IMPE Abstracts

Background: Thyroid function tests are the most performed endocrine test indicated in various disorders. Appropriate assessment is essential for the timely diagnosis and management of these disorders. Lack of access to specialist pediatric endocrine care makes interpretation of thyroid function tests in resource-poor settings. There is a need for developing a point-of-care tool for guidance on thyroid function interpretation.

Aim: To develop and validate Thyroid Interpreter, a point of care tool for the interpretation of thyroid functions.

Methods: The Thyroid interpreter interprets thyroid functions following input of key parameters (age, total or Free T4, and TSH), providing guidance for further evaluation and management. The guidance provided by the Thyroid interpreter was validated against the expert management in children and adolescents presenting to the Pediatric Endocrine Clinic of our hospital from January 2020-November 2022.

Results: The Thyroid interpreter was validated in 233 children and adolescents. Thyroid disorders included acquired hypothyroidism (n=116), subclinical hypothyroidism (n=49), congenital hypothyroidism (n=49), thyrotoxicosis (n=12), and central hypothyroidism (n=7). 27 subjects with incomplete data were excluded from the study. Thyroid interpreter was concordant with expert opinion diagnosis in 199 (96.6%) cases with discordance in seven subjects (diagnosis of central hypothyroidism in two with primary hypothyroidism, primary hypothyroidism in two with subclinical hypothyroidism, and normal neonatal screening in three due to delayed TSH rise).

Conclusion: Our Thyroid interpreter has high accuracy in guiding the management of pediatric thyroid disorders while limiting the extent of exhaustive workup.