Nolan J P, Tarsa N J, DiBenedetto G
Am J Clin Pathol. 1985 Mar;83(3):346-55. doi: 10.1093/ajcp/83.3.346.
An algorithmic test strategy was used in 5,002 hospital and clinic patients to detect unsuspected thyroid disease. The strategy eliminated redundant secondary tests; only 9.4% of patients required a T3 uptake determination and 2.7% a TSH or T3. Twenty-six cases of hypothyroidism (incidence: 0.5%) and seven cases of hyperthyroidism (incidence: 0.1%) were diagnosed. Costs of laboratory tests were analyzed in relation to health benefits. Fully allocated production and induced costs, after discounting to present value, amounted to $31,061. Health benefits were computed using a measure of quality of life derived from health status indices. Sensitivity analysis of selected patient groups demonstrated cost-effectiveness ratios ranging from $2,022 to $1,739 per quality adjusted life year.
一种算法测试策略被应用于5002名医院和诊所患者，以检测未被怀疑的甲状腺疾病。该策略消除了冗余的二次检测；仅9.4%的患者需要进行T3摄取测定，2.7%的患者需要进行促甲状腺激素（TSH）或T3检测。诊断出26例甲状腺功能减退症（发病率：0.5%）和7例甲状腺功能亢进症（发病率：0.1%）。对实验室检测成本与健康效益进行了分析。在折算为现值后，完全分摊的生产成本和诱导成本总计31061美元。使用从健康状况指数得出的生活质量衡量标准来计算健康效益。对选定患者群体的敏感性分析表明，每质量调整生命年的成本效益比在2022美元至1739美元之间。
