Rizzolo P J, Fischer P M
J Fam Pract. 1982 Jun;14(6):1017-21.
Once thyroid hormone is prescribed, it is usually continued throughout a persons's lifetime. It is therefore important that the diagnosis be based on the most definitive test available. In this study with a primary care population of 6,000 individuals, 24 patients were found to carry the diagnosis of hypothyroidism. A careful view of the records showed that the diagnosis was inadequately documented by current standards in 20 of these 24 individuals. A 21-day hormone withdrawal test was done in ten of the patients in whom the diagnosis was suspected, and 60 percent were found to be euthyroid. Although the number of patients was small, this does encourage the speculation that many patients diagnosed in the past as hypothyroid may in fact be euthyroid. The medical as well as economic impact of this high rate of misdiagnosis becomes apparent when the one contemplates the 15,000,000 prescriptions for thyroid hormone written annually in the United States.
一旦开了甲状腺激素药物，通常需终身服用。因此，基于现有最确切的检查来做出诊断非常重要。在这项针对6000名初级保健人群的研究中，发现有24名患者被诊断为甲状腺功能减退。仔细查看记录发现，按照当前标准，这24名患者中有20名的诊断记录不充分。对其中10名疑似诊断的患者进行了为期21天的激素撤药试验，结果发现60%的患者甲状腺功能正常。尽管患者数量较少，但这确实引发了一种猜测，即过去许多被诊断为甲状腺功能减退的患者实际上可能甲状腺功能正常。当人们考虑到美国每年开出的1500万份甲状腺激素处方时，这种高误诊率对医疗和经济的影响就显而易见了。
