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@ -5,6 +5,50 @@ progress<!--# Write after I write everything else -->
## Summary of Results
The findings of this study indicate that within another commonly ordered
laboratory testing, the diagnostic value of Free T4 can be predicted
accurately 80% of the time. While examining only the elevated TSH
results, the algorithm had a false positive rate of 2% and a false
negative rate of 16%. In the original data, 76% of the time, the result
was non-diagnostic for Hypo-Thryodism. For the decreased TSH results,
the algorithm had a false positive rate of 8% and a false negative rate
of 20%. In the original data, 67% of the time, the result was
non-diagnostic for Hyper-Thryodism.
1846 - Hypo
423 - Hyper
9170 - High TSH (hypo)
## Real World Applications
While the current algorithm did not quite achieve an accuracy ready for
deployment, it is hypothesized that a system like this could be
implemented in clinical decision-making systems. As stated previously,
current practice is a physician (or other care providers) orders a TSH,
and if the value is outside laboratory-established reference ranges, the
Free T4 is added on. In the current study database, this reflex testing
was non-diagnostic 76% of the time for elevated TSH values and 67% for
decreased TSH values. Using clinical decision support first to predict
whether the Free T4 would be diagnostic, the care provider can use this
prediction and other patient signs and symptoms to determine if running
a Free T4 lab test is needed.
Similarly to Luo et al., the idea that the diagnostic information
offered by Free T4 often duplicates what other diagnostic tests provide
suggests a notion of "informationally" redundant testing [-@luo2016]. It
is speculated that informationally redundant testing occurs in various
diagnostic settings and diagnostic workups. It is much more frequent
than the more traditionally defined and narrowly framed notion of
redundant testing, which most often includes unintended duplications of
the same or similar tests. Under this narrow definition, redundant
laboratory testing is estimated to waste more than \$5 billion annually
in the United States, potentially dwarfed by the waste from
informationally redundant testing [@luo2016]. However, since Free T4 and
all other tests used in this study are performed on automated
instruments, the cost savings to the lab and patient may be minimal.
## Study Limitations
Section overview - In progress
@ -51,31 +95,3 @@ more powerful algorithm
### Future Studies
Explain how to fix these issues.
## Real World Applications
While the current algorithm did not quite achieve an accuracy ready for
deployment, it is hypothesized that a system like this could be
implemented in clinical decision-making systems. As stated previously,
current practice is a physician (or other care providers) orders a TSH,
and if the value is outside laboratory-established reference ranges, the
Free T4 is added on. In the current study database, this reflex testing
was non-diagnostic 76% of the time for elevated TSH values and 67% for
decreased TSH values. Using clinical decision support first to predict
whether the Free T4 would be diagnostic, the care provider can use this
prediction and other patient signs and symptoms to determine if running
a Free T4 lab test is needed.
Similarly to Luo et al., the idea that the diagnostic information
offered by Free T4 often duplicates what other diagnostic tests provide
suggests a notion of "informationally" redundant testing [-@luo2016]. It
is speculated that informationally redundant testing occurs in various
diagnostic settings and diagnostic workups. It is much more frequent
than the more traditionally defined and narrowly framed notion of
redundant testing, which most often includes unintended duplications of
the same or similar tests. Under this narrow definition, redundant
laboratory testing is estimated to waste more than \$5 billion annually
in the United States, potentially dwarfed by the waste from
informationally redundant testing [@luo2016]. However, since Free T4 and
all other tests used in this study are performed on automated
instruments, the cost savings to the lab and patient may be minimal.