Trends and components of thyroid status evaluation in commercially insured adults in the US, 2006-2020.

Morris EJ, Vouri SM, Maraka S, Singh Ospina N. Trends and components of thyroid status evaluation in commercially insured adults in the US, 2006-2020. The Journal of clinical endocrinology and metabolism. 2023 Oct 27; doi.org/10.1210/clinem/dgad632.

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Abstract:

BACKGROUND: Thyroid stimulating hormone (TSH) is one of the most ordered laboratory tests. OBJECTIVE: Determine trends of TSH testing rates and components of thyroid function testing. DESIGN: Retrospective analysis. PARTICIPANTS: Adults 18-64 years old without evidence of thyroid disease with at least 365 days of continuous enrollment between 2006 and 2020 in the IBM MarketScan Claims Database. MAIN MEASURES: Trends of TSH tests/1,000 eligible patient-months stratified by age, sex, and region and composition of thyroid function testing. KEY RESULTS: Among 67,353,280 patients meeting eligibility criteria, we identified 25,606,518 TSH tests and 15,138,211 patients with ? 1 TSH test. Patients contributing an episode of TSH testing were most commonly 45-54 years old (29.8%) and female (63.6%).TSH testing rates remained consistent throughout the study period with 11.4 and 11.7 TSH tests/1,000 person-months in the first and last study months, respectively (mean 12.2 TSH tests/1,000 person-months). TSH testing rates dropped sharply in the spring of 2020 (4.2 TSH tests/1,000 person-months).Females showed a nearly twofold higher rate of TSH testing compared with males (16.1 TSH tests/1,000 person-months vs. 8.6 TSH tests/1,000 person-months). TSH testing rates increased with age (8.2 TSH tests/1,000 person-months among individuals 18-34 years vs. 15.4 TSH tests/1,000 person-months among individuals 55-64 years old). No difference in TSH testing rates was noted between regions.Thyroid function testing episodes included only TSH in most cases (70.8%). CONCLUSION: TSH testing rates among commercially insured individuals without known thyroid disease appears stable over time, with higher frequency in females and with increasing age.