Print

Thyroid Function Test (M2)

S Jill Stocks, Evangelos Kontopantelis, Artur Akbarov, Sarah Rodgers, Anthony J Avery, Darren M Aschroft

Type
Biomarker
ID
PH664
Version ID
1328
Data Sources
Valid event data range
Start - 01/02/2013
Sex
Female, Male
Agreement Date
2015-11-03
Coding system
Read codes v2
Tags /Collections
ClinicalCodes Repository Phenotype Library

Definition

Study question:

What is the prevalence of different types of potentially hazardous prescribing in general practice in the United Kingdom, and what is the variation between practices?

Methods:

A cross sectional study included all adult patients potentially at risk of a prescribing or monitoring error defined by a combination of diagnoses and prescriptions in 526 general practices contributing to the Clinical Practice Research Datalink (CPRD) up to 1 April 2013. Primary outcomes were the prevalence of potentially hazardous prescriptions of anticoagulants, anti-platelets, NSAIDs, β blockers, glitazones, metformin, digoxin, antipsychotics, combined hormonal contraceptives, and oestrogens and monitoring by blood test less frequently than recommended for patients with repeated prescriptions of angiotensin converting enzyme inhibitors and loop diuretics, amiodarone, methotrexate, lithium, or warfarin.

Study answer and limitations:

49 927 of 949 552 patients at risk triggered at least one prescribing indicator (5.26%, 95% confidence interval 5.21% to 5.30%) and 21 501 of 182 721 (11.8%, 11.6% to 11.9%) triggered at least one monitoring indicator. The prevalence of different types of potentially hazardous prescribing ranged from almost zero to 10.2%, and for inadequate monitoring ranged from 10.4% to 41.9%. Older patients and those prescribed multiple repeat medications had significantly higher risks of triggering a prescribing indicator whereas younger patients with fewer repeat prescriptions had significantly higher risk of triggering a monitoring indicator. There was high variation between practices for some indicators. Though prescribing safety indicators describe prescribing patterns that can increase the risk of harm to the patient and should generally be avoided, there will always be exceptions where the indicator is clinically justified. Furthermore there is the possibility that some information is not captured by CPRD for some practices—for example, INR results in patients receiving warfarin.

What this study adds:

The high prevalence for certain indicators emphasises existing prescribing risks and the need for their appropriate consideration within primary care, particularly for older patients and those taking multiple medications. The high variation between practices indicates potential for improvement through targeted practice level intervention.

Publications

  • S Jill Stocks, Evangelos Kontopantelis, Artur Akbarov, Sarah Rodgers, Anthony J Avery, Darren M Ashcroft, Examining variations in prescribing safety in UK general practice cross sectional study using the Clinical Practice Research Datalink. BMJ, 351(h5501), 2015.

Clinical Code List

Rows: 58
Code Description Entity type Category Coding System (Read)
442..00 Thyroid hormone tests res25: M2_TFT test Read
442..11 TRH level res25: M2_TFT test Read
442..12 TSH level res25: M2_TFT test Read
442..13 Thyroid function tests res25: M2_TFT test Read
442..14 Thyroxine binding globulin res25: M2_TFT test Read
4421 Thyroid hormone tests normal res25: M2_TFT test Read
4421.11 Euthyroid res25: M2_TFT test Read
4422 Thyroid hormone tests high res25: M2_TFT test Read
4423 Thyroid hormone tests low res25: M2_TFT test Read
4424 Serum T3 level res25: M2_TFT test Read
4424000 Serum T3 level normal res25: M2_TFT test Read
4424100 Serum T3 level high res25: M2_TFT test Read
4424200 Serum T3 level low res25: M2_TFT test Read
4425 Free T3 level res25: M2_TFT test Read
4426 Serum T4 level res25: M2_TFT test Read
4426000 Serum T4 level normal res25: M2_TFT test Read
4426100 Serum T4 level abnormal res25: M2_TFT test Read
4427 Free T4 level res25: M2_TFT test Read
4428 Free thyroxine index res25: M2_TFT test Read
4429 Thyroxine binding globulin-TBG res25: M2_TFT test Read
442A.00 TSH - thyroid stim. hormone res25: M2_TFT test Read
442A000 Serum TSH level normal res25: M2_TFT test Read
442A100 Serum TSH level abnormal res25: M2_TFT test Read
442B.00 TRH - thyroid release. hormone res25: M2_TFT test Read
442C.00 Thyroid horm tests borderline res25: M2_TFT test Read
442D.00 T3 uptake test res25: M2_TFT test Read
442D000 T3 uptake test normal res25: M2_TFT test Read
442D100 T3 uptake test abnormal res25: M2_TFT test Read
442E.00 PBI - protein bound iodine estimation res25: M2_TFT test Read
442F.00 T3 suppression test res25: M2_TFT test Read
442G.00 Thyroid hormone tests abnormal res25: M2_TFT test Read
442H.00 Thyroid function tests normal res25: M2_TFT test Read
442I.00 Thyroid function tests abnormal res25: M2_TFT test Read
442J.00 Thyroid function test res25: M2_TFT test Read
442K.00 30 minute plasma TSH level res25: M2_TFT test Read
442L.00 60 minute plasma TSH level res25: M2_TFT test Read
442M.00 90 minute plasma TSH level res25: M2_TFT test Read
442N.00 120 minute plasma TSH level res25: M2_TFT test Read
442O.00 150 minute plasma TSH level res25: M2_TFT test Read
442P.00 30 minute serum TSH level res25: M2_TFT test Read
442Q.00 60 minute serum TSH level res25: M2_TFT test Read
442S.00 120 minute serum TSH level res25: M2_TFT test Read
442T.00 150 minute serum TSH level res25: M2_TFT test Read
442U.00 Serum free triiodothyronine level res25: M2_TFT test Read
442V.00 Serum free T4 level res25: M2_TFT test Read
442W.00 Serum TSH level res25: M2_TFT test Read
442X.00 Plasma TSH level res25: M2_TFT test Read
442Y.00 Plasma free triiodothyronine level res25: M2_TFT test Read
442Z.00 Thyroid hormone tests NOS res25: M2_TFT test Read
442a.00 Plasma total T4 level res25: M2_TFT test Read
442b.00 Serum total T4 level res25: M2_TFT test Read
442c.00 Plasma free T4 level res25: M2_TFT test Read
442d.00 Serum thyroglobulin level res25: M2_TFT test Read
442e.00 Blood spot TSH level res25: M2_TFT test Read
442f.00 Serum total T3 level res25: M2_TFT test Read
442g.00 Serum thyroglobulin recovery level res25: M2_TFT test Read
442h.00 Thyrotropin releasing hormone (TRH) stimulation test res25: M2_TFT test Read
C134300 TSH - thyroid-stimulating hormone deficiency res25: M2_TFT test Read

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH664/version/1328/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH664/version/1328/detail/?format=json
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get details of phenotype

details = get_phenotype_detail_by_version('PH664', '1328', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH664/version/1328/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH664/version/1328/export/codes/?format=json
CSV site_root/phenotypes/PH664/version/1328/export/codes/
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get codelists of phenotype

codelists = get_phenotype_code_list('PH664', '1328', api_client=client)

Version History

Version
ID
Name Owner Publish date
1328 Thyroid Function Test (M2) ieuan.scanlon 2021-10-06 currently shown

Export - export all codes into a csv file/JSON/XML for the current phenotype version.

Print - Print page.