Treatment choice, satisfaction and quality of life in patients with Graves’ disease

Conaglen, Helen M.; Tamatea, Jade; Conaglen, John V.; Elston, Marianne S.

doi:10.1111/cen.13611

Cited by 23 publications

(26 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In another survey-based study, 23% who were treated with surgery mentioned 'radioactive nature of the treatment' as one of the reasons for not choosing RAI. This was corroborated in a study in which 'preference to avoid RAI' was the most commonly reported reason for choosing surgery (34). In patients treated with RAI, the pre-treatment concerns significantly decreased after treatment, suggesting the absence of long-term concerns (32,41).…”

Section: Discussionmentioning

confidence: 62%

See 1 more Smart Citation

Preferences of patients and clinicians for treatment of Graves’ disease: a discrete choice experiment

Kinschot

Soekhai

Bekker‐Grob

et al. 2021

European Journal of Endocrinology

View full text Add to dashboard Cite

Objective: Treatment options for Graves’ disease (GD) consist of antithyroid drugs (ATD), radioactive iodine (RAI) and total thyroidectomy (TT). Guidelines recommend to discuss these options with patients, taking into account patients’ preferences. This study aims to evaluate and compare patients’ and clinicians’ preferences and the trade-offs made in choosing treatment. Design and methods: A discrete choice experiment (DCE) was performed with GD patients with a first diagnosis or recurrence in the previous year, and with clinicians. Participants were offered hypothetical treatment options which differed in type of treatment, rates of remission, severe side effects, permanent voice changes and hypocalcemia. Preference heterogeneity was assessed by latent-class analysis. Results: 286 (82%) patients and 61 (18%) clinicians participated in the DCE. All treatment characteristics had a significant effect on treatment choice (p<0.05). Remission rate was the most important determinant and explained 37% and 35% of choices in patients and clinicians, respectively. Both patients and clinicians preferred ATD over surgery and RAI. A strong negative preference towards RAI treatment was observed in a subclass of patients, whereas clinicians preferred RAI over surgery. Conclusion: In both patients and clinicians, remission rate was the most important determinant of treatment choice and ATD was the most preferred treatment option. Patients had a negative preference towards RAI compared to alternatives, whereas clinicians preferred RAI over surgery. Clinicians should be aware that their personal attitude towards RAI differs from their patients. This study on patients’ and clinicians’ preferences can support shared decision making and thereby improve clinical treatment.

show abstract

Section: Discussionmentioning

confidence: 62%

“…Insufficient data is available on the treatment preferences of patients with GD. Previous studies have focused on surgery versus RAI treatment or used non-validated instruments (32,33,34). The concordance of preferences between both patients and clinicians has never been studied.…”

Section: Introductionmentioning

confidence: 99%

Preferences of patients and clinicians for treatment of Graves’ disease: a discrete choice experiment

Kinschot

Soekhai

Bekker‐Grob

et al. 2021

European Journal of Endocrinology

View full text Add to dashboard Cite

show abstract

“…This is in contrast to some adult studies which have demonstrated that patients who have had a thyroidectomy for Graves’ disease report an improvement in QoL compared with those on prolonged ATD, 28,29 and a recent study which reported that RI‐treated adults had worse thyroid‐related and general QoL than those treated with ATD or thyroidectomy 11 . However, other adult studies have shown equal satisfaction and QoL improvement with all treatment modalities 13,30 …”

Section: Discussionmentioning

confidence: 79%

“…11 However, other adult studies have shown equal satisfaction and QoL improvement with all treatment modalities. 13,30 In our cohort of young people, around half said that they did not feel fully recovered from Graves' disease despite at least a year of treatment, including half of those whom had already received definitive treatment. This compares to a figure of around 25% in the adult population who did not feel fully recovered 6-10 years following treatment for Graves' disease.…”

