Pain R W, Duncan B M
Clin Chem. 1976 Oct;22(10):1562-6.
Clinicians experience difficulty in correctly interpreting the results of in vitro thyroid function tests in the presence of abnormalities of thyrobinding proteins or when results are borderline. This difficulty has been largely resolved in our laboratory by three innovations. First, the borderline areas for each of three routine tests of thyroid function (total thyroxine, thyrobinding index, and free thyroxine index) were accurately determined. Second, the results from this routine profile of three tests were displayed pictorially so as to produce patterns characteristic of various diagnostic situations, including euthyroidism in the presence of abnormalities of thyrobinding proteins. Third, interpretive comments and, in the case of borderline patterns, suggested further testing procedures were added to the report. Clinicians find the reporting system helpful and respond when additional tests are suggested. The system, operated manually at first, was later computerized.
临床医生在甲状腺结合蛋白异常或检测结果处于临界值时,难以正确解读体外甲状腺功能测试的结果。在我们实验室,通过三项创新措施,这一难题已基本得到解决。首先,准确测定了三项常规甲状腺功能测试(总甲状腺素、甲状腺结合指数和游离甲状腺素指数)各自的临界范围。其次,以图形方式展示这三项测试的常规结果概况,从而生成各种诊断情况的特征模式,包括存在甲状腺结合蛋白异常时的甲状腺功能正常情况。第三,在报告中添加了解释性注释,对于临界模式,还给出了进一步检测程序的建议。临床医生发现该报告系统很有帮助,并且在建议进行额外检测时会做出回应。该系统最初是手动操作的,后来实现了计算机化。