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    Change in Practice over Four Decades in the Management of Graves' Disease in Scotland. 
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    Change in Practice over Four Decades in the Management of Graves' Disease in Scotland.

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    Submitted version (289.9Kb)
    Volume
    2016
    Pagination
    9697849 - ?
    DOI
    10.1155/2016/9697849
    Journal
    J Thyroid Res
    ISSN
    2090-8067
    Metadata
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    Abstract
    There is continuing debate on the optimal treatment for Grave's thyrotoxicosis with a resultant variation in clinical practice. The present study aimed to ascertain changes in practice in the treatment of Grave's thyrotoxicosis in Tayside, Scotland, over the past four decades. Methods. The "Scottish automated follow-up register" (SAFUR) was queried to identify all patients treated for Grave's thyrotoxicosis from 1968 to 2007 inclusive. Patients were divided into 4 groups (Groups A to D) according to the decades. Demographic profile, treatment modalities, radioactive iodine (RAI) dose, and recurrence rates were studied and outcomes were compared by χ (2) test and ANOVA using SPSS v15.0. A p value of < 0.05 was considered significant. Results. Altogether, 3737 patients were diagnosed with Grave's thyrotoxicosis over the 4 decades. Use of RAI has increased from 43.1% in Group A to 68% in Group D (p < 0.001). The dose of RAI has increased (p < 0.001) and there has been a reduction in recurrence rate with higher dose of RAI. Surgical intervention rates decreased from 55.3% to 12.3% (p < 0.001) over time. Conclusions. Analysis of a large dataset of patients with Grave's thyrotoxicosis suggests increasing use of RAI as the preferred first line of treatment. Furthermore, using a single higher dose of RAI and adoption of total thyroidectomy have decreased recurrence rates.
    Authors
    Smith, DM; Dutta, S; Ahmed, F; Thaha, MA
    URI
    http://qmro.qmul.ac.uk/xmlui/handle/123456789/12470
    Collections
    • Centre for Neuroscience, Surgery and Trauma [961]
    Language
    eng
    Licence information
    CC-BY-NC-ND
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