Endocrine Abstracts (2012) 28 P352

Direct access thyroid ultrasound for general practice - clinical indications and frequency of thyroid function assessment prior to making request

Omair Raja, Bhim Odedra, Kirun Gunganah, Maralyn Druce & Polly Richards

Specialist Endocrinology/Radioology, St. Bartholomew's Hospital, QMUL, London, United Kingdom.

Introduction and Objectives: Guidelines are available for the investigation of thyroid nodules. These include a general agreement that patients with abnormal thyroid function tests (TFTs) do not need routine ultrasound (US) assessment. Thyroid US is a common imaging request made by General Practitioners (GPs). This audit was devised to determine the range of clinical indications for GP thyroid US and the frequency with which TFTs are assessed by the GP prior to requesting the scan. Methods A retrospective audit was [Audit Reference No: 124/11] conducted on patients referred for thyroid US at our institution between Oct 2009 and April 2010. Information regarding investigations and outcomes was obtained from electronic records.

Results: 329 GP neck and thyroid US requests were reviewed, of which 127 specifically requested thyroid US; 20 males and 107 females, mean age 41 years. 43 % presented with asymptomatic palpable nodules, 16 % symptomatic nodules, 26 % of requests contained no clinical information and 13 % were requested for ‘abnormal TFTs’. 19% had had TFTs performed at our institution in the previous year, with 66% detailed in the scan request; a further 5% had had TFTs performed at our institution but requested by another clinician. One third of TFTs were abnormal.

Discussion: Patients with abnormal TFTs do not require routine thyroid US assessment yet TFTs do not appear to be routinely checked by the majority of GPs prior to requesting a scan. Even when available, the results were frequently missing from the clinical information. Clear guidance and GP education could reduce the number of unnecessary scan requested.

Declaration of interest: There is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Funding: No specific grant from any funding agency in the public, commercial or not-for-profit sector.

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