The Diagnostic Yield of Thyroid Function Tests and their Cost-effectiveness in the Student Clinic at Sultan Qaboos University: Retrospective chart review

Abstract

Objectives: To assess the significance of requesting thyroid function tests (TFT) and their cost effectiveness for specific and non-specific symptoms of thyroid disease in a specific population in Oman.

Methods: A retrospective chart review study was conducted in the student clinic at Sultan Qaboos University in Oman in the year 2007-2008. It included all patients (N = 319) of both sexes for whom TFTs were requested. The patients' main complaints and the final diagnoses were collected from their medical records.

Results: The most common presentations for which TFTs were requested were irregular periods (n = 82); fatiguability (n = 49), palpitations (n = 39); weight changes (n = 22); hair changes (n= 20); sensation of heat and cold (n= 18); diarrhoea and constipation (n = 13), and neck swelling (n = 13). The most common diagnoses reached in relation to these complaints were polycystic ovarian syndrome (n = 51); iron deficiency anaemia (n = 42); anxiety and depression (n = 11); thyroid disease (n = 18), and no specific diagnosis (n = 193). The percentage of thyroid diseases among females (7.1%) compared to males (1.2%) was statistically significant (P <0.05). Thyroid disease accounted for 61.5% of those patient with neck swelling, 7.7% of those with palpitations, 4.1% of those with fatigue, 3% of those with other complaints, and 1.2% of those with irregular periods. The cost of the tests was around 20,000 US dollars.

Conclusion: TFT is necessary for those presenting with neck swelling, but restraint should be used in administering the test for those complaining of palpitations or fatigue. Additionally, irregular periods have little link with TFT abnormality.

Keywords: Cost-effective; Oman; Retrospective study; Student clinic; Thyroid function tests.