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CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ |
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Česky / Czech version | Vnitř. Lék., 47, 2001, No. 4, p. 253-256 |
Diagnosis of Thyreopatic Diseases
by Laboratory Examinations - Possibility for Racional Economy Bielik J., Vindiš J., Voglová V., Kaušitz J., Lepej . Interné oddelenie II, NsP, Nové Mesto nad Váhom, primár doc. MUDr. J. Bielik, CSc. Oddelenie klinickej biochémie, NsP, Trenčín, primár MUDr. J. Vindiš Endokrinologická ambulancia interného oddelenia NsP, Trenčín, primár MUDr. M. Kaščák Onkologický ústav sv. Alžbety, Bratislava, riaditeľ doc. MUDr. J. Kaušitz, CSc. Oddelenie nukleárnej medicíny NsP, FDR B. Bystrica, primár MUDr. J. Lepej, CSc. |
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Summary: This paper is oriented on the possibility of racional economy of laboratory diagnostical process of
thyreopathies. The study was based on analysis of 29 683 examinations made at biochemical
department in hospital Trenčín. The overuse - mostly of antibodies and also, but less of thyreoidal
hormones was discovered, mostly in the group of physicians in general practise and less in
hospital and internal practise. The absence of initial algoritmus in thyreoidology is documented.
The followed approach was formulated as new proposal: the first step is the examination of TSH
(by ultrasensitive method) with possibility for all groups of physicians. Clinical and biochemical
department should have responsibility to add fT4 in the case of pathological TSH. The endokcrinologist should have responsibility for all other thyreoidal examinations, but in reasonable case
also the internists in ambulatory and hospital care, and other relevant hospital physicians could
order these examinations. Probability of cost saving was about 34 % of expanditures on thyreoidology. To make the recount for Slovak republic the saving cost could be about 42 500 000 Sk
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