2014 Volume 2 Issue 1 Pages 19-26
Objective: We developed a new, simple, low-cost screening method for detecting patients with overt thyroid dysfunction (PTDs) using a combination of six routine tests, and identified 7 new PTDs in the Ningen Dock of JR Sendai Hospital. The aim of this study was to investigate whether we can use this screening method on many more people taking Ningen Dock health check-ups and detect a lot of PTDs who should be further examined soon.
Methods: The screening was applied to 8,831 Japanese people undergoing a health check-up in the Ningen Dock of Tohoku Kousai Hospital from September 2011 to March 2013. Six types of routine test data (alkaline phosphatase, serum creatinine, total cholesterol, heart rate, lactate dehydrogenase and red blood cells), which had already been measured, were input to a personal computer.
Results: Through the measurement of serum TSH and free T4 (FT4) in 144 people who were suspected of having thyroid dysfunction in our screening (probability of >60%), we identified 14 new overt PTDs (8 Graves’ disease, 2 painless thyroiditis, 4 hypothyroidism). Except for the patient with Graves’ disease, none of them was suspected of having thyroid dysfunction in a medical examination. If we limit additional testing consisting of TSH and FT4 measurement to subjects with a thyroid dysfunction probability of >85%, this would greatly decrease the number of false positives and no Graves’ disease patient would be overlooked.
Conclusions: The clinical usefulness of our method in screening for overt PTDs was confirmed. More than 10,000 PTDs would be discovered if this screening were performed at all Ningen Docks in Japan.
