title: Request of thyroid function tests from Primary Care in Spain.
abstract: OBJECTIVE
  Laboratory tests are crucial for diagnosis and monitoring of thyroid disorders. It is therefore necessary to study the pattern and variability in requests of thyroid function tests. The study objectives were to compare the inter-regional variability in the request of laboratory thyroid tests by general practitioners (GPs) in Spain, and to investigate the potential economic savings if the goals set for some suitability indicators were reached.
  
  
  METHODS
  Test requests per 1,000 inhabitants and test ratios (free thyroxine (FT4)/thyrotropin (TSH), free triiodothyronine (FT3)/TSH, thyroglobulin antibody (TgAb)/peroxidase antibody (TPOAb)) were compared between the different areas, according to their setting, location, and management. The resulting savings if each department achieved the goals for indicator (0.25 for FT4/TSH, 0.1 for FT3/TSH) were estimated.
  
  
  RESULTS
  Seventy-six laboratories covering a population of 17,679,195 inhabitants participated in the study. TSH was requested significantly less in urban-rural areas, and the requests for FT3/1,000 inhabitants, FT3/TSH, and TgAb/TPOAb were higher in departments with private management. The savings generated if specifications for the ratios of related tests were met would be 937,260.5 €.
  
  
  CONCLUSIONS
  The high variability reported in requests for thyroid function and autoimmunity tests in Spain suggests the need for implementing strategies to improve use of such tests.
authors.affiliation: Servicio de Análisis Clínicos, Hospital Universitario de San Juan, San Juan de Alicante, España; Departamento de Bioquímica y Biología Molecular, Universidad Miguel Hernández, Elche, España. Electronic address: salinas_mar@gva.es.
authors.forename: Maria
authors.initials: M
authors.lastname: Salinas
authors.affiliation: Servicio de Análisis Clínicos, Hospital Universitario de San Juan, San Juan de Alicante, España; Departamento de Bioquímica y Biología Molecular, Universidad Miguel Hernández, Elche, España.
authors.forename: Maite
authors.initials: M
authors.lastname: López-Garrigós
authors.affiliation: Sección de Endocrinología y Nutrición, Hospital Universitario de San Juan, San Juan de Alicante, España.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Pomares
authors.affiliation: Servicio de Análisis Clínicos, Hospital Universitario de San Juan, San Juan de Alicante, España; Departamento de Medicina Clínica, Universidad Miguel Hernández, Elche, España.
authors.forename: Emilio
authors.initials: E
authors.lastname: Flores
authors.affiliation: Departamento de Salud Pública, Universidad de Alicante, Alicante, España.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Uris
authors.affiliation: Departamento de Radiología, Universidad de Virginia, Charlottesville, VA, Estados Unidos.
authors.forename: Carlos
authors.initials: C
authors.lastname: Leiva-Salinas
mesh_terms: D001323:Autoantibodies / Q000032:analysis; D006801:Humans; D011320:Primary Health Care; D013030:Spain; D013960:Thyroid Function Tests / Q000706:statistics & numerical data*; D013961:Thyroid Gland / Q000503:physiopathology*; D013972:Thyrotropin / Q000032:analysis; D013974:Thyroxine / Q000032:analysis; D014284:Triiodothyronine / Q000032:analysis
chemical_list: D001323:Autoantibodies; D014284:Triiodothyronine; D013972:Thyrotropin; D013974:Thyroxine
keywords: Adecuación; Clinical laboratory; Laboratorio; Pruebas de función tiroidea; Suitability; Thyroid function tests; Variabilidad clínica; Variability