Vidal-Trécan G, Toubert M E, Paycha F, Fulla Y, Fior R, Abella A, Georges P
Département de santé publique, CHU Cochin-Port Royal, université René-Descartes, Paris.
Ann Endocrinol (Paris). 1999 Mar;60(1):48-55.
To determine the distribution of orders for hormonal tests assessing thyroid function in a hospital setting. To collect the opinion of physicians specialized in endocrinology concerning free triodothyronine (FT3) assessment.
Using a cross-sectional survey numbers of free thyroxine (FT4), total T4 (TT4), FT3, total T3 (TT3), and TSH tests were collected from the heads of laboratory assessing thyroid function in June 95 at the Assistance Publique-Hôpitaux de Paris (AP-HP). Cost for these tests was estimated. The physicians of the AP-HP specialized in endocrinology were asked through a questionnaire for circumstances justifying FT3 test ordering.
Twenty-eight laboratories (93%) responded: 28455 measurements (TSH: 43%, FT4: 33%, TT4: 2%, FT3: 20%, TT3: 2%) were performed and were valued at 3.4 million French Francs. Proportions of T4 (36%) and T3 (20%) tests were lower in hospitals with an inpatient department of endocrinology than in hospitals with an outpatient clinic with specialists in endocrinology (T4: 36%; T3: 27%) or with no endocrinology unit (T4: 33%, T3: 27%); proportion of TSH tests was higher in hospitals with an inpatient endocrinology unit (respectively 44%, 40%, 32%). Forty-two endocrinologists (76%) from 21 departments answered. Follow-up of treatment with amiodarone and euthyroid sick syndrome were considered the only conditions justifying FT3 test ordering.
Though the opinion of physicians specialized in endocrinology was not uniform regarding recommendations for TT3 or FT3 tests as a first-line measurement, the cost of these tests has been estimated at 650 thousand Francs for a month at the AP-HP.
确定医院环境中评估甲状腺功能的激素检测订单分布情况。收集内分泌专科医生对游离三碘甲状腺原氨酸（FT3）评估的意见。
采用横断面调查，于1995年6月从巴黎公立医院集团（AP-HP）评估甲状腺功能的实验室负责人处收集游离甲状腺素（FT4）、总T4（TT4）、FT3、总T3（TT3）和促甲状腺激素（TSH）检测的数量，并估算这些检测的费用。通过问卷调查向AP-HP的内分泌专科医生询问开具FT3检测订单的理由。
28个实验室（93%）做出回应：共进行了28455次检测（TSH：43%，FT4：33%，TT4：2%，FT3：20%，TT3：2%），价值340万法国法郎。设有内分泌科住院部的医院中，T4（36%）和T3（20%）检测的比例低于设有内分泌专科门诊的医院（T4：36%；T3：27%）或没有内分泌科的医院（T4：33%，T3：27%）；设有内分泌科住院部的医院中TSH检测的比例更高（分别为44%、40%、32%）。来自21个科室的42位内分泌科医生（76%）做出了回应。胺碘酮治疗随访和甲状腺功能正常的病态综合征被认为是开具FT3检测订单的唯一合理情况。
尽管内分泌专科医生对于将TT3或FT3检测作为一线检测的建议并不统一，但据估计，AP-HP每月这些检测的费用为65万法郎。
