Missed Hypothyroidism Diagnosis Uncovered by Linking Laboratory and Pharmacy Data

Results:During the 2-year period, 982 (2.7%) of 36760 unique patients tested for TSH level had elevated TSH levels. Of these patients, 177 (18.0%) had no recorded levothyroxineprescriptions.Weattemptedtocontact177 patients with high TSH levels who were not taking thyroid medications and reached 123 (69.5%). Of the 123 patientswewereabletoreach,12in2000and11in2001 were unaware of their abnormal test results or a diagnosis of hypothyroidism, representing 2.3% of 982 patients with elevated TSH levels. We were unable to reach another 54 patients (5.5% of the total number of patients with elevated TSH levels) by either telephone or mail.