Today I fell across a brief letter suggesting that the intervals of Thyroid Function Tests are currently inappropriate. Typically, those with test results that are in range get tested more frequently than those who are out of range.
They might have a point.
The problem is their solution. That the lab should issue the requests.
We already have the situation in which labs refuse tests - and don't properly report back to the requester.
There are so many ethical issues. Who is responsible if a patient doesn't get the test they should? At least our relationship is currently (at least theoretically) with our doctors. Adding another party is concerning. Especially as it would very likely be implemented as a computer function without any personal responsibility being obvious.
If our FT3 doesn't get tested today, it is our doctors who we can blame, even if they shrug their shoulders and blame the lab.
Int J Clin Pract. 2017 Jan;71(1). doi: 10.1111/ijcp.12877.
Monitoring thyroid function in patients on levothyroxine: audit findings and suggested change in practice.
Scargill JJ1, Livingston M2, Holland D3, Khan A4, Duff CJ5,6, Fryer AA5,6, Heald AH4,7.
1Department of Clinical Biochemistry, Salford Royal Hospital, Salford, UK.
2Department of Blood Sciences, Walsall Manor Hospital, Walsall, UK.
3Keele University Benchmarking Service, School of Pharmacy, Keele University, Staffordshire, UK.
4Department of Medicine, Leighton Hospital, Crewe, UK.
5Department of Clinical Biochemistry, University Hospitals of North Midlands, Stoke-on-Trent, UK.
6Institute of Science & Technology in Medicine, Keele University, Staffordshire, UK.
7The School of Medicine and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK.
No abstract currently visible on PubMed.
We propose that direct requesting from the clinical labora
-tory (with a facility for clinician over-ride) may bring patients more
quickly to target with their TSH levels and reduce costs in relation
to unnecessary testing of TFTs when patients are already biochemi
-cally euthyroid. Such a change in practice, while requiring thorough
evaluation, has the potential to save money and improve patient outcomes.