Section: Discussionmentioning

confidence: 97%

A survey of the young person’s experience of Graves’ disease and its management

Lane

Rankin

Cheetham

2020

Clinical Endocrinology

View full text Add to dashboard Cite

ObjectiveA suboptimal quality of life (QoL) has been reported in patients with Graves’ disease treated in adult life, but long‐term QoL in those treated in childhood and adolescence is unclear. We wanted to understand how Graves’ disease and its management impact on the physical, psychological and social well‐being of young people and their longer‐term QoL.Design, patients and measurementsTwo questionnaires were used to assess QoL and patient experience of Graves’ disease; PedsQL™ Generic Core Scales and a Graves’ disease questionnaire devised for this project. The anonymized questionnaires were sent to young people (<30 years) diagnosed with Graves’ disease in childhood and adolescence and managed at a tertiary paediatric endocrine unit in the North of England. Respondent QoL scores were compared with a healthy UK cohort.ResultsQuestionnaires were sent to 51 young people, and 26 responded (51%). Graves’ patients reported a lower total QoL score compared with the healthy cohort (p = .003). This was particularly apparent in the psychosocial domain (p = .0016). No patient regretted having definitive treatment (surgery/radioiodine), and all said they would recommend it to others. Half of those who had received definitive treatment still did not feel recovered. There was no difference in the long‐term QoL in those who did/did not receive definitive treatment (p = .40).ConclusionsThis study highlights short‐ and long‐term impacts on the QoL and general well‐being of young people with Graves’ disease. There were no regrets regarding the choice of definitive treatment. This information will help inform the counselling of patients and their families.

show abstract

“…Thyrotoxicosis, most often caused by GD, potentially caused severe symptoms and is associated with premature mortality, primarily related to cardiovascular events. 11 Due to its progressiveness, early detection of the disease is vital to identify affected individuals and to prevent or reduce the risk of having a severe case of GD. Therefore, the development of rapid and cost‐effective methods for screening and monitoring GD progression is indispensable.…”

Section: Discussionmentioning

confidence: 99%

Comparative performance of ELISA and dot blot assay for TSH‐receptor antibody detection in Graves’ disease

Zulkarnain

Ulhaq

Sujuti

et al. 2022

Clinical Laboratory Analysis

View full text Add to dashboard Cite

Background Graves’ disease (GD) is an autoimmune disease, and it accounts for major cases of hyperthyroidism. Antibody against thyroid‐stimulating hormone receptor/TSHR (TRAb) is responsible for hyperthyroidism and is considered as a diagnostic marker for GD. Therefore, we developed a recombinant protein of human TSHR‐169 (hTSHR‐169), which was specifically recognized TRAb in the serum of GD patients and then compare the diagnostic performance between ELISA and dot blot of TRAb tests for their ability to diagnose GD. Methods 20 GD patients and 20 healthy individuals from the Indonesian population were enrolled. TRAb concentration and density were quantified. Comparative analysis was performed using receiver‐operating curve (ROC) analysis. Results For dot blot assay, the minimum concentration to detect TRAb requiring 100 ng of antigen with antiserum diluted at 1:60. For diagnosing GD, the ELISA yielded a higher AUC compared with the dot blot assay (0.95 and 0.85, respectively). Using the recommended cutoff values, the efficiency of both assays was examined by comparing the specificity and sensitivity of the assays to the clinical diagnosis. The ELISA showed 80% and 95%, while the dot blot assay showed 70% and 95% sensitivity and specificity, respectively. Conclusion Although the dot blot assay exhibited lower performance than the ELISA method, the dot blot assay is a simple and rapid diagnostic assay that is suitable for diagnosing GD in rural areas, in which healthcare facilities sometimes are not accessible.

show abstract

Treatment choice, satisfaction and quality of life in patients with Graves’ disease

Abstract: Patient satisfaction with therapy and QoL does not differ by treatment type. Therefore, clinical and social factors, in combination with patient choice and resource availability, should determine which treatment modality patients with Graves' disease should receive.

Cited by 23 publications

References 33 publications

Preferences of patients and clinicians for treatment of Graves’ disease: a discrete choice experiment

Preferences of patients and clinicians for treatment of Graves’ disease: a discrete choice experiment

A survey of the young person’s experience of Graves’ disease and its management

Comparative performance of ELISA and dot blot assay for TSH‐receptor antibody detection in Graves’ disease

Contact Info

Product

Resources

About