Improved expert system may lead to more clinical laboratory testing for patients with subclinical thyroid disease

It’s long been predicted that use of computer algorithms to sift through clinical data sets can be one way to detect disease. This is a diagnostic method that—in theory—could either increase or decrease the need to perform medical laboratory tests for certain types of diseases.

A paper recently published by researchers in India describes an improved algorithm to detect thyroid disease by computer screening. The advancement could lead to earlier detection of subclinical thyroid problems and allow for earlier diagnosis and intervention.

Detecting Disease with Computer Algorithm and Electronic Health Records

Jaganathan Palanichamy and Rajkumar Nallamuthu of the PSNA College of Engineering and Technology in Tamilnadu, India, showed that the classification of a raw dataset from patient records can allow the detection of undiagnosed thyroid problems through computerized screening. They described the results of the study in a paper published by the International Journal of Computational Science and Engineering.

“The [PSNA] screening algorithm… boosts the accuracy of earlier approaches, bringing the level [of accuracy] to almost 93.5%, as opposed to earlier tests that had 92% confidence or less,” wrote the co-authors in an announcement of the study.

Researchers at the PSNA College of Engineering and Technology in Tamilnadu, India, have developed an improved computerized expert system for the diagnosis of thyroid disease. Using an algorithm they developed and a raw dataset from patient records, they showed that computerized screening can allow detection of undiagnosed thyroid problems. Because thyroid disease is linked to other serious diseases, use of such an algorithm to screen electronic health records and identify undiagnosed diseases could contribute to an increase in more appropriate utilization of clinical laboratory testing. (Photo copyright iStockphoto.com.)

Palanichamy and Nallamuthu also pointed out that doctors could use the computer screening approach in clinical settings. This would allow them to assess patients that present with a range of symptoms. They could then more precisely determine whether a thyroid test and subsequent pharmaceutical intervention is required.

Earlier Detection and Treatment of Subclinical Thyroid Disease

Thyroid disease is a common health problem worldwide, the announcement stated. In the United States, about 20 million people currently have some form of thyroid disease, according to American Thyroid Association (ATA) statistics. Up to 60% of those—or 12 million people—are unaware of their condition. The ATA projects that over 12% of the U.S. population will develop a thyroid condition during their lifetime.

Traditional approaches to the diagnosis and management of thyroid disorders are based on multiple factors that include clinical presentation and accurate interpretations of appropriate clinical laboratory tests. However, the value of clinical diagnosis in thyroid dysfunction is limited, according to a paper titled “Laboratory Evaluation of Thyroid Function,” published in the Journal of the Association of Physicians of India (JAPI). This is because thyroid disorders have diverse clinical manifestations, the authors wrote.

Additionally, thyroid disease is often asymptomatic and is commonly undiagnosed, Palanichamy and Nallamuthu noted. According to ATA, when undiagnosed, thyroid disease may put patients at risk for certain serious conditions. These include cardiovascular diseases, osteoporosis, and infertility.

Increased Clinical Laboratory Testing for Thyroid Disease

The results of the PSNA study mean that, of the 1,000 screened datasets, 15 additional patients would avoid false positive or false negative results, the PSNA announcement stated. That number becomes significant from the perspective of datasets that cover millions of patients.

An increase in the detection of subclinical cases of thyroid disease through computer screening could mean more patients will require thyroid-specific clinical laboratory testing. “Thyroid disorders have diverse clinical manifestations,” wrote Shashank R. Joshi, M.D., in a supplement to the JAPI. “Thyroid disorders have diverse clinical manifestations, therefore… every suspected case of thyroid disease needs to be evaluated with laboratory investigations. Thereby appropriate treatment for thyroid disorders can be instituted or conservative monitoring carried out to anticipate potential future consequences.” Dr. Joshi is Consulting Endocrinologist at Lilavati Hospital in Mumbai, India.

Additionally, other factors may also drive the need for increased medical laboratory testing for thyroid disease. One is an aging population because the risk of thyroid disease increases with age.

Further, according to a story published by The New York Times, researchers are investigating a possible link between subclinical thyroid problems and some patient psychiatric difficulties, including depression and anxiety.

Even in an expanding environment of computer aided diagnostics, medical laboratory test data will continue to be essential. However, pathologists and clinical laboratory managers will note that an approach that uses the patient health record as the source material for accurate diagnosis is both progressive and innovative—as well as non-traditional.

—Pamela Scherer McLeod

Related Information:

An expert system for optimizing thyroid disease diagnosis

Thyroid Condition Linked to Heart Problems: Risk was especially elevated for atrial fibrillation

Laboratory Evaluation of Thyroid Function

For Some, Psychiatric Trouble May Start in Thyroid

Improved algorithm detects thyroid disease