Table 2.

Reasons for Definition as True Positive or False Positive

Reasons	n (%)
True-positive records (n = 163)
No documentation that addressed abnormal TSH (no recognition)	126 (77.3%)
No appropriate action taken (TSH acknowledged, but no action mentioned)	33 (20.2%)
Confusion regarding who should address the test (provider ordering the test vs. PCP)	2 (1.2%)
Provider documented that hypothyroidism was controlled despite abnormal TSH	2 (1.2%)
False-positive records (n = 108)
Patient failed to take medications as instructed, physician discussed appropriate dosing	58 (53.7%)
Dose increase documented only in free text	21 (19.4%)
Repeat TSH testing ordered with deliberate plan to test after 60 days	7 (6.5%)
Patient followed up with another external provider	6 (5.6%)
Referral made to endocrinology	5 (4.6%)
TSH found trending downward on consecutive testing and later retesting planned	5 (4.6%)
Elevated TSH caused by Thyrogen testing	3 (2.8%)
Inability to reach patient for follow-up despite multiple attempts	3 (2.8%)

PCP primary care provider, TSH thyroid-stimulating hormone