A 2011 survey of clinical practice patterns in the management of Graves' disease.
A 2011 survey of clinical practice patterns in the management of Graves' disease.
- 2012
Available online from MWHC library: 1997 - present, Available in print through MWHC library: 1999 - 2006
CONCLUSIONS: Striking changes have occurred in the management of GD over the past two decades, with a shift away from RAI and toward ATDs in patients with uncomplicated GD. Apparent international differences persist but should be interpreted with caution. Current practices diverge in some areas from recently published guidelines; these differences should be assessed serially to determine the impact of the guidelines on future clinical practice. CONTEXT: More than two decades have passed since members from the American Thyroid Association (ATA), European Thyroid Association, and Japan Thyroid Association were surveyed on management practices for patients with hyperthyroidism due to Graves' disease (GD). METHODS: Members of The Endocrine Society (TES), ATA, and AACE were invited to participate in a web-based survey dealing with testing, treatment preference, and modulating factors in patients with GD. OBJECTIVE: We sought to document current practices in the management of GD and compare these results both to those documented in earlier surveys and to practice recommendations made in the 2011 ATA/American Association of Clinical Endocrinologists (AACE) hyperthyroidism practice guidelines. Lastly, we sought to examine differences in GD management among international members of U.S.-based endocrine societies. RESULTS: A total of 730 respondents participated in the survey, 696 of whom completed all sections. Respondents included 641 TES members, 330 AACE members, and 157 ATA members. The preferred mode of therapy in uncomplicated GD was antithyroid drugs (ATDs) by 53.9% of respondents, radioactive iodine (RAI) therapy by 45.0%, and thyroid surgery in 0.7%. Compared with 1991, fewer U.S. (59.7 vs. 69%) and European (13.3% vs. 25%) respondents would use RAI therapy. Methimazole and carbimazole were the preferred ATDs, with only 2.7% of respondents selecting propylthiouracil. Patients with Graves' ophthalmopathy were treated with ATDs (62.9%) or surgery (18.5%) and less frequently with RAI plus corticosteroids (16.9%) or RAI alone (1.9%).
English
0021-972X
*Graves Disease/th [Therapy]
*Professional Practice/sn [Statistics & Numerical Data]
Adult
Data Collection
Endocrinology/lj [Legislation & Jurisprudence]
Endocrinology/ma [Manpower]
Endocrinology/og [Organization & Administration]
Female
Geography
Graves Disease/ep [Epidemiology]
Guideline Adherence/sn [Statistics & Numerical Data]
Humans
Internet
Practice Guidelines as Topic
Questionnaires
Societies, Medical/lj [Legislation & Jurisprudence]
Societies, Medical/sn [Statistics & Numerical Data]
United States/ep [Epidemiology]
World Health/sn [Statistics & Numerical Data]
MedStar Washington Hospital Center
Medicine/Endocrinology
Evaluation Studies
Journal Article
Available online from MWHC library: 1997 - present, Available in print through MWHC library: 1999 - 2006
CONCLUSIONS: Striking changes have occurred in the management of GD over the past two decades, with a shift away from RAI and toward ATDs in patients with uncomplicated GD. Apparent international differences persist but should be interpreted with caution. Current practices diverge in some areas from recently published guidelines; these differences should be assessed serially to determine the impact of the guidelines on future clinical practice. CONTEXT: More than two decades have passed since members from the American Thyroid Association (ATA), European Thyroid Association, and Japan Thyroid Association were surveyed on management practices for patients with hyperthyroidism due to Graves' disease (GD). METHODS: Members of The Endocrine Society (TES), ATA, and AACE were invited to participate in a web-based survey dealing with testing, treatment preference, and modulating factors in patients with GD. OBJECTIVE: We sought to document current practices in the management of GD and compare these results both to those documented in earlier surveys and to practice recommendations made in the 2011 ATA/American Association of Clinical Endocrinologists (AACE) hyperthyroidism practice guidelines. Lastly, we sought to examine differences in GD management among international members of U.S.-based endocrine societies. RESULTS: A total of 730 respondents participated in the survey, 696 of whom completed all sections. Respondents included 641 TES members, 330 AACE members, and 157 ATA members. The preferred mode of therapy in uncomplicated GD was antithyroid drugs (ATDs) by 53.9% of respondents, radioactive iodine (RAI) therapy by 45.0%, and thyroid surgery in 0.7%. Compared with 1991, fewer U.S. (59.7 vs. 69%) and European (13.3% vs. 25%) respondents would use RAI therapy. Methimazole and carbimazole were the preferred ATDs, with only 2.7% of respondents selecting propylthiouracil. Patients with Graves' ophthalmopathy were treated with ATDs (62.9%) or surgery (18.5%) and less frequently with RAI plus corticosteroids (16.9%) or RAI alone (1.9%).
English
0021-972X
*Graves Disease/th [Therapy]
*Professional Practice/sn [Statistics & Numerical Data]
Adult
Data Collection
Endocrinology/lj [Legislation & Jurisprudence]
Endocrinology/ma [Manpower]
Endocrinology/og [Organization & Administration]
Female
Geography
Graves Disease/ep [Epidemiology]
Guideline Adherence/sn [Statistics & Numerical Data]
Humans
Internet
Practice Guidelines as Topic
Questionnaires
Societies, Medical/lj [Legislation & Jurisprudence]
Societies, Medical/sn [Statistics & Numerical Data]
United States/ep [Epidemiology]
World Health/sn [Statistics & Numerical Data]
MedStar Washington Hospital Center
Medicine/Endocrinology
Evaluation Studies
Journal Article