Comparison of kodak amerlite FT4 and TSH-30 with T4 and TSH as first-line thyroid function tests
✍ Scribed by Vaijoo Rege; Olusegun Mojiminiyi; Hervey Wilcox; Jeffrey Barron
- Publisher
- Elsevier Science
- Year
- 1996
- Tongue
- English
- Weight
- 343 KB
- Volume
- 29
- Category
- Article
- ISSN
- 0009-9120
No coin nor oath required. For personal study only.
✦ Synopsis
Objectives:
To evaluate the effect of test automation and a change in strategy for thyroid function tests (TFT) on personnel needs and turn-around time. The first-line TFT were changed from T4 and TSH to FT 4 and TSH-30.
Design and Methods: Samples received for TFT from 357 randomly selected patients were analyzed by RIA for T 4, and by IRMA for TSH as first-line tests. FTz and TBG were requested as back-up tests when indicated. Patients were classified on the basis of these results and the clinical information received. All the samples were reanalyzed for FT 4 and TSH on the Amerlite Processing Center, which is a batch, semiautomated immunoassay system. The thyroid status of the patients was compared using the two protocols and available clinical data.
Results: There was good correlation between TSH-IRMA and TSH-30 in the 160 patients classified as euthyroid (r = 0.956; p < 0,001) and no euthyroid patient was reclassified with the new strategy. In 21 patients with borderline raised TSH-IRMA, FT 4 was found to be low in only 2. All 11 patients classified as hypothyroid had TSH results greater than 10 mU/L and all except 2 patients had FT4 less than 11 nmol/L. The status of 21 hyperthyroid as well as 40 patients on carbimazole could be determined biochemically on the basis ¢,f agreement between both the FT 4 and TSH-30 results. FT 3 was only required if the FT4 and TSH-30 results were not in agreement. In 42 patients on T4 therapy, adequacy of replacement was assessed better using FT 4 and TSH-30. No patient required backup testing with TBG to determine thyroid status using the new testing protocol. The change in TFT protocol reduced the 95% turn-around time from 3 days to 1 day.
Conclusion:
The introduction of FT 4 and TSH-30 as first-line TFT improved the turn-around time for TFT, resulted in 25% reduction in personnel requirements, 60% reduction in FT 3 assays, and discontinuation of TBG assay.