tests. Best Pract Res Clin Endocrinol Metab. 2013 Dec;27(6):745–62
  2. Spencer CA, LoPresti JS, Patel A, Guttler RB, Eigen A, Shen D, et al. Applications of a new chemiluminometric thyrotropin assay to subnormal measurement. J Clin Endocrinol Metab. 1990 Feb;70(2):453–60. 3. de los Santos ET, Starich GH, Mazzaferri EL. Sensitivity, specificity, and cost-effectiveness of the sensitive thyrotropin assay in the diagnosis of thyroid disease in ambulatory patients. Arch Intern Med. 1989 Mar;149(3):526–32
  3. Ladenson PW, Singer PA, Ain KB, Bagchi N, Bigos ST, Levy EG, Smith SA, Daniels GH, Cohen HD. American thyroid association guidelines for detection of thyroid dysfunction. Arch Intern Med. 2000;160:1573–5
  4. British Thyroid Association. UK Guidelines for the Use of Thyroid Function Tests July 2006 1. Consultant. 2006;(July):1–86
  5. Janssens PMW, Wasser G. Managing laboratory test ordering through test frequency filtering. Clin Chem Lab Med. 2013;51(6):1207–15
  6. HHS Office of Inspector General. Publication of OIG Compliance Program for Clinical Laboratories. Federal Register Notice, Vol. 63, No. 163, August 24, 1998, 45076-45087
  7. Bruce A. Jones, Leonas G. Bekeris, Raouf E. Nakhleh, Molly K. Walsh, and Paul N. Valenstein (2009) Physician Satisfaction With Clinical Laboratory Services: A College of American Pathologists QProbes Study of 138 Institutions. Archives of Pathology & Lab
  8. Richard J. Zarbo, Raouf E. Nakhleh, and Molly Walsh (2003) Customer Satisfaction in Anatomic Pathology. Archives of Pathology & Laboratory Medicine: January 2003, Vol. 127, No. 1, pp. 23-29
  9. May TA, Clancy M, Critchfield J, Ebeling F, Enriquez A, Gallagher C, et al. Reducing Unnecessary Inpatient Laboratory Testing in a Teaching Hospital. Am J Clin Pathol. 2006 Aug 1;126(2):200–6
  10. Wang TJ, Mort EA, Nordberg P, Chang Y, Cadigan ME, Mylott L, et al. A Utilization Management Intervention to Reduce Unnecessary Testing in the Coronary Care Unit. Arch Intern Med. 2002 Sep 9;162(16):1885
  11. Kim JY, Dzik WH, Dighe AS, Lewandrowski KB. Utilization Management in a Large Urban Academic Medical Center. Am J Clin Pathol. 2011 Jan 1;135(1):108–18
  12. Hilborne LH. When Less Is More for Patients in Laboratory Testing. Am J Clin Pathol. 2013 Mar 1;139(3):271–2
  13. Garmendia Madariaga A, Santos Palacios S, GuillénGrima F, Galofré JC. The Incidence and Pr