Identification and management of thyroid dysfunction using at-home sample collection and telehealth services

Abstract

Introduction: Programs aimed at modernizing thyroid care by pairing at-home sample collection methods with telehealth options may serve an important and emerging role in thyroid care. The primary objective of this analysis was to evaluate telehealth utilization, demographics, and clinical characteristics of a cohort of consumer initiated at-home lab thyroid test users who were also offered the option of follow-up telehealth consultations. Methods: This was a retrospective analysis of real-world data from a de-identified consumer database of home-collected, mail-in Thyroid Tests utilized from March to May 2021 (n=8,152). The mean age was 38.6 (range 18-85) years and 86.6% of individuals identified as female. Results: Seven percent of test takers fell into a thyroid dysfunction category (0.9% overt-hypothyroidism, 2.9% subclinical hypothyroidism, 0.1% overt-hypothyroidism, and 3.3% subclinical-hyperthyroidism). Twelve percent of the overall sample opted into a telehealth consultation, with 91.8% receiving a non-treatment telehealth consultation and 8.2% receiving a treatment telemedicine consultation. Sixteen percent of individuals with overt or subclinical thyroid dysfunction engaged in telehealth consultations. Of those opting into a treatment consultation, 59.3% reported a history of thyroid issues, 55.6% indicated wanting to discuss their current thyroid medication, and 48% received a prescription medication. Discussion: The combination of at-home sample collection and telehealth is an innovative model for screening for thyroid disorders, monitoring thyroid function, and increasing access to care that can be implemented at a large scale and across a wide range of age groups.

Diagnostic criteria and scoring systems for thyroid storm: An evaluation of their utility – comparative review

“…The challenge arises when scoring systems designed for a younger demographic encounter elderly patients who deviate from the expected clinical profile. [18] Laboratory variability, influenced by variations in reference ranges, casts a shadow over the diagnostic process. Inconsistent results in interpreting thyroid function tests, a cornerstone of scoring systems, may emerge due to these variations.…”

“…Controversies and debates within the medical community surround the utility of diagnostic criteria and scoring systems for thyroid storm, touching upon several critical points of contention. [17,18] Sensitivity versus specificity is an ongoing debate, with arguments about the potential trade-off. Some contend that stricter criteria with higher specificity might miss milder cases, while more sensitive criteria could lead to overdiagnosis and unnecessary treatment.…”

“…The challenge arises when scoring systems designed for a younger demographic encounter elderly patients who deviate from the expected clinical profile. [18]…”

“…[5] Point-of-care testing devices for thyroid hormones and relevant biomarkers are developing, offering rapid diagnostic capabilities in emergency settings where timely intervention is paramount. [18] Patient monitoring apps and wearable devices enable remote tracking of vital signs and symptoms. These technologies can potentially monitor individuals at risk for thyroid storm, facilitating early intervention.…”

Identification and Management of Thyroid Dysfunction Using At-Home Sample Collection and Telehealth Services: Retrospective Analysis of Real-World Data

“…The authors of this work are full-time employees of Everly Health, Inc. Portions of the data included in this manuscript were presented at the 90th Annual Meeting of the American Thyroid Association, September 30 to October 3, 2021. This paper has been published as a preprint [ 37 ].…”